REVIEW  LOCAL TREATMENT OF SYNOVITIS 

The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2022 December;66(4):334-44

DOI: 10.23736/S1824-4785.22.03474-4

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

The value of radiosynoviorthesis for treatment of chronic synovitis in hemophilic joint disease

Silvia HORNEFF ¹ ✉, Barbara BODDENBERG-PÄTZOLD ²

¹ Institute for Experimental Hematology and Transfusional Medicine, Clinical University of Bonn, Bonn, Germany; ² Praxis Nuramed Köln-West, Köln, Germany

Chronic synovitis is contributing to the development of arthropathy in hemophilia A and B. In most patients with severe and moderate hemophilia, during lifetime, joint damage progresses despite early prophylaxis and intense treatment with coagulation factor concentrates. Recurrent hemorrhages into the joints and subclinical bleeding lead to chronic inflammation of the synovium, neoangiogenesis and remodeling, sustaining a vicious circle of bleeding-remodeling-bleeding and progression of osteochondral damage. Imaging techniques including ultrasound and MRI are able to early visualize synovitis and osteochondral changes. Early detection and sustained therapy of synovitis are important preconditions to prevent further deterioration of joint status. Chronic synovitis requires intensified substitution of coagulation factors and concomitant analgetic, antiphlogistic and physical therapy. The value of early radiosynoviorthesis (RSO) as effective method to control ongoing synovitis is discussed here. RSO is recommended as first choice therapy in case of persistant chronic synovitis, recorded in both national and international guidelines.

KEY WORDS: Hemophilia A; Synovitis; Hemarthrosis