Thesis supervisor: Margit Szentesi
Web address (URL): http://doktoriiskola.etk.pte.hu/ Location of studies (in Hungarian): Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary Abbreviation of location of studies: EDI
Description of the research topic:
The role of ultrasound examination in the pre-treatment diagnosis and evaluation of treatment effectiveness in radiosynoviorthesis.
In the treatment of chronic synovitis, surgical synovectomy is an alternative to radiosynoviorthesis. Its performance is justified in all chronic synovitis cases lasting longer than 4-6 months, not responding to conventional treatments, including 2-3 long-acting steroid injections, if there are no operable lesions.
The significance of ultrasound examination lies in the diagnosis of knee joint synovitis and associated joint abnormalities, as well as in measuring the effectiveness of therapy. In inflammatory knee joint diseases, the synovium, which forms the inner surface of the joint capsule, bursae, and the layer adjacent to the tendon sheath, thickens and proliferates, resembling glove fingers. The looser, edematous, hypervascularized synovium appears hypoechoic, in contrast to the chronically proliferated, fibrotically transformed, hyperechoic synovium, which may also contain calcifications. The thickening of the synovial membrane is clearly visible on ultrasound, often providing a very bizarre image. Its thickness can be precisely measured in the suprapatellar recess, circumferentially under the collateral ligaments, and dorsally under the capsule. In rheumatoid arthritis, proliferating synovium destroys surrounding cartilage, menisci, causes erosions on bone surfaces (initially on the marginal part of the tibial condyles), destroys collateral ligaments, and the capsule, leading to joint instability. After surgical or isotopic synovectomy, newly formed synovium, the neosynovium, which can appear extremely bizarre and heterogeneous, with layered hypoechoic-hyperechoic images. The vascularity of the synovium can be well visualized using color Doppler and power Doppler examinations, with appropriate flow parameters set.
The objectives of the study are:
Exclusion of operable lesions that contraindicate radiosynoviorthesis.
Examination of the Baker's cyst structure to determine contraindications. Under what conditions can radiosynoviorthesis be performed alongside a Baker's cyst?
Comparison of the ultrasound and Tc scintigraphic images of the Baker's cyst.
Measurement of synovial membrane thickness, both before and after isotope administration (at 1, 3, 6, 12 months following administration), using measurements taken at defined anatomical points with mm precision, to assess the effectiveness of radiosynoviorthesis.
Exploring the correlation between ultrasound results and clinical effectiveness.
Investigating the relationship between the clinical effectiveness of radiosynoviorthesis, the number of punctures after radiosynoviorthesis, and synovial membrane thickness.
Refining the indications for radiosynoviorthesis based on the results obtained.
Required language skills: English language exam B2 level Number of students who can be accepted: 1
Deadline for application: 2024-05-31
2024. IV. 17. ODT ülés Az ODT következő ülésére 2024. június 14-én, pénteken 10.00 órakor kerül sor a Semmelweis Egyetem Szenátusi termében (Bp. Üllői út 26. I. emelet).
Login
