Under what circumstances would you consider low-dose radiation therapy for osteoarthritis in an older adult patient?

Here is a recent expert consensus by Joel Block on the use of low-dose radiation therapy in OA:

Some highlights:

"Placebo-controlled randomized clinical trials have now been reported using LDRT for OA of the knees and of the hands. Taken together, they do not show benefit beyond placebo... While a discussion regarding the potential utility of leveraging the placebo response clinically is reasonable, it should be clear that any ethical use of pure placebo should entail no extra risk. In the case ...

I believe that older adult patients are often the ones who can benefit most from LDRT. These patients often have osteoarthritis in multiple joints and are the same patients suffering from comorbid conditions that limit the use of systemic analgesic medications, including NSAIDs and Acetaminophen. In the case of refractory OA, they can be limited with regard to physical therapy and opioid use, and surgical management is often not an option.

LDRT can then be utilized to help limit morbidity in this...

Almost any and all circumstances.