RSO (Paint therapy for the joints)

Radiosynovectomy (RSO) stops inflammation and damage in the joints – a nuclear medicine local therapy primarily for inflammation of the joints and activated arthrosis.

• A small ambulatory operation that does not require rehabilitation.
• Normally, one treatment per joint will last for several years.
• When needed, it can be repeated three months later.
• It also can be performed on inoperable patients.
• Very highly efficient, with a minimum risk of side effects.
• Several joints can undergo therapy simultaneously or at short intervals.
• An operation later on is still possible.
• It is an inexpensive operation, and paid for in full by health insurance.

An interdisciplinary therapy concept ...

With local treatment of chronically inflammatory diseases of the joints, radiosynovectomy (RSO) has proven over the course of many years to be a very efficient and mild form of therapy. It is administered by a specialist in nuclear medicine in close cooperation with a physician who has extensive experience in rheumatology.

Depending upon the condition of the joint, after a RSO treatment 60 – 80% of the patients experience an improvement in the symptoms relating to pain, swelling, and the mobility of the joints within 3 – 4 months. In general, the earlier RSO is administered during the course of the disease, the better the results.

Unlike intra-articular cortisone application, which is also often extremely efficient but only lasts for a short time, RSO has long-lasting, positive effects on synovitis, as well as in reducing articular effusions and pain symptoms.

When the therapy is performed properly, there are no serious side effects. The radiation exposure is comparable to an X-ray of the pelvis.

... is a convincing, successful treatment.

With RSO, the inflamed synovial membrane is exposed to radiation "from the inside." Using a fluoroscope as a guide, a precisely measured dosage of radionuclides is injected directly into the joint cavity. The radionuclides used in this procedure are pure beta radiation with an extremely short range, so their effects are limited to the interior of the joint. There is no damage to the cartilage tissue.

As the radionuclides are bound to colloids of a certain size, a homogenous irradiation of the mucous membrane is guaranteed, and also that the irradiation will remain in the joint cavity. The irradiation leads to a crust forming gradually on the mucous membrane as the swelling and excrescence of the mucous membrane decreases. At the same time, the very tiny canals from which the effusion fluids flowed into the joint are sealed and the tiny nerve endings are deactivated, which lessens the pain or eliminates it, and improves the function of the joint.

After the therapy, the joint is immobilized for about 48 hours, to prevent the radioactivity from seeping away via the lymph channels.

When individual joints still hurt despite a basic therapy ...

Some of the classic indications for RSO are chronic polyarthritis together with psoriatic arthritis, villonodulary synovitis, and other forms of rheumatoid arthritis. It is particularly true for such patients that they will always need a basic therapy, as these are systematic ailments. When the individual joints, however, are not reacting sufficiently during the six-month minimum of basic therapy, then RSO should be considered.

The RSO procedure usually consists of three sessions. During the first session, the necessary pre-examinations, e.g., a joint sonography and bone scan, are performed to check the indication and help plan the therapy, and the patient is informed about the procedure. The therapy is administered during the second session, and 4 to 6 months later the success of therapy is evaluated during an obligatory post-examination. The RSO does not replace further treatment by colleagues who specialize in rheumatology.

Activated arthrosis – is an artificial joint the last resort?

With an activated arthrosis, a synovitis with a relapsing articular effusion occurs as a reaction to the degenerative cartilage process. This secondary synovitis is a target for the RSO therapy. In particular, relapsing effusions and pain symptoms are eliminated or relieved significantly. It is suspected that RSO hinders the advancement of arthrosis by stopping detritus synovitis and the formation of effusions.

Should, however, an operation be necessary over the long term, such as an implant of an artificial joint, then RSO will not have a negative influence on this. On the contrary, putting off such an operation is one of the goals of RSO therapy, especially with younger patients.

Relapsing effusions with a painful restriction of mobility, which frequently occur after an arthroscopic remediation or an implant of a knee endoprosthesis, can be effectively treated with RSO.

We will be happy to schedule a personal consultation to provide you with information about RSO and the procedures and side effects.