Magnetic resonance with gadolinium (MRGd): a new method of testing the efficiency of isotopic synoviorthesis (IS)

The objective of this work was the response of the synovial membrane after isotopic synoviorthesis. The work presents a study conducted on 22 patients afflicted with knee arthritis, refractory to conventional treatments. The IS is achieved by means of colloidal citrate of 90Y (YMM-1, CIS) using an average dose of 185 MBq. The patients' follow-up was of 6 months. The clinical parameters (pain, flow and articular mobility) as well as the cellularity of the synovial liquid (SL) and the MRGd were measured before the IS as well as after 1,3 and 6 months. The following results were obtained: in 10 cases (45.4%), the total or partial clinical remission was the rule. In 7 patients (31.8%) the IS has produced an amelioration of certain parameters while in the remaining 5 cases (22.7%) no response was made evident. A significant amelioration of pain (p = 0.0192) as well as of the flow (p = 0.0289) and of the cellularity of as well (p = 0.0181) were obtained. The MRGd has shown a progressive diminution of the synovial membrane thickness (2.4 mm before IS vs 1.2 mm 6 months after, hence p 0.0005) and also, of the SL volume (p 0.0449). In conclusion, this study has demonstrated the possibility of using the MRGd to test the effect of IS and made evident a reduction in the synovial thickness as well as in the flow, as an index of IS efficiency