La sinoviortesis radioisotópica en la artritis reumatoide. Estudio de 108 casosRadioisotopic synoviorthesis in rheumatoid arthritis. a study of 108 cases

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Resumen

En el tratamiento local de la artritis reumatoide (AR) existen diversas alternativas terapéuticas: los corticoides intraarticulares, la sinoviortesis química, la sinovectomía quirúrgica y la sinoviortesis con radioisótopos.

Presentamos los resultados de un estudio observacional sobre la sinoviortesis radioisotópica realizado en un área sanitaria de Valencia desde enero de 1989 hasta mayo de 1997 que incluye 108 sinoviortesis realizadas en 51 pacientes. Los objetivos del estudio fueron valorar la eficacia y la seguridad de la radiosinoviortesis en el tratamiento de la AR que no había respondido al tratamiento convencional.

Se obtuvieron resultados buenos y regulares en el 76,2% de los casos, observándose diferencias significativas en la eficacia de la sinoviortesis entre pacientes sin y con alteraciones radiográficas avanzadas. Los efectos secundarios fueron escasos (3,7%). Concluimos que la radiosinoviortesis es un instrumento terapéutico útil y seguro en la AR que no responde al tratamiento convencional, es más efectiva en articulaciones grandes con poco deterioro cartilaginoso y su aplicación repetida no disminuye el efecto terapéutico esperado.

Summary

There are several therapeutic alternatives in the local treatment of rheumatoid arthritis (RA): intraarticular corticosteroids, chemical synoviorthesis, surgical synovectomy and synoviorthesis with radioisotopes.

We present the results of an observational study on radioisotopic synoviorthesis carried out in the Valencian health care area from January 1989 to May 1997 which included 108 synoviortheses performed in 51 patients. This study aimed to assess the efficacy and safety of radiosynoviorthesis in the treatment of RA which had not responded to conventional treatment.

Good and moderate results were obtained in 76.2% of the cases, there being significant differences in the efficacy of synoviorthesis in patients with and without advanced radiographic alterations. There were few side effects (3.7%). We conclude that radiosynoviortesis is a useful and safe therapeutic tool in RA that does not respond to conventional treatment, that it is more effective in large joints with little cartilaginous deterioration and that its repeated use does not decrease the expected therapeutic effect.

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