Indication: Persistent Synovitis

A dedicated EANM guideline for radionuclide therapy  for radiosynovectomy has been published [1]. 

[¹⁶⁹Er]-Erbium-citrate, [¹⁸⁶Re]Rhenium-sulphide, or [⁹⁰Y] Yttrium- citrate are indicated for the treatment of joint pain arising from arthropathies including:

• Rheumatoid arthritis;

• Spondylarthropathy (e.g. reactive or psoriatic arthritis);

• Other inflammatory joint diseases, e.g. Lyme disease, Behcet’s disease;

• Persistent synovial effusion;

• Haemophilic arthritis;

• Calcium pyrophosphate dihydrate (CPPD) arthritis;

• Pigmented villonodular synovitis (PVNS);

• Persistent effusion after joint prosthesis;

• Undifferentiated arthritis (where the arthritis is characterized by synovitis, synovial thickening or effusion).

Depending on the joint, [¹⁶⁹Er]Erbium-citrate (meta-carpophalangeal, proximal interphalangeal, or meta-tarsophalangeal), [¹⁸⁶Re]Rhenium-sulphide (shoulder, elbow, wrist, hip, or ankle), or [⁹⁰Y]Yttrium-citrate (knee) is used.

National rules concerning the different approvals of all radionuclides used for radiosynoviorthesis must be strictly considered.