Indication: Persistent Synovitis

A dedicated EANM guideline for radionuclide therapy  for radiosynovectomy has been published [49].

[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.