I-Ankle kunye neenyawo Ukuxilongwa kwe-Arthritis & Trauma II | El Paso, TX.

I-Lisfranc Fracture-Dislocation

• M / C ukuchithwa kweenyawo kwintetho ye-tarsal-metatarsal (idibene yaseLisfranc). Impembelelo ngqo okanye ukuthutha kunye nokutshala okanye ukuguqula ukutshintsha kweenyawo. Lisfranc ligament ephethe isiseko se-2nd MT kunye ne-1st Cu ichithwe. Ibonisa okanye i-o / o ukuphulwa kwe-fracture-evulsion.
• Ukucinga: inyathelo le-1: i-rayography yonyawo kwiimeko ezininzi ezaneleyo kwi-Dx. I-MSK yaseMelika inokunceda: bonisa ukuphazamiseka kweCu1-Cu2. I-Ligament kunye nendawo ebanzi> 2.5mm. I-MRI inokunceda kodwa ayibalulekanga. Izinto zokuncedisa ukujonga ubunzima Dx.
• Iindidi ze-2: i-homolateral (i-1st MTP iqhagamshelana) kunye nokuhlukana (i-2-5 MT ihambelane ngokukhawuleza kunye ne-1st MT phakathi)
• Ulawulo: Ukulungiswa komsebenzi kubalulekile
• Ukuphazamiseka kwe-Atraumatic yaseLisfranc yintlupheko rhoqo yesifo sikashukela seCharcot

I-Osteochondral Injury yeTalus (OCD)

• Eziqhelekileyo. Ukungahambi kabuhlungu okufumaneka kwidome ye-talar ephezulu. Ingxaki echaphazelekayo inokuchaphazela idome ephezulu.
• Kwizonyango: intlungu / ukuxhamla / ukuvala. Ukucinga kubalulekile.
• Isinyathelo se-1st: i-radiografi ingabonisa ukuxhaswa kwe-radiolucent / halo, isahluko.
• MRI inceda esp. ukuba i-OCD iyigqirha kwaye ibonise i-edema ye-bone.
• Ulawulo: ongasebenziyo: ukukhangela imilenze emfutshane / ukuxhatshazwa-4-6 wk. esebenzayo: ukususwa kwe-arthrocsopic.
• Iingxaki: I-DJD yangaphambi kwe2nd

Ukulimala kweMatatarsal

• Ukuqhaqhaqhaqhaqhaqeka kunye noxinzelelo kuqhelekile: m / c 5th MT & 2, 3rd MT.
• Jones Fx: I-Fx eyongezelelekileyo ye-metaphysis ye-5th MT. Ikhokelwa kumanyano. Ngokuqhelekileyo ichanekile ngokusebenzayo.
• I-Pseudo-Jones: I-intra-articular avulsion ye-5th MT istloid / isiseko ngokuqina kwe-Peroneus Brevis M. Ulawulwa ngokufanelekileyo: i-boot-cast immobilization. Zombini iJones kunye nePseudo-Jones Dx ngothotho lwe-radiography.
• Uxinzelelo lweFx. ICalcaneus, yesi-2, yesi-3, yesi-5 yee-MT. Ukuphinda kulayishwe (kuyaqhutywa) okanye "Matshi unyawo" 2nd / 3rd MT. Klinikhi: iintlungu zomsebenzi, ezincitshiswe ngokuphumla. I-Dx: ii-x-ray zihlala zingabuyiseli ngaphambili. I-MRI okanye i-MSK US inokunceda. Ulawulo: Ngokulondolozwa. Iingxaki; inkqubela phambili kwiFx epheleleyo
• Inyosi yeTurf: ukuxhaphaza okuqhelekileyo kwezemidlalo ze-1st MTP-sesamoid/ plantar isicatshulwa esiyinkcenkcesha. I-1st MTP ayiqinisekanga / ikhululekile. Lawulwa ngokusebenzayo.

Isifo samathambo seenyawo kunye neqatha

• DJD ye-ankle: iqhelekileyo i-OA. Ngokuqhelekileyo ikhula njenge-2nd kwi-trauma / AVN, RA, CPPD, i-Hemophilic arthropathy, i-Juvenile Idiopathic Arthritis, njl njll ibonakalisa njenge-DJD: i-osteophytes, i-JSL, i-cycs subchondral yonke ebonwa kwi-ray-ray
• Arthritis evuthayo: I-RA ingahlakulela kuyo maqatha okanye nayiphi na intlangano ye synovial. Ngokuqhelekileyo iza kubonisa iiHands / iinyawo ezilinganayo RA ekuqaleni (i-2nd, i-3rd MCP, ii-WP, i-MTPs ezinyaweni) ngokuqhelekileyo kunye nokukhukhula, i-JSL efanayo, i-osteopenia ye-jticta-articular, kunye nokulibaziseka.
• I-HLA-B27 i-spondyloarthropathies: ixhaphaze ngokuqhelekileyo umgama osezantsi: isithende, i-ankle in Reactive (Reiter). Ukwanda kwamathambo okuvelisa i-Erosi ebaluleke kakhulu.
• Gouty Arthritis: eziqhelekileyo kumgca ophantsi. I-Ankle, ezinyaweni ezinyaweni nge-1st MTPs. Ukuqala kokuqala: isifo se-arthritis esisisigxina nge-ST effusion kunye no-erosions / tophi. I-gout yokuphefumula engapheliyo: i-peri-articular, intra-osseous-out-out-out exosions with edges-hanging edges, akukho JSL / osteopenia, ST. I-Tophi ibonakala.
• Uxinzelelo oluninzi: PVNS. Akuqhelekanga. Ichaphazela i-3-4th eminyaka yobomi. Isiphumo sokusasazeka kwe-synovial kunye ne-Macrophages kunye nee-cell nucleated Multi-cell ezinokuzaliswa kwe-hemosiderin kunye nobutyebi zingakhokelela ekubhubhiseni, umonakalo we-cartilage, umonakalo we-bone exerinsic. I-Dx: ii-ray-ray zizinzileyo, imodareythi yokuzikhethela. Synovial biopsy. Ulawulo: ukusebenza, kunokuba nzima.

Neuropathic Osteoarthropathy

• (Ilungu likaCharcot) Ngokuqhelekileyo kunye nokunyuka kwed / ubhubhane ngohlobo lwe-2 DM. Unokuthi ungabonakalisa ngentlungu ekuqaleni (50% yamatyala) kunye nobuthakathaka obubi obungonakaliyo njengobonakaliso obusemva kwexesha. Ekuqaleni kweDx: ukulibaziseka. Ukucingwa kubalulekile: x-ray: ekuqalekeni ukungabonakali, ukukhwabanisa kwe-SF kubonakala. I-MRI inceda nge-Dx yokuqala kunye neyokuphela kokulayishwa. Ixesha elide Dx: ukuchithwa okungenakuguquka, ukuwa, ukukhubazeka. Qaphela: Ukutshintshwa kokungeniswa kwempahla kwi-Charcot ngokubambisana
• I-M / C phakathi kweenyawo (i-TM joint) kwi-40% yamatyala, i-ankle 15%. Inkqubela: Iinyawo-ezantsi, isilonda, izifo, ukunyuka kwamanzi kunye nokufa.
• Ukuqala kweDx: nge-MRI ibalulekile. Mxhomekeke kwizigulane ezine-type 2 DM ngokukodwa xa ubuhlungu bokuqala beinyawo / iintlungu ze-ankle zibikwe.

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