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INTRODUCTION: To describe the therapeutic efficacy of radiosynoviorthesis with [90Y]Yttrium citrate (90Y), in patients with chronic knee synovitis refractory to systemic treatments and/or infiltrations, correlating the results with the different etiologies and degenerative changes that they showed, in order to optimize the indication of the technique. MATERIAL AND METHODS: Observational retrospective study with 32 patients (22 men and 10 women) and 34 knees, with refractory chronic knee synovitis, who underwent radiosynoviorthesis between January 2013 and December 2022. Its efficacy was described and analyzed by the subjective improvement referred by the patients and its relationship with the existing etiologies and radiological degenerative changes, expressed by the Kellgren-Lawrence (K-L) scale. RESULTS: A statistically significant subjective improvement was observed in 70.6% of the cases (p < 0.001). There were 92.3% of cases with absent, doubtful or mild degenerative changes (K-L 0-2) who improved, while only 50% with moderate or severe changes (K-L 3-4) improved, showing statistically significant differences (p = 0.03). Among patients with chronic inflammatory origin of synovitis (spondyloarthropathies and rheumatoid arthritis), 80% improved, while in those with osteoarthritis (degenerative) origin, only 25% improved with statistically significant differences (p = 0.006). CONCLUSIONS: Radiosynoviorthesis with 90Y is an effective treatment in patients with knee refractory chronic synovitis, especially in the presence of mil degenerative joint changes and chronic inflammatory origin. We must ensure the appropiate selection of patients according to these criteria.
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La osificación heterotópica es una condición limitante, que afecta predominantemente a la cadera. Dada su relación con patología postraumática/posquirúrgica, la gammagrafía ósea SPECT/TC resulta de especial utilidad en el diagnóstico diferencial con movilización protésica, aun cuando no hay alteraciones radiológicas. Además, resulta ser una herramienta eficaz para planificación quirúrgica atendiendo al grado de maduración ósea y la posibilidad de fabricar biomodelos mediante impresión 3D.(AU)
Heterotopic ossification is a limiting condition that predominantly affects the hip. Because of its association with post-trau-matic/postoperative pathology, bone SPECT/CT scintigraphy has proven to be especially useful regarding differential diag-nosis involving prosthetic mobilization, even in the absence of radiological abnormalities. Additionally, it is an effective toolfor surgical planning, considering the degree of bone maturation and the possibility of creating biomodels using 3Dprinting.(AU)
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Humanos , Masculino , Pessoa de Meia-Idade , Ossificação Heterotópica , Artroplastia de Quadril/métodos , Cintilografia , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , Prótese de Quadril , Pacientes Internados , Exame Físico , Osteoporose , Fraturas Ósseas/cirurgia , Osteoartrite do Quadril , Quadril/cirurgiaRESUMO
AIM: To analyze the sample of pregnant patients who underwent pulmonary perfusion scintigraphy to rule out the pulmonary embolism (PE) suspicion during the acute COVID-19 infection hospitalization period in our hospital. MATERIAL AND METHODS: SPECT scintigraphy with a reduced dose (111 MBq) of 99mTc-macroaggregated albumin was performed in all of the patients (n=5). The obtained images were interpreted by comparing the findings with the radiological images according to the PISAPED criteria. RESULTS: Only one of the 5 patients was diagnosed with PE. Two patients obtained pathological findings of the scintigraphy attributable to radiological alterations due to COVID-19 pneumonia, and the other two had normal pulmonary perfussion. CONCLUSION: Given the non-specific features of the clinical manifestations and D-dimer values in COVID-19, as well as their similarity to those of PE, the pulmonary perfusion scintigraphy plays a crucial role in the screening of PE in these patients due to its high sensitivity and lower irradiation compared to CT. Despite the limited number of patients, the results obtained have special relevance related to the absence of scientific publications on this group of patients within the context of COVID-19 pandemic exceptional situation.
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