As far as I know, the only hospital do this procedure in Kuwait is Al Farwaniya hospital and we just injected one case. So, basically we have referrals from rheumatologists who failed managing patients conservatively. Patients are having inflammatory joint disease most commonly from rheumatoid arthritis or to the lesser extent other inflammatory joint diseases e.g. Lyme disease, Behcet´s disease and spondylarthropathy (e.g. reactive or psoriatic arthritis).. etc. Patient are complaining of limitation of movement, swelling and painful joint. Multiple aspirations is not helping. The pathophysiology behind it is inflamed and swollen synovium. So our rule is to give high radiation Beta emitters radioisotopes like Yttrium-90 as in today's case. Those radiations are working amazingly in destroying the inflamed synovium with good outcome in terms of relieving patients symptoms. That was today's thought, Have a good day guys.