Synoviorthesis or Radiosynovectomy is the medical removal of the swollen lining of the joint. A radiosynovectomy is the injection of a small amount of radioactive substance into the joint. This procedure is similar to joint aspiration, but a substance is injected rather than fluid being drawn out.

The chemical substance destroys the swollen synovial tissue, which reduces pain and swelling, and decreases the frequency of acute bleeds. The radionuclides are injected in colloidal form so that they remain in the synovium and are not transported by lymphatic vessels causing radiation exposure to other organs. Complete reduction of knee joint swelling has been seen in above 40% and pain relief in 88% of patients. Wrist, elbow, shoulder, ankle and hip joints showed significant improvement in 50-60% and restoration of normal function and long term pain relief has been achieved in about 70% of small finger joints. In hemophilic arthropathies complete cessation of bleeding in about 60% and improved mobility in 75% of patients has been reported.

A medical synovectomy is usually done as an outpatient procedure. It is much less invasive than a surgical synovectomy, and results in less loss of range of motion. There is less need for rehabilitation and after about 24 hours of moderate rest you may be able to gradually return to regular physical activity. It generally does not require hospitalization and requires less clotting factor therapy, therefore, it is less costly.

The lesser range (weaker) beta rays are used in smaller joints like Erbium-169 for finger joints. Similarly the medium range beta rays of Rhenium-186, Phosphorus-32, etc. are used for larger joints (wrist, elbow, shoulder, ankle and hip joints) while the high-energy beta rays of Yttrium-90 with tissue penetration of 3 to 11 mm are used for knee joints. In recent years several other radionuclides like Holmium-166, Rhenium-188, Samarium-153, etc. have successfully been introduced [10-18].

It is difficult to exactly determine the required dosage. The absorbed dose is not only dependent on the type of the radionuclides and the amount of activity (MBq
/ mCi) used but also on various other factors like the size of joint cavity, synovial thickness, distribution of the colloids in the joint fluid (water, gelatinous or
Hemorrhagic) and the inflammatory activity of the joints. A typical dose of 185 MBq (5mCi) of Yttrium (Yt-90) is used for knee joints. Approximately 100 Gy per 100 gm synovial tissue should be absorbed, to have optimal effect.

If done properly, no side effects have been observed. Infection of the joint is very rare (one in 35,000) in comparison to intra-articular corticosteroid injections. This is because of the intense beta radiation emitted by the high concentration of radioactive material in the joint killing all the bacteria. Temporary radiation or crystal synovitis, thrombosis due to immobilisation and lymphoedema may occur.

Here’s what Dr. Manoranjan Chouhan has to say about this treatment in his own words.

“I do Radiation synovectomy the treatment to relieve the joint pain in patients of Arthritis and this is most effective therapy for cases of joint pain. I am trained in Germany for same.”

MBBS,DRM,DNB (Nuclear Medicine)
Fellow Molecular imaging TUM, Germany
Consultant and Head, Nuclear Medicine Dept.
Ruby Hall Clinic, Pune Maharhashtra India

Some of his success stories:


Dr Manorajan Chowhan has sent you a message.

Date: 4/10/2009

Subject: Dear Abdulrehmanji

I convey my sincere thanks for your blog.I think this is nice as it gives detail information in nutshell about this treatment.You will be happy to know that today a patient flew from USA for the treatment of his arthritis.I treated the same today.
This patient also had undergone surgical synovectomy by a orthopedic surgeon but there was persistent swelling and pain so patient came to me for this treatment.
I am thankful to colleague like you who does everything to popularize this treatment.
We can surely reach maximum patients through your sincere help.
I thank you and God bless you.
with warm regard from Dr Chowhan

Views: 261

Tags: RADIOSYNOVECTOMY:, arthirithis, medicine, nuclear, orthopedic, treatments


You need to be a member of The International NanoScience Community to add comments!

Join The International NanoScience Community

Welcome - about us

Welcome! Nanopaprika was cooked up by Hungarian chemistry PhD student in 2007. The main idea was to create something more personal than the other nano networks already on the Internet. Community is open to everyone from post-doctorial researchers and professors to students everywhere.

There is only one important assumption: you have to be interested in nano!

Nanopaprika is always looking for new partners, if you have any idea, contact me at

Dr. András Paszternák, founder of Nanopaprika

Publications by A. Paszternák:

Smartphone-Based Extension of the Curcumin/Cellophane pH Sensing Method

Pd/Ni Synergestic Activity for Hydrogen Oxidation Reaction in Alkaline Conditions

The potential use of cellophane test strips for the quick determination of food colours

pH and CO2 Sensing by Curcumin-Coloured Cellophane Test Strip

Polymeric Honeycombs Decorated by Nickel Nanoparticles

Directed Deposition of Nickel Nanoparticles Using Self-Assembled Organic Template,

Organometallic deposition of ultrasmooth nanoscale Ni film,

Zigzag-shaped nickel nanowires via organometallic template-free route

Surface analytical characterization of passive iron surface modified by alkyl-phosphonic acid layers

Atomic Force Microscopy Studies of Alkyl-Phosphonate SAMs on Mica

Amorphous iron formation due to low energy heavy ion implantation in evaporated 57Fe thin films

Surface modification of passive iron by alkylphosphonic acid layers

Formation and structure of alkylphosphonic acid layers on passive iron

Structure of the nonionic surfactant triethoxy monooctylether C8E3 adsorbed at the free water surface, as seen from surface tension measurements and Monte Carlo simulations

Next partner events of TINC

We are Media Partner of: