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yttrium (90Y) ferrihydroxide colloid

V10AA02

Forms & Strengths

Suspension for intra-articular injection
Radioactivity concentration varies per batch (typically provided with specific activity at calibration time)

Adult Dosing

Knee joints: 185-222 MBq (5-6 mCi) administered intra-articularly
Medium joints (shoulder, elbow, wrist, hip, ankle): 74-111 MBq (2-3 mCi)
Small joints (metacarpophalangeal, interphalangeal): 37-55 MBq (1-1.5 mCi)
Administered as a single intra-articular injection, potentially repeated after 6 months if necessary

Pediatric Dosing

Safety and efficacy in pediatric patients have not been established
Use in children is generally avoided unless alternative therapies fail and benefits outweigh radiation risks

Indications

Radiation synovectomy for chronic inflammatory joint diseases (e.g., rheumatoid arthritis, hemophilic arthropathy)
Treatment of recurrent joint effusion refractory to conventional systemic or local corticosteroid therapy

Mechanism of Action

Pure beta-minus emitter with a maximum tissue penetration of 11 mm (mean 3.6 mm)
Colloid particles are phagocytosed by the inflamed synovial membrane
Emits ionizing radiation locally to destroy hypertrophied, inflamed synovial tissue, leading to fibrosis and reduced joint effusion

Contraindications

Pregnancy and lactation
Active infection at the injection site or systemic infection
Joint instability or severe structural destruction of the joint
Ruptured synovial cyst communicating with the joint space

Adverse Reactions

Transient local pain and swelling at the injection site
Radiation-induced skin necrosis or subcutaneous atrophy due to leakage along the needle track
Allergic or hypersensitivity reactions
Joint infection (septic arthritis) secondary to injection procedure
Chromosomal aberrations in local lymphocytes from radiation exposure

Drug Interactions

Concurrent intra-articular corticosteroids may alter joint inflammation and particle retention, though sometimes co-administered to reduce initial radiation synovitis
No significant systemic pharmacokinetic drug-interactions due to minimal systemic absorption from the joint space

Curated Content: Needs Vetting Before Put to Clinical Use