Ukuvavanywa kwabagulana ukuhambisa nge-Knee Pain: Icandelo II. Ukuxilongwa ngokungafani

Amadolo awona manqaku amakhulu emzimbeni womntu, apho izakhiwo eziyinkimbinkimbi zemilenze engaphantsi nephezulu zihlangene. Ukuxhomekeka kwamathambo amathathu, i-femur, i-tibia, kunye ne-patella ejikelezwe ziintlobo ezinamaqhina adibeneyo, kuquka i-cartilage, i-tendon kunye nemigqa, i-knee isebenza njenge-hinge, ikuvumela ukuba uhambe, ugxume, u-squat okanye uhlale. Ngenxa yoko, nangona kunjalo, idolo libhekwa njengelinye lamalungu amaninzi afanelekile ukuhlaselwa. Ukulimala kwamadolo yisona sizathu esibalulekileyo buhlungu.

Ukulimala kwamadolo kungenzeka ngenxa yempembelelo ngqo kwi-accident ye-slip-falling-accident okanye imoto yengozi, ukulimala ngokugqithiseleyo kwingozi yemidlalo, okanye ngenxa yeemeko ezinjenge-arthritis. Intlungu yesisu ngumqondiso oqhelekileyo ochaphazela abantu babo bonke ubudala. Ikwaqala kwakhona ngokukhawuleza okanye ithuthuke ngokuthe ngcembe kwexesha, ukuqala njengentlungu emncinci okanye ngokuthe ngcipheko ngokunyuka ngokukhawuleza njengoko ixesha liqhubeka. Ngaphezu koko, ukunyamezela kunokwandisa ingozi yamadolo. Injongo yale nqaku ilandelayo kukuxubusha ukuvavanywa kwezigulane ezenza ubuhlungu beentolo kwaye zibonise ukuxilongwa kwazo ngokwahlukileyo.

Abstract

Intlungu yamadolo sisikhalazo esiqhelekileyo sokubonisa ngezizathu ezininzi ezinokubangela. Ukwaziswa kweepateni ezithile kunokunceda ugqirha wosapho ukuba abone oyena nobangela ngokufanelekileyo. Amantombazana akwishumi elivisayo kunye nabasetyhini abasebancinci kunokwenzeka ukuba babe neengxaki zokulandela umkhondo njenge patellar subluxation kunye ne patellofemoral syndrome, ngelixa amakhwenkwe akwishumi elivisayo kunye nabafana abancinci banamathuba okuba neengxaki zedolo ezifana ne-tibial apophysitis (i-Osgood-Schlatter lesion) kunye ne-patellar tendonitis . Iintlungu ezichaziweyo ezibangelwa kukudumba okuhlangeneyo, njengokutsalwa kwemali eyinkunzi epiphysis, nayo inokubangela iintlungu emadolweni. Izigulana ezisebenzayo kunokwenzeka ukuba zibe ne-ligamentous sprains kunye nokulimala kakhulu okufana ne-pes anserine bursitis kunye ne-medial plica syndrome. Umothuko unokubangela ukophuka okuqatha okanye ukuqhekeka, okukhokelela kukudumba ngokudibeneyo kunye ne-hemarthrosis. I-Septic arthritis inokukhula kwizigulana zanoma yiphina iminyaka, kodwa i-arthropathy yokunyanzeliswa kwe-crystal inokwenzeka kubantu abadala. I-Osteoarthritis yedolo elihlangeneyo liqhelekile kubantu abadala. (NdinguGqirha weNdawo u-2003; 68: 917-22. Ilungelo lokushicilela ngo-2003 iAmerican Academy yoGqirha boSapho.)

intshayelelo

Ukugqiba isizathu esisisiseko sentlungu yamadolo kunokuba nzima, inxalenye ngenxa yokuxilongwa okubanzi kokuhlukana. Njengoko kuxutyushwa kwinxalenye I yale nqaku yamacandelo amabini, i-1 ugqirha wentsapho kufuneka aqhelane ne-knee anatomy kunye neendlela eziqhelekileyo zokulimala, kunye nembali ecacileyo kunye nokuhlolwa okugxilwe ngokomzimba kunokunciphisa izizathu ezinokwenzeka. Ubudala besigulane kunye nendawo ye-anatomic yentlungu zizinto ezimbini ezinokubaluleka ekufezekiseni ukuxilongwa ngokuchanekileyo (Iitheyibhile 1 kunye ne-2). �

Abantwana kunye nentsha

Abantwana kunye nabaselula abasondela ngeentlungu zedolo banokuba neemeko ezintathu eziqhelekileyo: i-patellar subluxation, tibial apophysitis, okanye i-patellar tendonitis. Ukuxilongwa okongeziweyo kokuqwalasela kubantwana kubandakanya ukunyusa i-epiphysis ye-femoral kunye ne-septic arthritis.

I-Patellar Subluxation

I-Patellar subluxation yinkcazo ebonakalayo kwintombazana ekhulayo eyenza ngeendlela zokunika i-knee .2 Oku kwenzakala kubangelwa kaninzi kumantombazana kunye nabasetyhini abancinci ngenxa yokwanda kwe-quadriceps (i-angle engama-Q), ngokuqhelekileyo kunamadrikhi e-15.

Ukukhathazeka kwe-Patellar kuyanqunyulwa ngokuxhomekeka kwe-patella kamva, kwaye kudla ngokukhawuleza. Ukuqhaqha kwamadolo okuxinayo kungabonakalisa i-hemarthrosis, ebonisa ukuba i-patellar ichithwa kunye ne-osteochondral fracture kunye negazi.

Tibial Apophysitis

Umfana osemncinci oveza ubuhlungu bendoda engama-knee kwi-tibial tuberosity kungenzeka ukuba abe ne-tibial apophysitis okanye i-Osgood -Sillatter lesion3,4 (umfanekiso we1) .5 Umguli oqhelekileyo ungumfana we-13 okanye we-14 ubudala (okanye i-10- okanye intombazana eneminyaka eyi-11) esandula ukuhamba ngokukhula.

Isigulane esine-tibial apophysitis sichaza ngokubanzi ukuxutywa kunye nokuncipha kweentlungu zedolo ixesha leenyanga. Iintlungu ziba mandundu xa u-squatting, ukunyuka okanye ukuhla izinyuko, okanye ukufinyaniswa okunamandla kwezihlunu ze-quadriceps. Le apophysitis yokusetyenziswa ngokugqithiseleyo igqithiswa ngokuxhuma kunye nokuphosa ngenxa yokuba ukuhlalisa okuphindaphindiweyo kubeka uxinzelelo olugqithisileyo ekufakweni kwe-tendon patellar.

Ekuhlolweni komzimba, i-tuberosity ye-tibial ithenda kwaye idumbile kwaye inokufudumala. Iintlungu zedolo ziveliswa kwakhona kunye nokwandiswa okusebenzayo okuchasayo okanye i-hyperflexion ye-passive yamadolo. Akukho nto ikhoyo. Iiradiographs zidla ngokuba zi-negative; ngokungaqhelekanga, babonisa ukuvuswa kwe-apophysis kwi-tuberosity ye-tibial. Nangona kunjalo, ugqirha akafanele enze iphutha ukubonakala okuqhelekileyo kwe-tibial apophysis yokuphuka kwe-avulsion. �

Patellar Tendonitis

Idolo leJumper (ukucaphuka kunye nokudumba kwetellar tendon) kuxhaphake kakhulu kubafana abakwishumi elivisayo, ngakumbi ngexesha lokukhula2 (Umzobo 1) .5 Isigulana sinika ingxelo engacacanga yentlungu engaphandle yedolo eqhubekeke iinyanga kwaye iba mandundu emva kwemisebenzi efana nokuhamba phantsi izitepsi okanye ukubaleka.

Kuhlolisiso lomzimba, ithenda ye-patellar ithenda, kwaye intlungu iveliswa ngokunyuswa kwamadolo. Ngokuqhelekileyo akukho nkunkuma. Iidrafrafikhi azibonakalwanga.

I-Slipped Capital Femoral Epiphysis

Iimeko ezininzi zezilwanyana zibangelwa ukuthunyelwa kwentlungu emadolweni. Ngokomzekelo, ukutsalwa kwe-epiphysis ye-capital femel kufuneka iqwalaselwe kubantwana nakwishumi elivisayo elinobuhlungu bexolo.6 Isigulane esinalo meko sihlala sichaza ubuhlungu bendoda engendawo kwaye akukho mlando wexinzelelo.

Isigulane esifana nesigxina esiphezulu se-epiphysis ye-femor isaphezu komzimba kwaye ihleli kwitafile yeemviwo kunye ne-hip echaphazelekayo iguquguquke kwaye ijikeleze ngaphandle. Ukuhlolwa kweedolo kuyinto eqhelekileyo, kodwa intlungu ye-hip isenziwa ngokujikeleza kwangaphakathi okanye ukongezwa kwe-hip echaphazelekayo.

Ii-radiographs zibonisa ukufuduka kwe-Epiphysis ye-head head. Nangona kunjalo, i-radiographs engakhiyo ilawule ukuxilongwa kwezigulane ezinokufumana iziphumo zonyango. Ukukhangela kwe-tomuted (CT) ekhompyutheni kuboniswa kwezi zi gulane.

Osteochondritis Dissecans

I-Osteochondritis dissecans yinto e-articular osteochondrosis ye-etiology engaziwayo ebonakala ngokutshabalalisa nokuhlaziywa kwe-articalular cartilage kunye namathambo angaphantsi. Kwidolo, i-condyle ye-femoral ixhaphake kakhulu.7

Isigulane sibika iingcamango ezingaqhelekanga, ubuhlungu bendoda engendawo, kunye nokuqina kokusa okanye ukuchithwa okuphindaphindiweyo. Ukuba umzimba ovulekileyo ukhona, iimpawu zokungena okanye ukubamba ixolo kunye nazo zingabikwa. Ekuhloleni ngokomzimba, isigulane sinokubonisa i-quadriceps i-atrophy okanye isisa kunye ne-chondral ebandakanyekayo. Umonakalo odibeneyo onokubakho ungaba khona.7

I-radiographs ye-Plain-film ingabonisa isilonda se-osteochondral okanye umzimba okhululekile kwi-joint joint. Ukuba i-osteochondritis dissecans iyakrokrelwa, ii-radiographs ezicetyiswayo ziquka i-anteroposterior, itonela ye-posteroanterior, i-lateral, kunye neembono zoMrhwebi. Izilonda ze-Osteochondral kwi-lateral ye-condyle ye-femoral ephakathi zinokubonakala kuphela kwi-postteroanterior tunnel view. I-Magnetic resonance imaging (MRI) inovakalelo oluphezulu ekuboneni ezi zinto zingaqhelekanga kwaye iboniswa kwizigulane ezine-lesion osteochondral ekrokrelekayo.7 �

Ukulimala kwamadolo okubangelwa ukulimala kwezemidlalo, izingozi zeemoto, okanye imeko ephantsi, phakathi kwezinye izizathu, kunokuchaphazela i-cartilage, i-tendon kunye nemigqa edibanisa idolo. Indawo yokudabuka kwamadolo ahluke ngohlobo lwesakhiwo esithintekayo, kwakhona, iimpawu ziyahluka. Amadolo onke angaba buhlungu kwaye avuvuke ngenxa yokuvuvukala okanye usulelo, kanti i-meniscus okanye i-fracture eqhekekileyo ingabangela iimpawu kwiindawo ezichaphazelekayo. UDkt Alex Jimenez DC, i-CCST Insight

abadala

Ukusetyenziswa kweSyncromes

Interior Knee Pain. Izigulana ezine-patellofemoral pain syndrome (i-chondromalacia patellae) zihlala zinembali engacacanga yokuqaqanjelwa ngamadolo okuqala ukuya kumodareyitha okuhlala kwenzeka emva kwexesha elide lokuhlala (oko kubizwa ngokuba yi- theater sign ) .8 Patellofemoral pain syndrome sisizathu esiqhelekileyo iintlungu zangaphambili zamadolo kubafazi.

Kuvavanyo lomzimba, ukunganyanzeliswa okuncinci kunokuba khona, kunye ne-patellar crepitus kuluhlu lokuhamba. Intlungu yesigulana inokuphinda iveliswe ngokufaka uxinzelelo ngokuthe ngqo kumbonakalo wangaphandle wepatella. I-Patellar tenderness inokuphakanyiswa ngokufaka i-patella ngaphakathi okanye emva kwexesha kwaye iphakamise amanqaku aphezulu kunye nephantsi kwepatella. Radiographs zihlala zingaboniswanga.

Ubuhlungu Bomzimba Ophakathi. Enye into ehlala igujulwa ngayo i-plica syndrome. I-plica, i-redundancy ye-synovium edibeneyo, iyakwazi ukutshatyalaliswa ngokuphindaphindiweyo.4,9 Isigulane sibonisa ukuqala kabuhlungu kwintlungu yokuguqula idolo emva kokunyuka okuphawulekayo kwimisebenzi eqhelekileyo. Kuhlolisiso lomzimba, ithenda, ukuxhaswa kweselula kufumaneke kwimiba emxhatshazo emadolweni, nje kumgca kumgca odibeneyo. Akukho mveliso ehlangeneyo, kwaye isisele se-knee uvavanyo luqhelekile. Iidrafrafikhi azibonakalwanga.

I-Pes anserine bursitis ngomnye unobangela onokubakho wentlungu yedolo eliphakathi. Ukufakwa kwe-tendinous ye-sartorius, i-gracilis, kunye nemisipha ye-semitendinosus kwinqanaba le-anteromedial ye-proximal tibia yenza i-pes anserine bursa.9 I-bursa inokutsha ngenxa yokusetyenziswa ngokugqithiseleyo okanye ukuxhatshazwa ngokuthe ngqo. I-Pesânserine bursitis inokubhidaniswa ngokulula kunye ne-medial collateral ligament sprain okanye, ngokungaqhelekanga, i-osteoarthritis yecandelo eliphakathi kwedolo. �

Isigulane nge pes pes anserine bursitis sigxeka intlungu kwizinto eziphambene namadolo. Le ntlungu ingaba nzima ngakumbi ngokuphindaphindiweyo kunye nokwandiswa. Kuhlolisiso lomzimba, ububele bukhona kwimiba emxolweni yexolo, nje emva komda kwaye uphazamise kumgca odibeneyo ophakathi. Akukho ukuxubana kwamadolo okuhlangeneyo okukhoyo, kodwa kunokubakho ukuqhubela okuncane ekufakeni ukuxhamla kwemizimba. Ukuhlolwa koxinzelelo lwe-Valgus kwindawo ephakamileyo okanye ukuxhathisa ukuguqa kwamadolo kwisimo esifanelekileyo kunokuvelisa intlungu. Iidrafiografi ayidlalwa.

I-Lateral Pain Pain. Ukuqhaqhaqhaqhaqha phakathi kwebhodi yeliyobial kunye ne-condyle ye-femal yesikhokelo kungabangela i-tendonitis ye-band i-liyobial. I-9 Le syndrome engaphezulu kakhulu ivela kubagijimi nabaqhubi, nangona ingahlakulela kunoma yimuphi umntu emva komsebenzi obandakanya ukuphindaphinda kwamadolo. Ubunzima bebhanti ye-aliotibial, ukunyanyiswa kweenyawo ezininzi, i-genu varum, kunye ne-tibial torsion ziyizinto eziphambili.

Isigulane nge-tendonitis yebhanti ye-aliotibial ibika iingxwaba kwiindawo ezixhamlayo zexolo. Intlungu iqhutywe ngumsebenzi, ngokukodwa ukuhla kwehla kunye nokunyuka kwezitepsi. Kuhlolisiso lomzimba, ububele bukhona kwi-epicondyle ye-lateral ye-femur, malunga ne-3 cm ecaleni komgca odibeneyo. Ukuvuvukala kwamathambo kunye ne-crepitus kungabikho, kodwa akukho mveliso ehlangeneyo. Iidrafrafikhi azibonakalwanga.

Uvavanyo lweNoble lusetyenziselwa ukuvelisa kwakhona iintlungu kwi-iliotibial band tendonitis. Xa isigulana sikwindawo ethe tyaba, ugqirha ubeka ubhontsi phezu kwe-femoral epicondyle esecaleni njengoko isigulana siguquguquka ngokuphindaphindiweyo kwaye sandise idolo. Iimpawu zentlungu zihlala zibalaseleyo ngamadolo kwi-30 degrees of flexion.

I-popliteus tendonitis yinto ebangela ukuba ubuhlungu bendoda buxakeke. Nangona kunjalo, le meko ayinqabile.10

I ngxaki

I-Ligament yesiGaba esiPhakathi. Ukwenzakala kwimbumbulu yomphambili wangaphakathi kuhlala kwenzeka ngenxa yokungabikho koqhakamshelwano lokuncipha, njengaxa imbaleki ityala inyawo elinye kwaye ijikele kwelinye icala. Iziphumo zoxinzelelo lwevalgus emadolweni zikhokelela ekufudukeni kwangaphandle kwe-tibia kunye nokutsala okanye ukuqhekeka kwe-ligament.11 Isigulana sihlala sinika ingxelo yokuva okanye yokuziva i- pop ngexesha lokwenzakala kwaye kufuneka ayeke umsebenzi okanye ukhuphiswano kwangoko. Ukuvuvukala kwamadolo ngaphakathi kweeyure ezimbini emva kokulimala kubonisa ukuphuka kwe-ligament kunye ne-hemarthrosis elandelayo.

Ekuhloliseni ngokomzimba, isigulane sinomlinganiselo ochanekileyo wokuxuba ohlangeneyo owenza umda wokuhamba. Uvavanyo lwe-drawer yangaphakathi lunokuba luhle, kodwa lunokuba lubi ngenxa ye-hemarthrosis kunye nokulinda ngentshontsho. Uvavanyo lweLachman lufanele lube lukhuthaze kwaye lunokwethenjelwa kunokuba luvavanyo lwe-drawer yangaphambili (bona itekisi kunye nomfanekiso 3 inxalenye yendiqendu1).

Iidrafiographs ziboniswa ukuba zibone ukuphulwa komkhuhlane we-tibial. I-MRI yamadolo iboniswe njengenxalenye yolu vavanyo lwezonyango.

IsiLigamental Collateral Ligament. Ukulimala kwi-ligament ye-collateral ligament ngokuqhelekileyo kwaye ngokuqhelekileyo kubangelwa yintlungu. Isigulane sichaza ukugqithisa okanye ukudibanisa okubeka uxinzelelo lwe-valgus emadolweni, olulandelwa kukuqala kwentlungu kunye nokuvuvukala kwimpembelelo yexolo.11

Ekuhlolweni komzimba, isigulane esine-medial collateral ligament ukulimala sinophawu lwethenda kumgca we-medial joint. Uvavanyo loxinzelelo lwe-Valgus lwamadolo oluguquguqukayo ukuya kwii-degrees ze-30 luvelisa intlungu (jonga isicatshulwa kunye nomfanekiso we-4 inxalenye yeli nqaku1). Isiphelo esicacileyo esicacileyo sovavanyo loxinzelelo lwe-valgus lubonisa ibakala 1� okanye i-2 sprain, ngelixa ukungazinzi okupheleleyo kwe-medial kubonisa ukuphuka okupheleleyo kwe-ligament (i-grade 3 sprain).

I-Ligament Ligamental Collateral. Ukulimala kwe-ligal colalateral ligament ayifani ngokuqhelekileyo kunobungozi be-collateral ligament. I-latalal collateral ligament ixhomekeke kwimpembelelo ye-varus ukuya emadolweni, njengokuba kwenzeka xa umgijimi enyantya enye inyawo aze aphendukele kwi-knee ehambayo .2 Isigulane sichaza ngokuqaqambile kwintlungu yomzimba efuna ukuphelelwa komsebenzi ngokukhawuleza.

Ekuhloliseni ngokomzimba, ixabiso lentetho likhoyo kumgca wokudibanisa. Ukukhubazeka okanye intlungu kuqhutyelwa uvavanyo lwe-varus lokuxilongwa kwegolo oluguquguqukayo kwii-30 degrees (bona itekisi kunye ne-4 kwiNgxenye yeli nqaku1). Ii-radiographs aziqhelekanga kubonisiwe.

I-Meniscal Tear. I-meniscus inokutshatyalaliswa ngokukhawuleza kokulimala kwamadolo, njengokuba kunokuthi kwenzeke xa umgijimi eguquka ngokukhawuleza. I-11,12 Meniscal iinyembezi nazo zinokuthi zenzeke ngokubambisana nenkqubo yokuchitha ixesha elide, ngokukodwa kwisigulane esinomdla ongaphaya kwegciwane. idolo. Isigulane sivame ukubika ubuhlungu bentolo ephindaphindiweyo kunye neengqungquthela zokubamba okanye ukuvalela emadolweni, ngokukodwa ngokukrazula okanye ukuguqulwa kwamadolo.

Kuhlolisiso lomzimba, ukuxhatshaza okucothayo kubakho, kwaye kukho ububele kumgca odibeneyo okanye ohlangeneyo. I-Atrophy ye-vastus medialis obliquus isahlulo se-quadriceps muscle nayo inokubonakala. Uvavanyo lukaMcMurray lunokuba luhle (jonga umfanekiso we-5 kwinxalenye yendi nqaku1), kodwa ukuvavanywa kakubi akupheli ithuba lokulila.

I-radiographs ye-Plain-radiographs ngokuvamile ayibi kwaye ayifumaneki ngokucacileyo. I-MRI yiyo vavanyo lwe-radiologic olukhethiweyo kuba lubonisa iintlungu ezininzi ezibonakalayo.

Sulelo

Usulelo lwedolo lunokuthi lwenzeke kwizigulana nabuphi na ubudala kodwa luxhaphake ngakumbi kwabo amajoni omzimba abuthathaka ngenxa yomhlaza, isifo seswekile, ukunxila, “i-acquired immunodeficiency syndrome, okanye unyango lwe-corticosteroid. Isigulana esine-septic arthritis sibika ngokukhawuleza iintlungu kunye nokuvuvukala kwedolo ngaphandle kwe-antecedent trauma.13

Ekuhloleni ngokomzimba, idolo lifudumala, liyathukuthela, kwaye lithemba kakhulu. Nokuba ukunyuswa okufutshane kwendoda kubangele ubuhlungu obukhulu.

IArthrocentesis ityhila i-turbid synovial fluid. Uhlalutyo lolwelo luvelisa inani leeseli ezimhlophe zegazi (i-WBC) ngaphezulu kwama-50,000 nge-mm3 (50? 109 nge-L), ngaphezulu kwe-75 yeepesenti (0.75) iiseli zepolymorphonuclear, umxholo weprotheni ophakamileyo (ngaphezulu kwe-3 g nge-dL [30 g nge-L]), kunye noxinaniso lweswekile esezantsi (ngaphezulu kweepesenti ezingama-50 ezantsi kune-serum glucose concentration). Izifo eziqhelekileyo zibandakanya i-Staphylococcus aureus, iintlobo ze-Streptococcus, i-Haemophilus influenza kunye ne-Neisseria gonorrhoeae.

Ucwaningo lwe-Hematologic lubonisa i-WBC ephakamileyo, inani elinyukayo lamaseli e-polymoronekliya angaphantsi (okt, ukutshintshwa kwesobunxele), kunye ne-elethrocyte ye-sedimentation yezinga eliphezulu (ngokuqhelekileyo likhulu kune-50 mm ngeyure).

Abadala abadala

Osteoarthritis

I-osteoarthritis yexolo elidityanisiweyo yingxaki efanayo emva kweminyaka eyi-60. Isigulane sibonisa ubuhlungu besidolo esixhaswa yimisebenzi yokuthwala ubunzima kunye nokukhululeka ngokuphumla.15 Isigulane asikho iimpawu zenkqubo kodwa sivame ukuvusa ubunzima obusasaza obunokwenza umsebenzi othile. Ukongezelela kokuqina okungapheliyo kunye nentlungu, isigulane singabika iziqendu ze synovitis.

Iziphumo ekuhloliseni ngokomzimba ziquka ukuhla kweendonga zokunyakaza, i-crepitus, ukuchithwa okubambileyo kunye neenguqu ze-osteophytic ezitshintshiweyo emadolweni.

Xa i-osteoarthritis irhanelwa, ii-radiographs ezicetyiswayo ziquka i-anteroposterior kunye neembono ze-tunnel ze-posteroanterior, kunye nabathengisi abangenabunzima kunye neembono zecala. Iiradiographs zibonisa ukuncipha kwendawo edibeneyo, i-subchondral bony sclerosis, utshintsho lwe-cystic, kunye nokwakheka kwe-hypertrophic osteophyte.

I-Crystal-Impuced Inflammatory Arthropathy

Ukuqhaqhazela, intlungu kunye nokuvuvukala ekungabikho kwexinzelelo kubonisa ukuba kungenzeka ukunyuka kwe-crystal -ducedduced inflammatory arthropathy efana ne-gout okanye i-pseudogout.16,17 Gout ixhaphaza kakhulu idolo. Kule ngqungquthela, i-sodium urate crystals iyancipha kwi-knee kunye kwaye ibangela impendulo evuzayo. Kwi-pseudogout, i-calcium pyrophosphate crystals yi-agent engumzekelo.

Ekuhloliseni ngokomzimba, idolo elihlangeneyo lithengeleka, lifudumala, lithenda, kwaye livuvuka. Nangona uluhlu oluncinane lokunyakaza lubuhlungu kakhulu.

I-Arthrocentesis ityhila ulwelo olucacileyo okanye olunamafu kancinci. Uhlalutyo lolwelo luvelisa inani le-WBC lama-2,000 75,000 ukuya kuma-3 nge-mm2 (75 ukuya kwi-109? 32 nge-L), umxholo ophezulu weprotheni (ngaphezulu kwama-320 g nge-dL nganye (i-75 g nge-L]), kunye ne-glucose concentration Iipesenti ezingama-14 ze-serum glucose kugxininiso.XNUMX I-microscopy ekhanyayo ye-synovial fluid ibonisa iintonga ezinobungozi ezimbi kwisigulana esine-gout kunye ne-rhomboids eyi-birefringent ngokuqinisekileyo kwisigulana esine-pseudogout.

Popliteal Cyst

I-cyst popliteal cyst (Baker's cyst) yeyona cynovial cyst ixhaphakileyo edolweni. Ivela kwinqanaba lokudibana kwamadolo kwinqanaba le-gastrocnemio-semimembranous bursa. Isigulana sichaza ukuqala okunganyamezelekiyo kwintlungu ethambileyo ukuya kumodareyitha kwindawo epliteal yasedolweni.

Kuhlolisiso lomzimba, ukuzaliseka okubonakalayo kubakho kwimimandla ephakathi kwendawo ye-popliteal, okanye kufuphi nemvelaphi yintloko yentloko ye-gastrocnemius muscle. Uvavanyo lukaMcMurray lunokuthi lube lukhuthaze ukuba i-meniscus yenzelwa ingozi. Ukuxilongwa okucacileyo kwe-cyst popititis kungenziwa nge-arthrography, i-ultrasonography, i-CT, okanye i-MRI.

Ababhali babonisa ukuba abanalo iimbambano zomdla. Imithombo yenkxaso: ayikho ingxelo.

Ekugqibeleni, nangona idolo lihlangene kakhulu emzimbeni womntu apho kuhlanganiswe khona izakhiwo zamagqabi angaphantsi, kuquka i-femur, i-tibia, i-patella kunye nezinye izicubu ezincinci, idolo lingakwazi ukulimala okanye ukulimala kwaye buhlungu. Intlungu yesisu yenye yezona zikhalazo eziqhelekileyo phakathi koluntu jikelele, nangona kunjalo, ngokuqhelekileyo kubonakala kubadlali. Ukulimala kwezemidlalo, izingozi ze-slip-and-falling, kunye neengozi zezimoto, phakathi kwezinye izizathu, kunokukhokelela ekubuhlungu kweendolo.

Njengoko kuchazwe kwinqaku elingentla, ukuxilongwa kubalulekile ekunqumeni indlela yonyango engcono kakhulu yokulimala kwamadolo, ngokwezizathu zabo. Nangona indawo kunye nobukhulu bokulimala kwamadolo kunokuhluka ngokuxhomekeka kwisizathu somcimbi wezempilo, iintlungu zedolo ziyimpawu eziqhelekileyo. Izinketho zonyango, ezifana nokunyamekela kwe-chiropractic kunye nonyango lomzimba, lunokunceda ukunyanga iintlungu zamadolo. Ubungakanani bolwazi lwethu lukhawulelwe kwi-chiropractic kunye nemiba yempilo yomgogodla. Ukuxoxa ngalo mbandela, nceda uzive ukhululekile ukubuza uGqr. Jimenez okanye uqhagamshelane nathi apha915-850-0900 .

Ikhethwe nguGqirha Alex Jimenez

Ingongoma eyongezelelweyo Ingxoxo: Ukuxoxisa ubuhlungu be-Knee Pain ngaphandle kokuPhenywa

Intlungu yedolo luphawu olwaziwayo olunokuthi lwenzeke ngenxa yeengozi zamadolo kunye / okanye iimeko, kubandakanya ukulimala kwezemidlalo. Amadolo ngenye yezona zinto ezinzima kakhulu emzimbeni womntu njengoko zenziwe yintlupheko yamathambo amane, iigamente ezine, iintlobo ezihlukahlukeneyo, i-menisci emibini, kunye ne-cartilage. Ngokwe-American Academy ye-Family Physicians, izizathu eziqhelekileyo zokubandezeleka kwamadolo zibandakanya i-patellar subluxation, i-patellar tendinitis okanye i-jumper, kunye ne-Osgood-Schlatter. Nangona ubuhlungu beentolo buya kwenzeka kubantu abantu abangaphezu kwe-60 ubudala, ubuhlungu beendolo buya kwenzeka kubantwana nakwishumi elivisayo. Iintlungu zesisu zingaphathwa ekhaya emva kweendlela ze-RICE, nangona kunjalo, ukulimala kwamadolo amakhulu kunokufuna ukunyangwa kwangoko kunyango, kubandakanya ukunakekelwa kwe-chiropractic.

I-EXTRA EXTRA | INGXELO EBALULEKILEYO: El Paso, TX I-Chiropractor Kunconywe