The treatment goals include suppressing inflammatory activity and preventing bone destruction by suppressing the excessive immune response.
In addition to clinical examination with precise determination of the affected joints, imaging procedures (sonography, X-ray, magnetic resonance imaging) are available to evaluate the existing damage. Differentiation from other inflammatory rheumatic diseases is very important. Rheumatoid factors and anti-CCP antibodies in the blood are important diagnostic markers. It is also important to assess any organ infestation (skin, heart, blood vessels, lungs, eyes, nervous system).
Cortisone preparations are mainly used in flare-up situations. Basic therapeutics replace the long-term use of cortisone and can have a favorable influence on the course of the disease. These include synthetic basic drugs and so-called biologics: genetically engineered preparations that can specifically inhibit individual inflammatory messengers and inflammatory cells, as well as their cooperation. Early initiation of basic therapy is crucial for preventing joint destruction. Non-drug measures supplement the therapy principles.
Chronic joint diseases are treated with radioactive substances known as beta emitters. This cauterizes the synovial membrane, which leads to a reduction in the formation of effusion in the joint and to a reduction or elimination of pain. The effects occur gradually, sometimes after just a few days. The final effect can be assessed after three to four months.
Normally, treatment takes place as part of a short inpatient stay. Depending on the situation, an outpatient procedure is also possible. The radioactive preparation is injected on the first day. The joint should then be protected and relieved, for example by using walking sticks or splints for the night.
If everything goes normally, you will leave the hospital three days after the treatment without walking sticks and the joint can be used again as usual. In order to avoid a temporary irritation caused by the radioactive preparation, you will receive an injection of cortisone approximately one week before the treatment. This takes place as part of an outpatient appointment.
From a medical point of view, radiosynoviorthesis is a minor procedure. The risks are the same as for a normal joint puncture: there is a minimal risk of infection or bleeding.
Our team cooperates in the field of rheumatoid arthritis within the framework of the Swiss Clinical Quality Management Program (SCQM).
Senior Physician, Vice Director of Department, Department of Rheumatology
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