Effectiveness and Safety of Ultrasound-Guided Radiosynovectomy for Persistent Joint Effusion: A Retrospective Single-Center Study

Abstract Purpose Radiosynovectomy is a minimally invasive treatment used in patients with persistent joint effusion associated with synovial hypertrophy, particularly when conventional pharmacological therapy is insufficient. To evaluate the effectiveness and safety of ultrasound-guided radiosynovectomy in a heterogeneous population of patients treated in a single tertiary care center. Methods This retrospective study included 247 patients who underwent 345 RSV procedures between 2021 and 2023. Clinical outcomes were assessed at least three months after treatment using a patient-reported ordinal scale. Clinically significant improvement was defined as complete resolution, near-complete resolution, or long-term partial improvement. Statistical analyses included descriptive methods, comparative subgroup analyses and multivariable regression. Results Among 278 procedures with available efficacy follow-up, 83.8% of procedures resulted in clinical improvement, including 78.1% with clinically significant improvement. Complete resolution of symptoms was achieved in 27.3% of cases. Adverse events were recorded in 11 of all 345 (3.2%) of procedures and were predominantly mild. The highest effectiveness was observed in patients with juvenile idiopathic arthritis (JIA), whereas lower response rates were observed in patients with conditions such as osteoarthritis. In a first-procedure-only analysis adjusted for age, sex, diagnosis and joint/isotope, no factor remained an independent predictor of outcome; age was significant in unadjusted analysis only, and could not be separated from juvenile idiopathic arthritis. Approximately 30% of patients required repeat treatment. A strong association was observed between clinical improvement and patient satisfaction. Conclusions In this retrospective single-center study, ultrasound-guided RSV was associated with substantial patient-reported symptom improvement among procedures with available follow-up and a low recorded complication rate. Repeat treatment was feasible when clinically indicated.