Assessment of the Effectiveness of Knee Joints Treatment With the Use of 90 Y : Prospective Ultrasound and Clinical Analysis.

PURPOSE: The purpose of this prospective study was to assess the effectiveness of knee joints treatment by radiosynoviorthesis with the use of 90 Y based on ultrasound and clinical analysis. MATERIALS AND METHODS: Ninety-seven patients were qualified for treatment from October 2016 to June 2017, and observation period lasted until December 2017. Bioethics Committee of the Medical University of Silesia approved this study. The effectiveness of knee joints treatment with the use of 90 Y was based on 927 ultrasound measurements of fluid and 927 synovial thickness in 3 sites of the suprapatellar recess, 309 assessments of patient's disability documented in Lequesne questionnaire, 309 assessments of pain on visual analog scale, as well as 103 overall self-assessment. Statistical methods were used to process the results. RESULTS: A reduction in fluid was found in 62.14% of the knees; synovial thickness reduction was observed in 97.09% of all knees. The greatest benefit from the therapy was experienced by patients complaining of morning stiffness lasting more than 15 minutes (in 85.71% of joints). There was reduction in pain at rest in 94.52% of knee joints and in 80.39% of joints with pain while walking. At the second follow-up visit after treatment, the percentage of improvement in self-assessment was 74.76%. CONCLUSIONS: Statistically significant decreases in the amount of fluid and thickness of the synovial membrane as well as the level of disability and the intensity of pain after radiosynoviorthesis 90 Y treatment were demonstrated.

First Metatarsal Bone Metastasis From Clear Cell Renal Cell Carcinoma on SPECT/CT.

ABSTRACT: We report metatarsal metastasis in SPECT/CT in a 65-year-old man, 5 years after radical right nephrectomy. Tumor from first metatarsal was histopathologically proven from clear cell renal cell carcinoma. Metatarsal metastasis is very rare. Less than 0.01% of patients have metastases in the foot bone. Tumor histotype is mainly lung cancer. Metastases from renal carcinoma are often lytic with a poor osteoblastic response, there may be limited uptake of the 99mTc-MDP tracer, and all uncertain regions should be diagnosed with SPECT/CT, if it is possible.