{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T00:43:30Z","timestamp":1791593010599,"version":"4.3.4"},"reference-count":76,"publisher":"American Veterinary Medical Association (AVMA)","issue":"5","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["javma"],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Canine osteoarthritis (OA) is a major contributor to chronic pain, mobility loss, and premature euthanasia. Although multimodal care is standard, many dogs experience incomplete relief, adverse events, or limited access to care. Radiosynoviorthesis (RSO) is a targeted IA therapy that delivers localized radiation to inflamed synovial tissue, reducing synovial effusion and alleviating joint pain. While various RSO agents have been used for over 70 years in human medicine to manage inflammatory joint disease, tin-117m (Sn-117m) is the first RSO agent adapted for veterinary use and approved for the treatment of canine OA. Sn-117m is a radionuclide emitting low-energy conversion electrons with minimal tissue penetration and, unlike systemic radiotherapeutics, Sn-117m remains confined within the joint capsule and does not form radioactive metabolites. This containment minimizes environmental contamination and limits caregiver exposure. This narrative review synthesized current evidence on the clinical use of Sn-117m RSO in dogs, addressing therapeutic efficacy and effectiveness, safety, and caregiver radiation exposure. Sn-117m offers a minimally invasive alternative to fill this treatment gap. Following a single injection for OA, prospective clinical trials report sustained improvements in objective gait analysis and caregiver-reported pain scores with benefits lasting up to 12 months. Modeled and measured radiation exposures for caregivers remain below US Nuclear Regulatory Commission limits, allowing outpatient use without isolation. This review evaluated existing data, highlighted regulatory and implementation considerations, and identified areas of potential further research. Long-term outcome tracking and expanded joint-specific data could help refine the use of RSO in human and veterinary medicine.<\/jats:p>","DOI":"10.2460\/javma.25.08.0564","type":"journal-article","created":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T16:09:55Z","timestamp":1767802195000},"page":"1-5","source":"Crossref","is-referenced-by-count":2,"title":["Tin-117m radiosynoviorthesis safely and effectively manages canine osteoarthritis with minimal radiation exposure: a narrative review"],"prefix":"10.2460","volume":"264","author":[{"given":"Matthew G.","family":"Arno","sequence":"first","affiliation":[{"name":"Foxfire Scientific, Arlington, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5486-8660","authenticated-orcid":true,"given":"Jennifer A.","family":"Barnhard","sequence":"additional","affiliation":[{"name":"Tactical Veterinary Solutions, Cabin John, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn R.","family":"Webb","sequence":"additional","affiliation":[{"name":"Tactical Veterinary Solutions, Cabin John, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chad","family":"Smith","sequence":"additional","affiliation":[{"name":"FX Masse Associates, Danvers, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Donecker","sequence":"additional","affiliation":[{"name":"Lewes, DE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Menardi","sequence":"additional","affiliation":[{"name":"Exubrion Therapeutics Inc, Buford, GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5923-0001","authenticated-orcid":true,"given":"Matthew W.","family":"Brunke","sequence":"additional","affiliation":[{"name":"Tactical Veterinary Solutions, Cabin John, MD"},{"name":"Sports Medicine and Rehabilitation, Veterinary Referral Associates, Gaithersburg, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1272","reference":[{"issue":"4","key":"ref1","series-title":"Vet Clin North Am Small Anim Pract.","first-page":"699","article-title":"Osteoarthritis: joint anatomy, physiology, and pathobiology","volume":"27","author":"Johnston SA","year":"1997","unstructured":"Johnston SA. Osteoarthritis: joint anatomy, physiology, and pathobiology. Vet Clin North Am Small Anim Pract. 1997;27(4):699-723. doi:10.1016\/S0195-5616(97)50076-3"},{"issue":"8","key":"ref2","series-title":"J Small Anim Pract.","first-page":"609","article-title":"Identification of canine osteoarthritis using an owner-reported questionnaire and treatment monitoring using functional mobility tests","volume":"63","author":"Wright A","year":"2022","unstructured":"Wright A, Amodie DM, Cernicchiaro N,  Identification of canine osteoarthritis using an owner-reported questionnaire and treatment monitoring using functional mobility tests. J Small Anim Pract. 2022;63(8):609-618. doi:10.1111\/jsap.13500"},{"issue":"2","key":"ref3","series-title":"J Am Vet Med Assoc.","first-page":"225","article-title":"Influence of lifetime food restriction on causes, time, and predictors of death in dogs","volume":"226","author":"Lawler DF","year":"2005","unstructured":"Lawler DF, Evans RH, Larson BT, Spitznagel EL, Ellersieck MR, Kealy RD. Influence of lifetime food restriction on causes, time, and predictors of death in dogs. J Am Vet Med Assoc. 2005;226(2):225-231. doi:10.2460\/javma.2005.226.225"},{"issue":"1","key":"ref4","series-title":"Canine Med Genet.","first-page":"1","article-title":"Epidemiology and clinical management of elbow joint disease in dogs under primary veterinary care in the UK","volume":"7","author":"O\u2019Neill DG","year":"2020","unstructured":"O\u2019Neill DG, Brodbelt DC, Hodge R, Church DB, Meeson RL. Epidemiology and clinical management of elbow joint disease in dogs under primary veterinary care in the UK. Canine Med Genet. 2020;7(1):1. doi:10.1186\/s40575-020-0080-5"},{"issue":"7","key":"ref5","series-title":"Am J Vet Res.","first-page":"1000","article-title":"Use of the distomedial-proximolateral oblique radiographic view of the elbow joint for examination of the medial coronoid process in dogs","volume":"63","author":"Haudiquet PR","year":"2002","unstructured":"Haudiquet PR, Marcellin-Little DJ, Stebbins ME. Use of the distomedial-proximolateral oblique radiographic view of the elbow joint for examination of the medial coronoid process in dogs. Am J Vet Res. 2002;63(7):1000-1005. doi:10.2460\/ajvr.2002.63.1000"},{"issue":"4","key":"ref6","series-title":"J Am Vet Med Assoc.","first-page":"514","article-title":"Systematic review of clinical trials of treatments for osteoarthritis in dogs","volume":"230","author":"Aragon CL","year":"2007","unstructured":"Aragon CL, Hofmeister EH, Budsberg SC. Systematic review of clinical trials of treatments for osteoarthritis in dogs. J Am Vet Med Assoc. 2007;230(4):514-521. doi:10.2460\/javma.230.4.514"},{"issue":"8","key":"ref7","series-title":"Vet Rec.","first-page":"226","article-title":"Review of the safety and efficacy of long-term NSAID use in the treatment of canine osteoarthritis","volume":"166","author":"Innes JF","year":"2010","unstructured":"Innes JF, Clayton J, Lascelles BD. Review of the safety and efficacy of long-term NSAID use in the treatment of canine osteoarthritis. Vet Rec. 2010;166(8):226-230. doi:10.1136\/vr.c97"},{"key":"ref8","series-title":"Front Vet Sci.","first-page":"1581490","article-title":"Musculoskeletal adverse events in dogs receiving bedinvetmab (Librela)","volume":"12","author":"Farrell M","year":"2025","unstructured":"Farrell M, Waibel FWA, Carrera I,  Musculoskeletal adverse events in dogs receiving bedinvetmab (Librela). Front Vet Sci. 2025;12:1581490. doi:10.3389\/fvets.2025.1581490"},{"issue":"1","key":"ref9","series-title":"Clin Exp Rheumatol.","first-page":"130","article-title":"Radiation synovectomy with (90)Yttrium, (186)Rhenium and (169)Erbium: a systematic literature review with meta-analyses","volume":"27","author":"van der Zant FM","year":"2009","unstructured":"van der Zant FM, Boer RO, Moolenburgh JD, Jahangier ZN, Bijlsma JW, Jacobs JW. Radiation synovectomy with (90)Yttrium, (186)Rhenium and (169)Erbium: a systematic literature review with meta-analyses. Clin Exp Rheumatol. 2009;27(1):130-139."},{"issue":"4","key":"ref10","series-title":"Q J Nucl Med Mol Imaging.","first-page":"293","article-title":"Radiosynoviorthesis: almost seventy years of experience but still somewhat fameless","volume":"66","author":"van der Zant FM","year":"2022","unstructured":"van der Zant FM, Knol RJ, Broos WA. Radiosynoviorthesis: almost seventy years of experience but still somewhat fameless. Q J Nucl Med Mol Imaging. 2022;66(4):293-303. doi:10.23736\/S1824-4785.22.03470-7"},{"issue":"3","key":"ref11","series-title":"Reumatologia.","first-page":"174","article-title":"Joints and needles: summary of radiosynoviorthesis","volume":"63","author":"Bie\u0144kowski K","year":"2025","unstructured":"Bie\u0144kowski K, Kocemba M, Kunikowska J. Joints and needles: summary of radiosynoviorthesis. Reumatologia. 2025;63(3):174-181. doi:10.5114\/reum\/200530"},{"issue":"6","key":"ref12","series-title":"Gravierende Komplikationen nach Radiosynoviorthese: \u00dcberblick zu H\u00e4ufigkeit und therapeutischen Optionen Nuklearmedizin.","first-page":"262","article-title":"Serious complications after radiosynoviorthesis: survey on frequency and treatment modalities","volume":"45","author":"Kampen WU","year":"2006","unstructured":"Kampen WU, Matis E, Czech N, Soti Z, Gratz S, Henze E. Serious complications after radiosynoviorthesis: survey on frequency and treatment modalities. 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Osteoarthritis: joint anatomy, physiology, and pathobiology. Vet Clin North Am Small Anim Pract. 1997;27(4):699-723. doi:10.1016\/S0195-5616(97)50076-3"},{"issue":"8","key":"ref2","series-title":"J Small Anim Pract.","first-page":"609","article-title":"Identification of canine osteoarthritis using an owner-reported questionnaire and treatment monitoring using functional mobility tests","volume":"63","author":"Wright A","year":"2022","unstructured":"Wright A, Amodie DM, Cernicchiaro N,  Identification of canine osteoarthritis using an owner-reported questionnaire and treatment monitoring using functional mobility tests. J Small Anim Pract. 2022;63(8):609-618. doi:10.1111\/jsap.13500"},{"issue":"2","key":"ref3","series-title":"J Am Vet Med Assoc.","first-page":"225","article-title":"Influence of lifetime food restriction on causes, time, and predictors of death in dogs","volume":"226","author":"Lawler DF","year":"2005","unstructured":"Lawler DF, Evans RH, Larson BT, Spitznagel EL, Ellersieck MR, Kealy RD. Influence of lifetime food restriction on causes, time, and predictors of death in dogs. J Am Vet Med Assoc. 2005;226(2):225-231. doi:10.2460\/javma.2005.226.225"},{"issue":"1","key":"ref4","series-title":"Canine Med Genet.","first-page":"1","article-title":"Epidemiology and clinical management of elbow joint disease in dogs under primary veterinary care in the UK","volume":"7","author":"O\u2019Neill DG","year":"2020","unstructured":"O\u2019Neill DG, Brodbelt DC, Hodge R, Church DB, Meeson RL. Epidemiology and clinical management of elbow joint disease in dogs under primary veterinary care in the UK. Canine Med Genet. 2020;7(1):1. doi:10.1186\/s40575-020-0080-5"},{"issue":"7","key":"ref5","series-title":"Am J Vet Res.","first-page":"1000","article-title":"Use of the distomedial-proximolateral oblique radiographic view of the elbow joint for examination of the medial coronoid process in dogs","volume":"63","author":"Haudiquet PR","year":"2002","unstructured":"Haudiquet PR, Marcellin-Little DJ, Stebbins ME. Use of the distomedial-proximolateral oblique radiographic view of the elbow joint for examination of the medial coronoid process in dogs. Am J Vet Res. 2002;63(7):1000-1005. doi:10.2460\/ajvr.2002.63.1000"},{"issue":"4","key":"ref6","series-title":"J Am Vet Med Assoc.","first-page":"514","article-title":"Systematic review of clinical trials of treatments for osteoarthritis in dogs","volume":"230","author":"Aragon CL","year":"2007","unstructured":"Aragon CL, Hofmeister EH, Budsberg SC. Systematic review of clinical trials of treatments for osteoarthritis in dogs. J Am Vet Med Assoc. 2007;230(4):514-521. doi:10.2460\/javma.230.4.514"},{"issue":"8","key":"ref7","series-title":"Vet Rec.","first-page":"226","article-title":"Review of the safety and efficacy of long-term NSAID use in the treatment of canine osteoarthritis","volume":"166","author":"Innes JF","year":"2010","unstructured":"Innes JF, Clayton J, Lascelles BD. Review of the safety and efficacy of long-term NSAID use in the treatment of canine osteoarthritis. Vet Rec. 2010;166(8):226-230. doi:10.1136\/vr.c97"},{"key":"ref8","series-title":"Front Vet Sci.","first-page":"1581490","article-title":"Musculoskeletal adverse events in dogs receiving bedinvetmab (Librela)","volume":"12","author":"Farrell M","year":"2025","unstructured":"Farrell M, Waibel FWA, Carrera I,  Musculoskeletal adverse events in dogs receiving bedinvetmab (Librela). 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