Re: x-ray contrast media

[kgordon@cc.UManitoba.CA]

While we have done one  P-32 synovectomy ( a difficult case on the elbow of a 
hemopheliac patient) under fluoro control years ago, we prefer to verify  that 
the needle is properly into the joint space by injecting some Tc-99m sulphur 
colloid and imaging under the gamma camera prior to injecting the P-32.  This 
works very well and keeps the procedure in the nuc. med. department.  We have a 
very good orthopedic surgeon who performs  synovectomies in our NM department - 
I gave him special training in the radiation safety aspects of the procedure, 
and personally observed the first 5 he did to verify that he handled the 
radioactive sources appropriately, gowned and gloved, used  ring and badge 
dosimeters, and monitored himself for contamination, etc at the end of the 
procedure.  There are usually at least 2 NM techs in attendence .   He always 
gets the joint space (he does a lot of that to earn his living).  Our nuclear 
medicine physicians (who don't get that much practice sticking needles into 
joints) are quite happy with this arrangement and it has been working well. 
Getting properly into the spaces of seriously arthritic joints takes a great 
deal of skill, and they are happy to leave that to an expert.

Karin Gordon
Radiation Safety Office		voice	(204) 787-2903
Health Sciences Centre		fax	(204) 787-1313
Winnipeg, MB. Canada 		e-mail 	kgordon@cc.umanitoba.ca