Both procedures, radiosynoviorthesis and arthroscopic synovectomy, are well established in the local treatment of rheumatically deformed joints. By combining the two minimal invasive procedures one can increase the radicality and still decrease traumatization. A prospective study by Herresthal indicates the superiority of the combined therapy over the single nuclide therapy of knee joints in rheumatoid arthritis. This is due to the lesser traumatization as compared to the open synovectomy and to the possibility to remove fibrinous plaques which may impair the efficiency of radiosynoviorthesis. Histology, method and the respective indications regarding the joints of the upper and lower limbs are discussed.