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The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2022 Sep 15

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 haemophilic joint disease

Silvia HORNEFF 1 , Barbara BODDENBERG-PÄTZOLD 2

1 Institut für Experimentelle Hämatologie und Transfusionsmedizin, Universitätsklinikum Bonn (AöR), Bonn, Germany; 2 Praxis Nuramed Köln-West, Köln


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Chronic synovitis is contributing to the development of arthropathy in haemophilia A and B. In most patients with severe and moderate haemophilia, during lifetime, joint damage progresses despite early prophylaxis and intense treatment with coagulation factor concentrates. Recurrent haemorrhages into the joints and subclinical bleeding lead to chronic inflammation of the synovium, neoangiogenesis and remodeling, sustaining a vicious circle of bleeding-remodelingbleeding 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: Haemophilia; Radiosynoviorthesis; RSO; Synovitis; Joint bleeding; Chronic synovitis; Haemophilic joint disease

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