X-radiation in the management of rheumatoid disease

Few topics are more emotive than the use of radiotherapy for nonlethal diseases. Memories of Hiroshima and of patients with ankylosing spondylitis dying of leukaemia following irradiation haunt the physician. Nevertheless, there are exciting developments in our understanding of total lymphoid irradiation - a modality that results in striking immunosuppression. Should total lymphoid irradiation be used for rheumatoid disease?