intlungu Hip yimiba eyaziwayo yempilo enokubangelwa ziintlobo ezininzi zeengxaki, nangona kunjalo, indawo yesifo somlenze wesiguli ingaba nolwazi oluxabisekileyo malunga neyona nto ebangela ukuba le nkalo yempilo eqhelekileyo. Ubuhlungu ngaphakathi ngaphakathi kwintambo okanye i-groin kungenziwa ngenxa yeengxaki ngaphakathi kwendibano yokuzibandakanya ngokwayo xa intlungu engaphandle kwenyakatho, intambo ephezulu kunye neentsimbi zangaphandle zingabangelwa iingxaki ngeemigaments, i-tendon kunye nezihlunu, phakathi kwezinye iifom , ejikeleze umxube we-hip. Ngaphezu koko, intlungu ye-hip ingabangelwa ngenxa yezinye ukulimala kunye nemeko, kuquka intlungu.
Contents
Abstract
Intlungu ye-Hip yimeko eqhelekileyo kunye ekhubazayo echaphazela izigulane zonyaka. Ukuxilongwa ngokungafaniyo kweentlungu ze-hip kubanzi, kubonisa umngeni wokuxilonga. Izigulane zivame ukubonisa ukuba iintlungu zabo zindawo zendawo zihlala kwindawo enye ye-anatomic: i-hip yangaphambili kunye ne-groin, i-hip yangemva kunye ne-hip, okanye i-hip lateral. I-hip anterior kunye nentlungu ye-groin ixhomekeke kwi-intra-articular pathology, efana ne-osteoarthritis kunye neenyembezi ezinqabileyo. Ubunzima be-hip buhlungu buhambelana ne-piriformis syndrome, ukungasebenzi kwe-sacroiliac ngokubambisana, i-radiologypathy, kunye nokunyanzeliswa kwe-ischiofemoral ne-split-claudication. Intlungu yesikhumba se-lateral iyenzeka nge-syndrome enkulu yesifo se-trochanteric. Uvavanyo lweemvavanyo lwezonyango, nangona lu luncedo, aluxhomekekanga kakhulu okanye lucacise ngakumbi ukuxilonga; nangona kunjalo, indlela yokuqhelanisa ukuhlolwa kwe-hip ingasetyenziswa. Imifanekiso yezobugcisa kufuneka iqhutywe xa kukhankanywa ukukhubeka, ukuchithwa, okanye ukuphazamiseka kwengcinezelo. I-radiografi yokuqala ye-hip kufuneka ibandakanye indlela yokujonga i-pelvis kunye ne-frog-leg legal viewal of the hip. Ukucatshulwa kwemifanekiso yamagnetic kufuneka kuyenziwe ukuba imbali kunye neziphumo ze-radiograph ezicacileyo ayifumaneki. Ukucatshulwa kwe-magnontic resonance kubaluleke kakhulu ekufumaneni ukuphuka kwemimoya, ukuphazamiseka kwengqondo kunye ne-osteonecrosis yentloko yesifazane. I-arthrography ye-magnetic arthrography yiyo vavanyo lokuxilonga olukhethiweyo.
intshayelelo
Intlungu ye-Hip iyindlela eqhelekileyo yokunyamekela kwaye inokuchaphazela izigulane zonyaka. Kwisifundo esinye, i-14.3% yabantu abadala abadala be-60 iminyaka kunye nabadala babika ubuhlungu obukhulu be-hip kwiintsuku ezininzi kwiiveki ezithandathu ezedlulileyo. Ubuhlungu be-HipNUMX buvame ukubonisa umngeni wokuxilonga kunye neengxaki. Ukuxilongwa ngokuhlukileyo kwentlungu ye-hip (iTable A) ebanzi, kubandakanywa kokubili isifo se-intra-articular and extra-articular pathology, kwaye ihlukahluka ngobudala. Imbali kunye nokuhlolwa komzimba kubalulekile ukuze uhlolisise ngokuchanekileyo imbangela yentlungu ye-hip.
Anatomy
Umxube we-hip ngumxube we-synovial ibhola kunye ne-socket eyenzelwe ukuvumela ukunyakaza kwe-multiaxial ngelixa uhambisa umthwalo phakathi komzimba ophezulu nangaphantsi. I-acetabular rim ihlanganiswe yi-fibrocartilage (i-labrum), eyongeza ubunzulu nozinzo kwidilesi ye-femoroacetabular. Iindawo ezichaziweyo zixutywe yi-hyaline cartilage ezichitha i-shear kunye nokunyanzela umthwalo ngexesha lokuthwala kunye nokunyakaza. Iimvalo ezinkulu ezingabikhoyo ezivela kwingingqi ye-lumbosacral, ezinokukwenza kube nzima ukuhlula phakathi kwentlungu ye-hip kunye neentlungu ezinzima.
Uluhlu olubanzi lwe-hip ye-motion ye-motion lukwinto yesibini kuphela yoluhlu lwe-glenohumeral kwaye luvunyelwe liqela elikhulu lamaqela omsila ojikeleze umlenze. Izihlunu ze-flexor ziquka i-linoopsoas, i-rectus femoris, i-pectineus, ne-sartorius imisipha. I-gluteus maximus kunye namaqela angama-muscle avumela ukunyuselwa kwe-hip. Imisipha encinci, njenge-gluteus medius kunye ne-minimus, i-piriformis, i-obturator ngaphandle kunye ne-internus, kunye ne-quadratus femoris muscle, faka malunga ne-trochanter enkulu, evumela ukuthathwa, ukukhutshwa, kunye nokujikeleza kwangaphakathi nangaphandle.
Kubantu abanobuhlungu besifo, kunamaziko okukhula amaninzi eplavis kunye ne-femur apho kunokulimala khona. Iziza ezenzekayo zokulimala kwe-apophyseal kwingingqi ye-hip ziquka i-ischium, i-anicior ephezulu ye-iliac umgudu, umgudu ongaphantsi kwe-iliac umqolo, i-aliac crest, i-trochanter encinane kunye ne-trochanter enkulu. I-apophysis yesigxina esiphezulu sesigxina sesigxina siphelile kwaye iyakwazi ukulimala ukuya kwi-25 yeminyaka ubudala.2
Umxube we-hip ungomnye wamalungu amaninzi amakhulu atholakala emzimbeni womntu kwaye isebenza ekukhutsheni njengoko ithanga liqhubela phambili kwaye libuya. Umxube we-hip uphinde ujikeleze xa uhleli kunye neenguqu zenkqubela xa uhamba. Izakhiwo ezahlukeneyo ezinqamlekileyo zijikeleze ukudibanisa kwe-hip. Xa ukulimala okanye imeko ichaphazela ezi zinto, ekugqibeleni zikhokelela ekugqibeleni ubuhlungu.
UDkt Alex Jimenez DC, i-CCST
Ukuphononongwa kwe-Hip Pain
imbali
Ubudala bodwa bunokunciphisa ukuxilongwa ngokungafaniyo kweentlungu zentambo. Izigulana zangaphambili kunye nezigulane eziselula, ukungazalwanga kwesifo se-femoroacetabular joint, i-fultures evulsion, kunye nokulimala kwe-apophyseal okanye epiphyseal kufuneka kuqwalaselwe. Kulabo bavuthiweyo, ubuhlungu be-hip bubangelwa ngumxube we-musculotendin, i-ligamentous sprain, i-contusion, okanye i-bursitis. Abantu asebekhulile, i-osteoarthritis ephulukisayo kunye neziqhekeza kufuneka ziqwalaselwe kuqala.
Izigulane ezinomlenze we-hip kufuneka zibuzwe malunga noxinzelelo olubi okanye ukukhuthaza abantu, izinto ezinyukisayo okanye zinciphise intlungu, indlela yokulimala kunye nexesha lokuqala. Imibuzo enxulumene nomsebenzi wokuqhawula, njengokungenwa kokungena kunye nokuphuma emotweni, ukufaka izicathulo, ukuhamba, ukuhamba, nokunyuka nokuhla kwezitebhisi, kunokunceda.3 Indawo yentlungu ikwazisa kuba ubuhlungu be-hip buhlala kwindawo kwenye yezinto ezintathu ezisisiseko ze-anatomic: i-hip anterior kunye ne-groin, i-hip yangemuva kunye ne-buttock, ne-lateral hip (eFigure A).
Uvavanyo lweMvelo
Ukuhlolwa kwe-hip kufuneka kuhlolisise i-hip, back, isisu, kunye neenkqubo ze-neurologic. Kufuneka uqale ngokuhlalutya umgangatho kunye nokuhlolwa komgangatho (Umfanekiso we-1), olandelwa ukuvavanywa kwesigulane ehleli phantsi, ephakamileyo, esesikweni, nasesikweni esiphathekayo (izibalo ze-2 nge-6, kunye ne-EFigure B). Imivavanyo yokuhlola imvelo yokuphonononga ubuhlungu be-hip isishwankathelwe kwiTable 1.
Ukucinga
Imifanekiso. Imifanekiso yeengcingo kufuneka iqhutywe ukuba kukho nayiphi na insolo yokuphuka, ukuchithwa, okanye ukuphazamiseka kwengcinezelo. I-radiografi yokuqala ye-hip kufuneka ibandakanye umbono we-pelvic kunye ne-frog-leg legal viewal of the hip.4
UkuTyekiswa kweMagnetic Resonance kunye neArthrography. EziQhelekileyo intlokoma Imagnethi umfanekiso (MRI) kasikrobana bangabhaqa ezininzi zomzimba ethambileyo, kwaye mishini kutshintshwe ekhethwayo ukuba ray plain akuthethi ukuchonga leengxaki ezithile isigulane kunye ezingisayo pain.5 yesiqhelo MRI lunobuntununtunu bama 30% kunye nokuchaneka I-36% yokuxilonga iinyembezi ze-hip labral, kanti i-arthrography yamagnetic i-arthrography inikezela ubuzwe obuninzi be-90% kunye nokuchaneka kwe-91% ekufumaneni iinyembezi ezinqabileyo.6,7
Ultrasonography. I-Ultrasonography iyindlela yokunceda ukuhlola iintlobo zee-tendons, ukuqinisekisa ukukhankanya i-bursitis, kunye nokuchonga ama-effusions kunye kunye nezizathu ezisebenzayo zokubandezeleka kwe-hip.8 Ultrasonography iyona incedo ngokukhethekileyo ngokukhuselekileyo nangokuchanekileyo ukuqhuba ii-injections ezikhokelwa yi-imaging kunye neenqweno ezikujikelezayo .9 Kulungile umntu onamava e-ultrasonographer ukwenza isifundo sokuxilonga; Nangona kunjalo, ubungqina obusakhulayo bubonisa ukuba oogqirha abanamava abanokuqeqeshwa okufanelekileyo banokwenza ukuxilongwa ngokuthembekileyo kufana ne-experienced musculoskeal ultrasonographer.10,11
Ezi zimbangela ezininzi zeentlungu zentambo. Nangona ezinye iintlungu zengqumbo zingaphelelanga nje, ezinye iintlobo zeentlungu ze-hip zingaba zihlala zingapheliyo xa zishiywa zingaphendulwanga ixesha elide. Izizathu ezininzi eziqhelekileyo zokubandezeleka kwe-hip zibandakanya, isifo samathambo, i-fracture, sprain, i-avascular necrosis, isifo se-Gaucher, i-sciatica, i-muscle strain, i-uliotibial band syndrome okanye i-IT band syndrome kunye ne-hematoma, phakathi kwezinye ezichazwe ngezantsi.
UDkt Alex Jimenez DC, i-CCST
Ukuxilongwa okungafaniyo kwe-Hip-Hop yangaphakathi
I-hip yangaphambili okanye intlungu ye-groin iphakamisa ukubandakanyeka kwendibaniselwano ye-hip uqobo. Izigulana zihlala zenza indawo yokuhlala iintlungu ngokusika i-anterolateral hip ngesithupha kunye nomnwe wesikhombiso esimile kwi- C. Oku kwaziwa ngokuba luphawu C (Umzobo 1A).
Osteoarthritis
I-Osteoarthritis yinkxalabo ebonakalayo kubantu abadala asebekhulile kunye nokuqala kokuqala kweempawu. Izigulane zinentlungu ehlala ihlala, enzulu, ebuhlungu kunye nobunzima obunzima ngokuhlala ixesha elide kunye nesisindo. Uvavanyo lubonakalisa ukunciphisa intlobo yeendululo, kwaye ukugqithisa ukunyuka kwexesha kudla ngokubangela ukuba buhlungu. I-radiographs e-Plain ibonisa ubukho be-joint-space-joint space, osteophytosis, kunye ne-subchondral sclerosis kunye ne-cyst form.12
Ukubanjwa kwe-Femoroacetabular
Izigulane nge-femoroacetabular impingement zihlala ziselula kwaye zisebenza ngokusemthethweni. Bachaza ukuqala kweentlungu ezibi kakhulu ngokuhlala, ukunyuka esihlalweni, ukungena okanye ukuphuma emotweni, okanye ukuxhoma phambili.13 Intlungu ikhona ngokuyinhloko kwi-groin kunye neyomlilo ngokuthe rhoqo kwi-hip latal kunye nomlenze wangaphakathi.14 Uvavanyo lwe-FABER (ukuhamba, ukutshatyalaliswa, ukujikelezwa kwangaphandle; Umzobo 3) unomdla we-96% ukuya ku-99%. Uvavanyo lwe-FADIR (i-flor, ukutshintshwa, ukujikelezwa kwangaphakathi; Umzobo 4), uvavanyo lwemiqulu (umfanekiso we-5), kunye nokuphakanyiswa komlenze ochanekileyo ekuchaseni uvavanyo (umzobo 6) nawo uphumelele, kunye no-88%, 56%, kunye ne-30% , ngokulandelanayo.14,15 Ukongezelela kwimbono ye-radiograph yangaphambili kunye neyasemva, kufuneka kubonwe imbono ye-Dunn ukuze incede ibone izilonda ezintle.16
Iqhwa le-Labral Tear
Iinyembezi ze-Hip labral zibangela ubuhlungu obuhlungu okanye obubukhali obuhlungu, kunye nesiqingatha sezigulane ezineentlungu ezinqabileyo. Intlungu idla ngokuqala, kodwa ngokukhawuleza iqala ngokukhawuleza emva kwesiganeko esibuhlungu. Phantse isiqingatha sezigulane ezi nxakile zinezibonakaliso zogqirha, ezifana nokubamba okanye ukuchofoza ngokukrakra nomsebenzi.17 Uvavanyo lwe-FADIR ne-FABER lusebenza kakuhle ekufumaneni i-intra-articular pathology (uvakalelo yi-96% ukuya kwi-75% yovavanyo lwe-FADIR kwaye i-88% yovavanyo lwe-FABER), nangona akukho vavanyo luneenkcukacha eziphezulu.I-arthrography ye-14,15,18 i-arthrography ithathwa njengolu vavanyo lokuxilonga olukhethiweyo lwezinyembezi ezinqabileyo. njenge-radiography ecacileyo kunye ne-MRI eqhelekileyo, kufuneka isetyenziswe kuqala ukulawula ezinye izimbande ze-hip kunye ne-groin intlungu.
Iliopsoas Bursitis (I-Internal Snapping Hip)
Izigulane ezile meko zineentlungu zengqumbo zangaphakathi xa ziphakamisa umlenze kwisimo esiphezulu, ngokuqhelekileyo zidibaniswa nokubamba, ukukhahlela, okanye ukuphuma kwe-hip.XXMUMX Dynamic-real-time ultrasonography iyona incedo ekuhloleni iindlela ezahlukeneyo ze-hip.20
Ukusasazeka okanye ukuPhulwa koxinzelelo
Kufuneka kuthathelwe ingqondo okanye ukuphazamiseka kwengcinezelo xa kuqukunjelwa umonakalo okanye ukuphindaphinda umzimba, nangona ukuba iziphumo ze-radiograph ezibonakalayo zibi .21 Kliniki, le nzakalo yenze i-hip yangaphakathi okanye ubuhlungu be-groin obubi kakhulu nangomsebenzi. ikhona ngokunyuka okukodwa, ukuphakanyiswa komlenze ochanekileyo, ukuhlolwa kwelogi, okanye ukuxhoma .21 MRI iyakunceda ukufumanisa ukuphuka kwamathambo kunye neengxaki zengcinezelo ezingabonakali kwi-radiograph ecacileyo.22
I-Synovitis emfutshane kunye neSeptic Arthritis
Ukuqala ngokugqithiseleyo kwintlungu ye-hip yangaphambili ye-hip hop eyenza ukungathinteki kwesisindo kufuneka kuphakame ukusola kwi-synovitis yangasemva kunye ne-septic arthritis. Imiba yomngcipheko samathambo yokubolisa abadala ziquka ubudala nangaphezulu kweminyaka 80, iswekile sinwenwa, isifo samathambo, utyando kutshanje edibeneyo, wancothuka usikrobana womlenze okanye idolo prostheses.24 Fever, gcwalisa igazi count, umyinge neentlenge erythrocyte, yaye inqanaba iiproteins C-izidubuli kufuneka zisetyenziswe ukuvandlakanya umngcipheko yokubolisa arthritis.25,26 MRI kuluncedo ukuba umehluko samathambo yokubolisa ukusuka synovitis.27,28 zezomzuzwana Nangona kunjalo, ngeminqweno emihle hip usebenzisa umfanekiso ekhokelwa ezifana fluoroscopy, Itomography ngekhompyutha, okanye ultrasonography kuyacetyiswa ukuba sentlanganisela yokubolisa na suspected.29
Osteonecrosis
Isifo seLegg-Calv -Perthes yi-idiopathic osteonecrosis yentloko yabasetyhini kubantwana abaneminyaka emibini ukuya kweli-12 ubudala, benomlinganiso oyindoda ukuya kowasetyhini we-4: 1.4 Kubantu abadala, iimeko zomngcipheko we-osteonecrosis zibandakanya i-systemic lupus erythematosus, isele yesele isifo, usulelo lwentsholongwane kwintsholongwane, ukutshaya, ukunxila, kunye nokusetyenziswa kwe-corticosteroid. 30,31 Ubuhlungu luphawu olubonakalisayo kwaye luhlala lukhohlakele. Uluhlu lwesindululo ekuqaleni luyagcinwa kodwa lunokuthintelwa kwaye lube buhlungu njengoko isifo siqhubeka.32 I-MRI ibalulekile ekuchongeni nasekuchazeni i-osteonecrosis yentloko yesetyhini.30,33
Ukuxilongwa ngokungafaniyo kwe-Hip-Post ne-Buttock Pain
I-Piriformis Syndrome kunye ne-Ischiofemoral Impingement
I-Piriformis syndrome ibangela ubuhlungu beentlungu ezixhaswa ngokuhlala okanye ukuhamba, kunye nokungahambi ngaphandle kwemitha emisezantsi phantsi kwethanga elingaphandle kwindlela yokunyanzelisa iimbulunga. nokuxilongwa.34,35
Ukuphoswa kwe-Ischiofemoral yimeko engacaciswanga kakuhle engakhokelela ekubandezelweni kwamathambo angenasiphelo kunye nomswakama kwi-thigh post .36,37 Le mqathango kucatshangelwa ukuba yiphumo lokumiswa kwe-quadratus femoris muscle phakathi kwe-trochanter encinane kunye ne-ischium.
Ngokungafani ne-sciatica kwi-disc ye-disc, i-piriformis syndrome kunye nokutshintshwa kwe-ischiofemoral kuyenziwa ngokujikeleza kwe-hip yangaphandle. I-MRI iluncedo ekufumaneni le miqathango.38
omnye
Ezinye izinto ezibangela intlungu ngomva hip ziquka sacroiliac kwekhono joint, 39 empontshwa radiculopathy, 40 kunye nemithambo claudication.41 Ubukho a zanomkhinkqi, iintlungu nasemiphakathweni, yaye umda ujikelezo lwangaphakathi kasikrobana yi axelwe ngakumbi ukuphazamiseka kasikrobana ngaphezu ukuphazamiseka ezivela ukusuka low emva .42
Ukuxilongwa ngokungafaniyo kwe-Hipal Pain Pain
Isifo Sobunzima beTrochanteric
Intlungu ye-hip yangasemva ichaphazela iipesenti ezili-10 ukuya kuma-25% yabantu ngokubanzi.43 Isifo seentlungu ezikhulu kakhulu sibhekisa kwintlungu engaphezulu kwe-trochanter enkulu. Ukuphazamiseka okuninzi kwethambo elisecaleni kunokukhokelela kolu hlobo lwentlungu, kubandakanya ukuqina kwebhendi ye-iliotibial, i-bursitis, kunye neenyembezi ze-gluteus medius kunye ne-minimus attachment attachment. icala. I-Gluteus minimus kunye nokulimala kwe-medius okukhoyo kubangelwa ziimpawu zangasemva zangasemva kwesiphumo sokukrazuka okukhethekileyo okanye okugcweleyo ekufakweni kobukhazikhazi. Uninzi lwezigulana zineempawu ezibi zokuphindaphinda.43
Ukuqukumbela, iintlungu zenyonga sisikhalazo esiqhelekileyo esinokubakho ngenxa yemicimbi eyahlukeneyo yezempilo. Ngapha koko, indawo echanekileyo yesigulana sentlungu inokubonelela ngolwazi oluxabisekileyo kubaqeqeshi bezempilo ngokubhekisele kwesona sizathu sengxaki. Injongo yenqaku elingentla yayikukubonisa kunye nokuxoxa ngokuvavanywa kwesigulana ngentlungu ye-hip. Ubungakanani bolwazi lwethu bukhawulelwe kwi-chiropractic kunye nokulimala komqolo kunye neemeko. Ukuxoxa ngomxholo, nceda ukhululeke ukubuza uGqirha Jimenez okanye unxibelelane nathi ku915-850-0900 .
Ikhutshwe nguDkt. Alex Jimenez
Imithombo yolwazi: Siphakamise amanqaku e-hip pathology kwi-American Family Physician, kunye neengxelo zabo. Saphinda sisesa i-Arhente yeeNgxelo zoPhando lwezeMpilo kunye noBungqina boBungqina beeNgqungquthela, ubungqina bezonyango, iZiko loKuphuculwa kweeNkcubeko, i-US Guidelines Clearinghouse, kunye ne-UpToDate. Sasidlala ukhangelo PubMed usebenzisa amagama ezinkulu syndrome intlungu trochanteric, hip iimviwo iingqaqambo, yamophula umfanekiso femoral hip ntshikilelo, umfanekiso hip labral iinyembezi, umfanekiso osteomyelitis, ischiofemoral impingement syndrome, meralgia ngokutsha paresthetica, MRI arthrogram hip labrum, yokubolisa samathambo Ukujongwa kwakhona okwenziwe ngendlela, kunye nentlungu ye-hip. Usuku lokukhangela: Matshi no-Ephreli 2011, kunye no-Agasti 15, 2013.
Ulwazi Lombhali: Aafp.org
Imixholo eyongezelelweyo: I-Pain Back Pain
Umqolo obuhlunguSesinye sezona zizathu zixhaphakileyo zokukhubazeka kunye neentsuku eziphosiweyo emsebenzini kwihlabathi liphela. Iimpawu ezibuhlungu zangasemva kwisizathu sesibini esiqhelekileyo sokutyelelwa yi-ofisi kagqirha, ngaphezulu kwenani losulelo oluphezulu lokuphefumla. Phantse iipesenti ezingama-80 zabemi baya kufumana iintlungu zangasemva kube kanye ebomini babo. Umqolo sisakhiwo esintsonkothileyo esenziwe ngamathambo, amalungu, iigaments, kunye nezihlunu, phakathi kwezinye izicwili ezithambileyo. Ngenxa yoku, ukwenzakala kunye / okanye iimeko ezixineneyo, ezinje ngedisni, ekugqibeleni unokukhokelela kwiimpawu zentlungu. Ukulimala kwezemidlalo okanye ukulimala kwengozi yeemoto ngokuqhelekileyo kubangelwa yintlungu yokubuhlungu, kodwa ngamanye amaxesha ukuhamba kwezinto ezilula kunokuba neziphumo ezibuhlungu. Ngethamsanqa, ezinye iindlela zokhathalela unyango, ezifana nokunyamekelwa kwe-chiropractic, kunokunceda ukubuyisela intlungu emva kokusetyenziswa kwemilenze kunye nokunyanzeliswa kwemigaqo, ekugqibeleni ukuphucula intlungu.
INGXELO EBALULEKILEYO: Uphulo lwe-Hip Pain Chiropractic Treatment
Ngenanto
Ucaphulo
1. IKrisimesi C, uCrespo CJ, uFranckowiak SC, et al. Ngaba ixhaphake kangakanani intlungu ye-hip phakathi kwabantu abadala? Iziphumo ezivela kuPhando lweSithathu lwezeMpilo kunye noVavanyo lweZondloJ Fam Pract. 2002;51(4):345�348.
2. URossi F, uDragoni S.Ukuqhaqhaqhaqhaqhaqhaqhaqhaqhaqhaqhaqhaqho kwesinqe kwiimbaleki ezikhuphisanayoSkeletal Radiol. 2001;30(3):127�131.
3. UMartin HD, uShears SA, uPalmer IJ. Uvavanyo lwenyongaI-Med Med Arthrosc. 2010;18(2):63�75.
4. I-Gough-Palmer A, McHugh K. Ukuphanda iintlungu zenyonga kumntwana ophilileyoBMJ. 2007;334(7605):1216�1217.
5. IBencardino JT, iPalmer WE. Ukulinganisa ukuphazamiseka kwenyonga kwiimbalekiRadiol Clinic North Am. 2002;40(2):267�287.
6. UCzerny C, uHofmann S, uNeuhold A, et al. Izilonda ze-acetabular labrum: ukuchaneka kwe-MR imaging kunye ne-MR arthrography ekufumaneni nasekubekeni inqanaba.Radiology. 1996;200(1):225�230.
7. UCzerny C, uHofmann S, uMdolophu M, et al. I-MR arthrography yabantu abadala ye-acetabular capsular-labral complexAJR Am J Roentgenol. 1999;173(2):345�349.
8. I-Deslandes M, uGuillin R, uKhadinali E, et al. Ukuqhawula i-iliopsoas tendon: iindlela ezintsha zisebenzisa i-sonography enamandlaAJR Am J Roentgenol. 2008;190(3):576�581.
9. IBlankenbaker DG, iDe Smet AA. Ukulimala kwe-Hip kwiimbalekiRadiol Clinic North Am. 2010;48(6):1155�1178.
10. I-Balint PV, iSturrock RD. Ukuphindaphinda kwe-intraobserver kunye nokuzala kwakhona kwe-interobserver kwimilinganiselo yokucinga ye-musculoskeletal ultrasound.Iiklinikhi Exp Rheumatol. 2001;19(1):89�92.
11. URamwadhdoebe S, uSakkers RJ, u-Uiterwaal CS, et al. Uvavanyo lwenkqubo yoqeqesho yokuvavanywa kwe-ultrasound ngokubanzi kuphuhliso lwe-dysplasia yenyonga kukhathalelo lwempilo yabantwana.Radiol. 2010;40(10):1634�1639.
12. UAltman R, uAlarc n G, u-Appelrouth D, et al. Ikholeji yaseMelika yeRheumatology criteria yokuhlela nokunika ingxelo ngethrayithisi yamalungu esinqeArthritis Rheum. 1991;34(5):505�514.
13. IBanerjee P, iMcLean CR. Ukunyanzeliswa kwabasetyhiniCurr Rev Musculoskelet Med. 2011;4(1):23�32.
14. UClohisy JC, uKnaus ER, uHunt DM, et al. Inkcazo yeklinikhi yezigulana ezineempawu ezibonakalayo zangaphambi kwenyongaClin Orthop Relat Res. 2009;467(3):638�644.
15. Ito K, Leunig M, Ganz R.Iimpawu zembali ye-acetabular labrum kwi-femoroacetabular impingement.Clin Orthop Relat Res. Ngo-2004; (429): 262-271.
16. I-Beall DP, iCF emnandi, uMartin HD, et al. Ukulinganisa ukufumanisa isifo se-femoroacetabular impingement syndromeSkeletal Radiol. 2005;34(11):691�701.
17. UBurnett RS, uDella Rocca GJ, uPrather H, et al. Inkcazo yeklinikhi yezigulana ezineenyembezi ze-acetabular labrumI-Bone Joint Surg Am. 2006;88(7):1448�1457.
18. ULeunig M, Werlen S, Ungersb ck A, et al. Ukuxhamla Uvavanyo lwe-acetabular labrum yi-MR arthrography [ukulungiswa okupapashiweyo kuvela kwi- I-Bone Joint Surg Br. Ngo-1997; 79 (4): 693]I-Bone Joint Surg Br. 1997;79(2):230�234.
19. U-Groh MM, uHerrera J. Uphengululo olubanzi lweenyembezi zenyongaCurr Rev Musculoskelet Med. 2009;2(2):105�117.
20. IBlankenbaker DG, iDe Smet AA, uKeene JS. I-Sonography ye-iliopsoas tendon kunye nenaliti ye-iliopsoas bursa yokufumanisa isifo kunye nolawulo lwe-hip snap ebuhlungu.Skeletal Radiol. 2006;35(8):565�571.
21. I-Egol KA, uKoval KJ, uKummer F, et al. Ubunzima Uxinzelelo lokophuka kwentamo yobufaziClin Orthop Relat Res. Ngo-1998; (348): 72-78.
22. UFullerton LR Jr, uSnowdy HA. Intamo yesetyhini ixinzelela ukwaphukaAm J Sports Med. 1988;16(4):365�377.
23. INewberg AH, iNewman JS. Ukulinganisa inyonga ebuhlunguClin Orthop Relat Res. Ngo-2003; (406): 19-28.
24. UMargaretten ME, uKohlwes J, Moore D, et al. Ngaba lo mntu ugulayo une-septic arthritis?JAMA. 2007;297(13):1478�1488.
25. I-Eich GF, Superti-Furga A, Umbricht FS, okqhubekayo. I-hip ebuhlungu: kuvavanyo lweekhrayitheriya zokwenza izigqibo ngeklinikhiEur J Pediatr. 1999;158(11):923�928.
26. IKocher MS, iZurakowski D, uKasser JR. Umahluko phakathi kwe-septic arthritis kunye ne-synovitis edlulayo yomlenze ebantwaneniI-Bone Joint Surg Am. 1999;81(12):1662�1670.
27. UMphathiswa TJ, uFarooki S. Imagnetic resonance imaging ye-septic arthritisKwiKlinikhi yokuCamngca. 2000;24(4):236�242.
28. U-Lee SK, uSuh KJ, uKim YW, okqhubekayo. I-Septic arthritis xa ithelekiswa ne-synovitis yexeshana kwi-MR imagingRadiology. 1999;211(2):459�465.
29. I-Leopold SS, iBattista V, u-Oliverio JA. Ukhuseleko kunye nokusebenza ngokuchanekileyo kwenaliti yangaphakathi ye-hip usebenzisa amanqaku e-anatomicClin Orthop Relat Res. 2001; (391): 192-197.
30. UMitchell DG, uRao VM, uDalinka MK, et al. Intloko yesifazana i-avascular necrosis: unxibelelwano lwe-MR imaging, i-radiographic staging, imaging ye-radionuclide, kunye nokufunyanwa kweklinikhi.Radiology. 1987;162(3):709�715.
31. IMont MA, iZywiel MG, iMarker DR, et al. Imbali yendalo ye-asymptomatic osteonecrosis yentloko yabasetyhiniI-Bone Joint Surg Am. 2010;92(12):2165�2170.
32. UAsouline-Dayan Y, uCh Chang C, uGreenspan A, et al. I-Pathogenesis kunye nembali yendalo ye-osteonecrosisI-Semin Arthritis Rheum. 2002;32(2):94�124.
33. Amanqaku WG, Murphy WA, Ganz WI, et al. Imagnetic resonance imaging yentloko yesiqhelo kunye neschemic yentloko yabasetyhiniAJR Am J Roentgenol. 1984;143(6):1273�1280.
34. I-Kirschner JS, i-Foye PM, uCole JL. Isifo sePiriformis, isifo kunye nonyangoUmzimba weMisipha. 2009;40(1):10�18.
35. IHopayian K, Ingoma F, uRiera R, et al. Iimpawu zeklinikhi zesifo sepiriformisEur Spine J. 2010;19(12):2095�2109.
36. UTorriani M, uSouto SC, uThomas BJ, et al. Ischiofemoral impingement syndrome. AJR Am J Roentgenol. 2009;193(1):186�190.
37. UAli AM, uWhitwell D, uOstlere SJ. Ingxelo yetyala: imaging kunye nonyango lotyando lwe-hip snap ngenxa ye-ischiofemoral impingementSkeletal Radiol. 2011;40(5):653�656.
38. U-Lee EY, uMargherita AJ, uGierada DS, et al. I-MRI yesifo sepiriformisAJR Am J Roentgenol. 2004;183(1):63�64.
39. USlipman CW, uJackson HB, uLetetz JS, et al. Imimandla yokudlulisa iintlungu ngokudibeneyoIArch Phys Med Rehabil. 2000;81(3):334�338.
40. Moore KL, Dalley AF, kunye neAgur AMI-Anatomy eViweyo. Umhla wesi-6. IPhiladelphia, Pa.: Lippincott Williams kunye noWilkins; Ngo-2010.
41. I-Adlakha S, iBurket M, Cooper C. Ungenelelo ngoncedo olunokubakho okungagungqiyo kwimithambo yangaphakathi ye-iliac yokugungxula i-buttock claudication.Catheter Cardiovasc Interv. 2009;74(2):257�259.
42. UBrown MD, uGomez-Marin O, uBrookfield KF, et al. Ukwahluka okwahlukileyo kwesifo se-hip xa kuthelekiswa nesifo somqoloClin Orthop Relat Res. 2004; (419): 280-284.
43. Segal NA, Felson DT, Torner JC, et al .; Iqela leMfundo yeOsteoarthritis yeMulticenter. Isifo seentlungu ezinkulu se-trochantericIArch Phys Med Rehabil. 2007;88(8):988�992.
44. I-Strauss EJ, uNho SJ, uKelly BT. Isifo seentlungu ezinkulu se-trochantericI-Med Med Arthrosc. 2010;18(2):113�119.
45. UWilliam BS, uCohen SP. Isifo seentlungu ezinkulu se-trochantericAnesth Analg. 2009;108(5):1662�1670.
46. UTibor LM, uSekiya JK. Ukwahluka okwahlukileyo kwentlungu ejikeleze amalungu omlenzeArthroscopy. 2008;24(12):1407�1421.
Vala i-Accordion
Umgangatho wobuchule wokuSebenza *
Ulwazi olulapha ku "Ukuvavanywa koMonde kunye ne-Hip Pain"Akujoliswanga ukuthatha indawo yobudlelwane obubodwa kunye nomntu oqeqeshiweyo wezempilo okanye ugqirha onelayisensi kwaye akusiyo isiluleko sonyango. Sikhuthaza ukuba wenze izigqibo zezempilo ngokusekelwe kuphando lwakho kunye nentsebenziswano kunye nochwepheshe bezempilo abaqeqeshiweyo.
Ulwazi lweBlog kunye neengxoxo zoMda
Umda wethu wolwazi ilinganiselwe kwiChiropractic, i-musculoskeletal, amayeza omzimba, impilo, igalelo le-etiological ukuphazamiseka kwe-viscerosomatic ngaphakathi kweentetho zeklinikhi, ezinxulumene ne-somatovisceral reflex clinical dynamics, i-subluxation complexes, imiba yezempilo ebuthathaka, kunye / okanye amanqaku amayeza asebenzayo, izihloko kunye neengxoxo.
Sibonelela kwaye sibonise intsebenziswano yeklinikhi neengcaphephe kumacandelo ahlukeneyo. Ingcali nganye ilawulwa ngumsebenzi wabo wobugcisa kunye negunya labo lokufumana iphepha-mvume. Sisebenzisa iiprothokholi ezisebenzayo zempilo kunye nempilo entle ukunyanga nokuxhasa ukhathalelo lokwenzakala okanye ukuphazamiseka kwenkqubo ye-musculoskeletal.
Iividiyo zethu, izithuba, izihloko, imixholo, kunye nokuqonda zibandakanya imiba yezonyango, imiba, kunye nezihloko eziyelelene kwaye zixhase ngokuthe ngqo okanye ngokungathanga ngqo umda wokuziqhelanisa wethu.
I-ofisi yethu izamile ngokufanelekileyo ukubonelela ngeengcaphulo ezixhasayo kwaye ichonge uphando olufanelekileyo lophando okanye izifundo ezixhasa izithuba zethu. Sinikezela ngeekopi zophando ezixhasayo ezifumanekayo kwiibhodi ezilawulayo nakuluntu ngesicelo.
Siyaqonda ukuba sigubungela imicimbi efuna inkcazo eyongezelelweyo yokuba inganceda njani kwisicwangciso esithile sokhathalelo okanye inkqubo yonyango; ke, ukuqhubeka nokuxoxa ngombandela ongentla, nceda ukhululeke ukubuza UDkt Alex Jimenez, DC, okanye qha ga mshelana nathi 915-850-0900.
Silapha ukunceda wena kunye nosapho lwakho.
Iintsikelelo
UDkt Alex Jimenez D.C., I-MSACP, RN*, I-CCST, IFMCP*, I-CIFM*, I-ATN*
email: qeqeshi@elpasofunctionalmedicine.com
Ilayisenisi njengoGqirha weChiropractic (DC) kwi Texas & New Mexico*
Texas DC Ilayisensi # TX5807, New Mexico DC Ilayisensi # I-NM-DC2182
Unikwe Ilayisensi njengoMongikazi oBhalisiweyo (RN*) in Florida
Florida License RN Ilayisensi # I-RN9617241 (Nombolo yolawulo. 3558029)
Ubume obubambeneyo: ILayisensi yeeNkcazo ezininzi: Ugunyaziswe Ukuziqhelanisa I-40 States*
UGqr. Alex Jimenez DC, MSACP, RN* CIFM*, IFMCP*, ATN*, CCST
Ikhadi lam loShishino lweDijithali
