strontium-radioisotopes and Joint-Diseases

The short range tissue destruction of beta-emitting radioisotopes can be utilized in painful metastatic disease of the skeleton by employing a radionuclide that is specifically metabolized in or adjacent to these lesions. Sodium phosphate P 32 has been used for this purpose for the past 25 yr. It uptake in skeletal tumor and in osteoblastic new bone adjacent to tumor can be markedly increased by pharmacologic stimulation using androgenic steroids, or during rebound deposition after a course of parathyroid hormone. Although efficacy in terms of subjective pain relief is high, more objective signs of success are often lacking, and survival, while more confortable, is not prolonged. Marrow depression is the most significant side effect. A beta-emitting, bone-seeking isotope, 89Sr, may have a better therapeutic/toxic ratio, and should receive further trial. Radiation-induced necrosis has also been applied, though more hesitantly, to the proliferative, destructive, but nonmalignant synovium in rheumatoid disease. Here, a number of colloidal preparations, most commonly 198Au, have been employed. Again, relief of symptoms, particularly recurrent joint effusions, is quite high, although the basic disease process is not reversed. The major hazard here appears to be leakage of material to regional lymph nodes, resulting in irradiation of circulating lymphocytes. Although chromosomal damage can be detected when such cells are then cultured, the actual consequences of this, if any, are not presently known. Both shorter-lived (165Dy) and longer-lived (32P) larger-size colloids are being evaluated, which may prove safer in this regard than 198Au.

Topics: Bone Marrow; Bone Neoplasms; Gold Radioisotopes; Humans; Joint Diseases; Neoplasm Metastasis; Pain, Intractable; Palliative Care; Phosphorus Radioisotopes; Radiation Dosage; Radioisotopes; Strontium Radioisotopes; Synovial Membrane

Topics: Adolescent; Adult; Arthritis, Infectious; Bone Diseases; Bone Neoplasms; Bone Transplantation; Epiphyses, Slipped; Femoral Fractures; Femur Head; Follow-Up Studies; Fractures, Bone; Hip Joint; Humans; Joint Diseases; Osteochondritis; Osteomyelitis; Pseudarthrosis; Radionuclide Imaging; Strontium Radioisotopes; Transplantation, Homologous

Topics: Diagnosis, Differential; Humans; Indium; Joint Diseases; Radioisotopes; Radionuclide Imaging; Strontium Radioisotopes; Technetium

The uptake of Strontium-85 in the distal end of the femur and in the immediate vicinity of the lesion was measured in 12 young ment with ostoechondritis dissecans. The uptake was significantly but only slightly increased. It was confined to the area of the lesion, was less than observed in early cases of gonarthrosis and an order of magnitude less than in cases of osteonecrosis. It is concluded that the repair process of osteochondritis dissecans is very slow and involves only minor part of the bone tissue surrounding the lesion.

Topics: Adolescent; Adult; Femur; Humans; Joint Diseases; Knee Joint; Male; Osteochondritis; Radionuclide Imaging; Strontium Radioisotopes

The concentration of 99mTc-pyrophosphate was determined in the lower extremities of rabbits (normal, abacterial and bacterial affected soft tissues), in osteoarthritis of the hip joint (capsule and muscle) as well as in knee joint effusions. Compared with the 85Sr-concentration, reflecting the calcification capacity, concentrations of 99mTc-pyrophosphate in soft tissues were found to be lower 2 hours p.i., but were up to elevenfold higher 24 hours p.i. These findings should be due to a fixation of 99mTc-pyrophosphate in collagen containing tissues as in the soft tissue tumors (myosarcoma, synvialioma, breast cancer) presented. A mechanism of delayed equilibration could explain augmented uptake in lymph-edema, ascites and effusions in florid osteoarthritis of the knee joint. The possible dependence of 99mTc-pyrophosphate concentration in bone and soft tissue on collagenous contents is discussed.

Topics: Animals; Ascites; Bone and Bones; Breast Neoplasms; Diphosphates; Disease Models, Animal; Extremities; Freund's Adjuvant; Hip; Humans; Joint Diseases; Joint Prosthesis; Joints; Knee; Osteoarthritis; Phosphates; Rabbits; Rhabdomyosarcoma; Sarcoma, Synovial; Strontium; Strontium Radioisotopes; Technetium; Tibial Fractures; Time Factors; Tin

Topics: Acrylic Resins; Animals; Arthroplasty; Bone Cements; Carcinogens; Elbow; Gentamicins; Hemophilia A; Humans; Infections; Joint Diseases; Joint Prosthesis; Knee; Male; Metals; Osteoporosis; Plastics; Polyethylenes; Strontium Radioisotopes

Osteo-articular diagnosis is too often considered at present to be synonymous with radiological diagnosis. This has come to be almost a sine qua non. Nevertheless a normal X-ray does not mean that the patient is free of disease. On the contrary, there exists the considerable handicap of the latent period between the onset of disease and the appearance of radiological signs. If blind faith in such a notion is allowed to persist, a profitable means of progress is closed both to our discipline and pathology in general. Over the last decade has emerged a new tendency towards the study of the initial phases of disease and an earlier diagnosis during the pre-radiological phase. This tendency, which opens new perspectives, already enjoys highly promising success and deserves wider recognition, encouragement, development and study. It results more from an attitude of mind rather than the development of a technique and for this reason should lead to the suggestion of other methods and solutions. In bringing us closer to the source of the pathological process it will aid in better understanding of its true nature and pathogenesis. In a word, it will help us to understand the starting phases of disease whilst radiology reveals only the active process. Inasmuch as early physiopathological processes are reversible, it should open the door to new therapeutic approaches.

Topics: Bone Diseases; Humans; Joint Diseases; Radiography; Radionuclide Imaging; Strontium Radioisotopes; Thermography

Topics: Aged; Autoradiography; Calcium; Female; Hip Joint; Humans; Joint Diseases; Strontium; Strontium Radioisotopes

Topics: Aged; Arthritis, Rheumatoid; Autoradiography; Bone Cysts; Calcium; Diagnosis, Differential; Female; Femur Head; Hip; Hip Joint; Humans; Joint Diseases; Male; Osteoarthritis; Paget Disease, Extramammary; Radiography; Strontium; Strontium Radioisotopes

Topics: Evaluation Studies as Topic; Female; Femoral Fractures; Femur Head Necrosis; Fluorine; Hip Joint; Humans; Injections, Intravenous; Joint Diseases; Knee Joint; Middle Aged; Necrosis; Oscillometry; Osteoarthritis; Radionuclide Imaging; Strontium Radioisotopes; Time Factors

Topics: Arthritis, Rheumatoid; Humans; Joint Diseases; Knee Joint; Radionuclide Imaging; Strontium Radioisotopes; Technetium

Topics: Bone Diseases; Calcium; Humans; Joint Diseases; Kinetics; Radioactivity; Radioisotopes; Strontium; Strontium Radioisotopes