A technical complication of radiosynovectomy in the ankle: leakage to distal tibiofibular syndesmosis.

Chronic hemophilic synovitis due to intra-articular bleeding in hemophilia A (a congenital coagulation defect) is a common manifestation. Radiosynovectomy is used for the ablation of chronic hemophilic synovitis. Complications due to radiosynovectomy may be seen, such as leakage of radioactivity to the lymph nodes, liver, and spleen via the lymphatic system. We report herein 2 cases that developed leakage to the distal tibiofibular syndesmosis, lymph nodes, liver, and spleen after radiosynovectomy to the ankles. In order to prevent leakage, low-volume injection is recommended.