Limits...
MR evaluation of radiation synovectomy of the knee by means of intra-articular injection of holmium-166-chitosan complex in patients with rheumatoid arthritis: results at 4-month follow-up.

Lee SH, Suh JS, Kim HS, Lee JD, Song J, Lee SK - Korean J Radiol (2003 Jul-Sep)

Bottom Line: MR evaluation included measurement of the volume of synovial enhancement and wall thickness, the amount of joint effusion, and quantifiable scoring of bone erosion, bone edema and lymph nodes.MRI showed that joint effusion decreased significantly (p < 0.05), and that the volume of synovial enhancement tended to decrease, but to an insignificant extent (p = 0.107).The decreased joint effusion noted at 4-month follow-up resulted from radiation synovectomy of the rheumatoid knee by means of intra-articular injection of holmium-166-chitosan complex.

View Article: PubMed Central - PubMed

Affiliation: Department of Diagnostic Radiology, Yonsei University College of Medicine, Seoul, Korea. jss@yumc.yonsei.ac.kr

ABSTRACT

Objective: To determine whether MRI is able to demonstrate the effect of radiation synovectomy after the intra-articular injection of holmium-166-chitosan complex for the treatment of rheumatoid arthritis of the knee.

Materials and methods: Fourteen patients aged 36-59 years were treated with 10-20 mCi of holmium-166-chitosan complex. A criterion for inclusion in this study was the absence of observable improvement after 3- or more months of treatment of the knee with disease-modifying anti-rheumatic drugs. MR images were acquired both prior to and 4-months after treatment. Clinical evaluation included the use of visual analog scales to assess pain, and the circumference of the knee and its range of motion were also determined. MR evaluation included measurement of the volume of synovial enhancement and wall thickness, the amount of joint effusion, and quantifiable scoring of bone erosion, bone edema and lymph nodes.

Results: Visual analog scale readings decreased significantly after radiation synovectomy (p < 0.05). MRI showed that joint effusion decreased significantly (p < 0.05), and that the volume of synovial enhancement tended to decrease, but to an insignificant extent (p = 0.107).

Conclusion: The decreased joint effusion noted at 4-month follow-up resulted from radiation synovectomy of the rheumatoid knee by means of intra-articular injection of holmium-166-chitosan complex.

Show MeSH

Related in: MedlinePlus

MR images of a 54-year-old woman with rheumatoid arthritis of the knee.A. Postcontrast, fat-suppressed, three-dimensional spoiled gradient-echo sagittal image (TR/TE = 21.1/2.2, flip angle=15°) obtained before the intra-articular injection of 166Ho-chitosan complex depicts lymph nodes in the popliteal region (arrows).B. MR image obtained 4-months after treatment shows that the size and number of the lymph nodes are unchanged (arrows).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2698084&req=5

Figure 3: MR images of a 54-year-old woman with rheumatoid arthritis of the knee.A. Postcontrast, fat-suppressed, three-dimensional spoiled gradient-echo sagittal image (TR/TE = 21.1/2.2, flip angle=15°) obtained before the intra-articular injection of 166Ho-chitosan complex depicts lymph nodes in the popliteal region (arrows).B. MR image obtained 4-months after treatment shows that the size and number of the lymph nodes are unchanged (arrows).

Mentions: Between pre- and post-radiation synovectomy, a significant decrease in the visual analog scale was noted [20.1±20.7 (range, -21 to 44)] (p < 0.05). Knee circumference decreased by 0.8 (range, -1.5 to 4.0) cm (p = 0.054), but the range of motion of the knee joint was unchanged (p > 0.1). In nine of the 14 patients, synovial enhancement was reduced (Fig. 1), and in five it had increased (Fig. 3), but the difference was not statistically significant (Table 2, p = 0.107). Joint effusion decreased by 8.8±12.3 ml (p < 0.05), but bony erosion, marrow edema and lymph nodes showed no change (p > 0.1). Correlation between changes in visual analog scale values and in MRI scores was not significant (p > 0.01), but there was significant correlation between the former and changes in knee circumference (p < 0.05). Among MRI scores, changes in synovial volume showed positive correlation with changes in synovial thickness (p < 0.05) and the amount of effusion (p < 0.01).


MR evaluation of radiation synovectomy of the knee by means of intra-articular injection of holmium-166-chitosan complex in patients with rheumatoid arthritis: results at 4-month follow-up.

Lee SH, Suh JS, Kim HS, Lee JD, Song J, Lee SK - Korean J Radiol (2003 Jul-Sep)

MR images of a 54-year-old woman with rheumatoid arthritis of the knee.A. Postcontrast, fat-suppressed, three-dimensional spoiled gradient-echo sagittal image (TR/TE = 21.1/2.2, flip angle=15°) obtained before the intra-articular injection of 166Ho-chitosan complex depicts lymph nodes in the popliteal region (arrows).B. MR image obtained 4-months after treatment shows that the size and number of the lymph nodes are unchanged (arrows).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2698084&req=5

Figure 3: MR images of a 54-year-old woman with rheumatoid arthritis of the knee.A. Postcontrast, fat-suppressed, three-dimensional spoiled gradient-echo sagittal image (TR/TE = 21.1/2.2, flip angle=15°) obtained before the intra-articular injection of 166Ho-chitosan complex depicts lymph nodes in the popliteal region (arrows).B. MR image obtained 4-months after treatment shows that the size and number of the lymph nodes are unchanged (arrows).
Mentions: Between pre- and post-radiation synovectomy, a significant decrease in the visual analog scale was noted [20.1±20.7 (range, -21 to 44)] (p < 0.05). Knee circumference decreased by 0.8 (range, -1.5 to 4.0) cm (p = 0.054), but the range of motion of the knee joint was unchanged (p > 0.1). In nine of the 14 patients, synovial enhancement was reduced (Fig. 1), and in five it had increased (Fig. 3), but the difference was not statistically significant (Table 2, p = 0.107). Joint effusion decreased by 8.8±12.3 ml (p < 0.05), but bony erosion, marrow edema and lymph nodes showed no change (p > 0.1). Correlation between changes in visual analog scale values and in MRI scores was not significant (p > 0.01), but there was significant correlation between the former and changes in knee circumference (p < 0.05). Among MRI scores, changes in synovial volume showed positive correlation with changes in synovial thickness (p < 0.05) and the amount of effusion (p < 0.01).

Bottom Line: MR evaluation included measurement of the volume of synovial enhancement and wall thickness, the amount of joint effusion, and quantifiable scoring of bone erosion, bone edema and lymph nodes.MRI showed that joint effusion decreased significantly (p < 0.05), and that the volume of synovial enhancement tended to decrease, but to an insignificant extent (p = 0.107).The decreased joint effusion noted at 4-month follow-up resulted from radiation synovectomy of the rheumatoid knee by means of intra-articular injection of holmium-166-chitosan complex.

View Article: PubMed Central - PubMed

Affiliation: Department of Diagnostic Radiology, Yonsei University College of Medicine, Seoul, Korea. jss@yumc.yonsei.ac.kr

ABSTRACT

Objective: To determine whether MRI is able to demonstrate the effect of radiation synovectomy after the intra-articular injection of holmium-166-chitosan complex for the treatment of rheumatoid arthritis of the knee.

Materials and methods: Fourteen patients aged 36-59 years were treated with 10-20 mCi of holmium-166-chitosan complex. A criterion for inclusion in this study was the absence of observable improvement after 3- or more months of treatment of the knee with disease-modifying anti-rheumatic drugs. MR images were acquired both prior to and 4-months after treatment. Clinical evaluation included the use of visual analog scales to assess pain, and the circumference of the knee and its range of motion were also determined. MR evaluation included measurement of the volume of synovial enhancement and wall thickness, the amount of joint effusion, and quantifiable scoring of bone erosion, bone edema and lymph nodes.

Results: Visual analog scale readings decreased significantly after radiation synovectomy (p < 0.05). MRI showed that joint effusion decreased significantly (p < 0.05), and that the volume of synovial enhancement tended to decrease, but to an insignificant extent (p = 0.107).

Conclusion: The decreased joint effusion noted at 4-month follow-up resulted from radiation synovectomy of the rheumatoid knee by means of intra-articular injection of holmium-166-chitosan complex.

Show MeSH
Related in: MedlinePlus