Teleradiotherapy of joints in rheumatoid arthritis: lack of efficacy

Background: Low dose radiotherapy is commonly used for painful rheumatic conditions in clinical practice. Teleradiotherapy may be a cheap, painless procedure which is applicable to many joints at a time. Objective: To determine if the local application of x rays to inflamed joints in rheumatoid arthritis (RA) affects the signs and symptoms of inflammation. Methods: In a randomised, controlled, double blind study, roentgen irradiation was administered in a total dose of 20 Gy during 2 weeks to single joints in six patients with RA who were receiving constant and stable pharmacological treatment with DMARDs and NSAIDs. Single inflamed joints on the contralateral side of the body were used as controls and received sham irradiation. Swelling and tenderness was assessed by blinded investigators before and until 3 months after the irradiation; general disease activity and pain scales were included in the assessment. Results: No change in the scores for tenderness, swelling, pain, or disease activity was seen. The trial was stopped for ethical reasons. Conclusion: Local roentgen treatment of RA at a substantial dose of 20 Gy was ineffective in this pilot trial.