Radiation Therapy of Osteoarthritis Knee Joint. The Features of Topometry for Orthovoltage X-ray Therapy
Abstract
Osteoarthritis is the most common disease among all rheumatic disease. Orthovoltage X-ray therapy (OXRT) is the alternative method of pain syndrome treatment for degenerative inflammatory joint diseases. The techniques of OXRT were developed in 1970 years. The study aims to offer a modern scientifically grounded methods of conducting pre-treatment CT topometry for OXRT of the knee joint in the treatment of gonarthritis. From 2012 to 2015 topometry the pre-treatment carried out using specialized CT scanner in 102 patients. The article describes the methodology of the pre-treatment topometry. Using modern methods of diagnostics (MRI, ultrasound) there were able to determine the precise localization of the pathological process in the joint and calculate the optimal depth of dose delivery. So, the average value for tibiofemoral joint made up 5,7 (95 % CI: 5,0 to 6,5) cm, patellofemoral articulation in the medial along the passage of the joint space in the medial of 3,8 (95 % CI: 3.9 to 4,7) cm. These data differed from the accepted standards average depth of 3 cm. Irradiation of the knee joint must oriented to the individual dose estimation for reducing the impact on the surrounding unaffected tissue.
About the Authors
Mariya V. Makarova
Northern State Medical University
Russian Federation
Russian Federation
Ph. D. Med., Assistant of Department of Radiation Diagnosis, Radiation Therapy and Oncology
Andrej M. Shubin
Arkhangelsk Regional Oncology Center
Russian Federation
Russian Federation
Radiologist
References
1. Luchikhina L.V., Karateev D. E. New approaches to early diagnosis of osteoarthritis and the prospects for its pathogenetic therapy. Modern rheumatology. 2014. No. 4. P. 33–38 (in Russian).
2. Makarova M. V., Titova L. V., Valkov М. Y. Orthovoltage radiotherapy in combination with chondroprotectors in osteoarthritis of knee joints stage 0–2: results of a randomized trial. Vestnik RNCRR. 2015. No. 15. URL: http://vestnik-rncrr. ru/vestnik/v15/papers/makarova_v15. (in Russian).
3. Naumov A. V., Alekseeva L. I., Vertkin A. L. The management of patients with osteoarthritis and comorbidity in General practice. Klinicheskie recommendations of the consensus of experts from the Russian Federation. Moscow: RNMOT, 2015. 38 p. (in Russian).
4. Filatova E. S., Turovskaja E. F., Alekseeva L. I., Jerdes Sh. F., Filatova E. G. Analysis of the pathogenetic mechanisms of chronic joint pain in patients with rheumatoid arthritis and osteoarthritis of the knee joints. Scientific-practical rheumatology. 2014. V. 52. No. 6. P. 631–635 (in Russian).
5. Anish P., Mansoor M., Mohiuddin A. M., Coleman N. Exploiting sensitization windows of opportunity in hyper and hypo-fractionated radiation therapy // J. Thorac. Dis. 2014. V. 6. № 4. P. 287–302.
6. Hochberg M., Altman R., April K. American college of rheumatology 2015: Recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip and knee // Arthritis Care & Research. 2015. V. 64. No. 4. Р. 465–474.
7. International commission on radiological protection (ICRP): Proceedings of the third International symposium on the system of radiological protection // Ann. ICRP. 2016. V. 45. № 1. P. 38.
8. Keller S., Müller K., Kortmann R., Wolf U., Hildebrandt G., Liebmann A., Micke O., Flemming G., Baaske D. Efficacy of lowdose radiotherapy in painful gonarthritis: experiences from a retrospective East German bicenter study // Radiat. Oncol. 2013. V. 8. № 29.
9. Niewald M., Seegenschmiedt M. H., Micke O., Graeber S., Muecke R., Schaefer V., Scheid C., Fleckenstein J., Licht N., Ruebe C. Randomized, multicenter trial on the effect of radiation therapy on plantar fasciitis (painful heel spur) comparing a standard dose with a very low dose: mature results after 12 months, follow-up // Int. J. Radiat. Oncol. Biol. Phys. 2016. V. 84. № 2. P. 455–462.
10. Ulsh B. A. Are risks from medical imaging still too small to be observed or nonexistent? // International dose-response society. 2015. V. 13. № 1. P. 120.
Review
For citations:
Makarova M., Shubin A. Radiation Therapy of Osteoarthritis Knee Joint. The Features of Topometry for Orthovoltage X-ray Therapy. Radiology - Practice. 2017;(6):15-26. (In Russ.)
Views:
314
Email this article 