Arthritis
IQela leKlinikhi eNgemva kweArthritis. I-arthritis sisifo esixhaphakileyo kodwa asiqondwa kakuhle. Igama elithi arthritis alibonisi isifo esinye kodwa libhekisela kwiintlungu zamalungu okanye izifo ezidibeneyo. I-100 iintlobo ezahlukeneyo ezikhoyo. Abantu bayo yonke iminyaka, isondo kunye neentlanga banokuhlakulela isifo samathambo. Ngoyena nobangela uphambili wokukhubazeka eMelika. Abantu abadala abangaphezu kwezigidi ezingama-50 kunye nabantwana be-300,000 banohlobo oluthile lwentlungu edibeneyo okanye isifo. Ixhaphakile phakathi kwabasetyhini kwaye iyenzeka ngakumbi njengoko abantu besiya bekhula. Iimpawu ziquka ukuvuvukala, intlungu, ukuqina, kunye nokunciphisa uluhlu lokunyakaza (ROM).
Iimpawu zinokuza kwaye zihambe, kwaye zinokuba buthathaka, ziphakathi, okanye ziqatha. Basenokuhlala befana iminyaka kodwa banokuba mandundu ngokuhamba kwexesha. Kwiimeko ezinzima, kunokubangela intlungu engapheliyo, ukungakwazi ukwenza imisebenzi yemihla ngemihla kunye nobunzima bokuhamba okanye ukunyuka izitebhisi. Inokubangela umonakalo odibeneyo osisigxina kunye notshintsho. Olu tshintsho lusenokubonakala, oko kukuthi, amalungu omnwe we-knobby, kodwa aqhele ukubonwa kuphela kwi-x-reyi. Ezinye iintlobo zesifo samathambo zichaphazela amehlo, intliziyo, izintso, imiphunga nolusu.
by UGqr Alex Jimenez | Arthritis
Ukunciphisa uxinzelelo ibalulekile kwimpilo-ntle yempilo kunye nasemzimbeni. IRumatoid isifo samathambo yimeko entsonkothileyo enganyangiyo kwaye inokubangela iintlungu ezingapheliyo. Uxinzelelo lwenza kuphela iimpawu, luchaphazele ukuqonda, kwaye buthathaka umzimba. Ukulawulwa koxinzelelo kubaluleke kakhulu ekunciphiseni iintlungu. Kwimeko ebuthathaka, umntu usengozini ngakumbi kwiimpawu zamathambo, ezifana Ukugqabhuka, ubuthathaka, kunye nokudinwaI-Chiropractic inokunceda.
Kukho unyango olungalwenziyo unyango lwamathambo, njengamayeza, unyango lomzimba kunye nonyango lokuthomalalisa imeko yobume bemeko. Ngu Ukususa izinto ezinokubangela uxinzelelo kunye nokwenza iinguqu kwindlela yokuziphatha / yokuphila umbono ongcono wokuba sempilweni unokufezekiswa.
Iimpawu ezahlukeneyo zingaqhuba:
- Ukudideka
- unxunguphalo
- Intukuthelo
- Buhlungu
- Ukunceda
Kwaye zonke ezi mvakalelo zinokuvelisa uxinzelelo olukhulu kumntu ngamnye. I-Chiropractic igqwesa kakuhle kwaye ixhaphake kakhulu kubantu abatyelele iikliniki ze-chiropractic ukunyanga iintlobo ezahlukeneyo zeempawu zentlungu kunye neemeko. Uhlengahlengiso lweChiropractic lubonelela izibonelelo ezingenakubalwa kwabo banazo isifo samathambo. Siza kuvavanya indlela i-chiropractic enokubanceda ngayo abo bane-arthritis kwaye sinike ulwazi olongezelelweyo kunye neengcebiso malunga nendlela yokunciphisa iintlungu.
Yintoni eyenziwa yiChiropractic
Ugqirha I-chiropractic yingcali yezempilo egxile kukuphila kakuhle kunye nokusempilweni endaweni yokugula / iimpawu zokugula. Ubungcali babo bujolise ekuhlengahlengiseni umgogodla ukulungisa ukungalunganga okunokuthi kucinezele ezantsi kwi-nerve kwaye kubangele ukuphazamiseka okukhulu emzimbeni. I-chiropractic eqhelekileyo ayibuyisi kuphela impilo emzimbeni wonke kodwa inceda ukunciphisa iintlungu zangasemva kunye nazo naziphi na iimpawu ezinxulumene nokuphuma komqolo.
Basebenza ekumiseleni iinkqubo zokuzivocavoca ezichaphazela imeko ekunyangwa nayo ukutya okufanelekileyo ukuze usebenzise ekuncedeni kulawulo lokuvuvukala kunye nentlungu.
Arthritis
Arthritis kukudumba kwamalungu omzimba athe Iziphumo zentlungu, ukuqina kunye nobubanzi bokuhamba. Zingaphezulu kwe-200 iintlobo ezahlukeneyo zesifo samathambo. Ngokubanzi ezinxulunyaniswa nobudala, inokuchaphazela abantu abancinci. Kungabetha kakhulu nangayiphi na indawo yomzimba. Isifo samathambo sinakho bangela umonakalo kwizicubu ezithambileyo kunye nezihlunu.
Osteoarthritis ikwabizwa ngokuba sisifo esidibeneyo sobudlolo, lolona hlobo luqhelekileyo. Ivela kukukhathazeka okuphindaphindiweyo ukuya emajoyini kwaye ihlala ihlala ikhona kubantu abadala.
Ezinye iindlela zibandakanya:
- I-rheumatoid arthritis luhlobo lwesibini oluqhelekileyo apho amajoni omzimba ahlasela amalungu.
- I-Psoriatic arthritis, a ngokuzenzekelayo Uhlobo lwesifo samathambo.
- I-Ankylosing spondylitis luhlobo lwesifo samathambo apho umzimba uzihlasela ngokwawo.
- Isifo samathambo esibangelwa sisifo esibangelwa sisifo esibangelwa sisifo okanye isifo esibangelwa sisifo.
Ukuqondwa
Ukuxilonga isifo samathambo kubandakanya uvavanyo lomzimba oluchanekileyo. Rheumatologists bahlala bedinga uncedo kunye ezi meko, kwaye ke umsebenzi wokunyanga unokwenziwa kwaye a chiropractor inokucetyiswa. Oku kuquka Ii-X-ray okanye ii-MRIs, umchamo, uhlalutyo lwegazi, kunye neemviwo zomzimba. Ukufumana imeko ichazwe ngokufanelekileyo kuya kunceda ukunyanga iimpawu.
Chiropractic
Olona nyango luqhelekileyo ngamayeza, athabatha usulelo, ukudumba kunye nokunciphisa iintlungu. Ii-chiropractors zinokuba luncedo olukhulu ekulawuleni isifo samathambo. Umsebenzi wamayeza kodwa njengoko sesibonile banokuba nexesha elide Imingcipheko yempilo njengokuphazamiseka komzimba, ukonakala kwilindle lesisu kunye nokopha ngaphakathi.
I-chiropractor inokunciphisa uxinzelelo, kunye nokuxhomekeka kumayeza, lonke eli xesha ukuphatha iintlungu kunye neempawu ngendlela yendalo. Unyango lweChiropractic:
- Ukuphucula uluhlu lwesinyanzelo
- Gcina umqolo ulungelelaniswe kakuhle
- Ukuphucula unyamezelo
- Ukuphucula ukuguquguquka
- Ukwandisa amandla
- Yandisa ithoni yemisipha
- Phuhlisa isicwangciso sokutya kunye nesondlo ukuze unciphise ukuvuvukala
- Cebisa uhlobo lokuzilolonga elilungele iimpawu zesifo samathambo
Ngokombutho weAmerican Chiropractic Association, oku kubalulekile kulawulo lweempawu zamathambo.
impatho
Qonda ukuba i-chiropractic ayinakho ukunyanga isifo samathambo. Banokunceda ukunciphisa iimpawu, ukucothisa ukuqhubela phambili kunye nokunceda ukunciphisa amanqanaba oxinzelelo. Baza kusebenzisa uhlengahlengiso ngokudibeneyo nolunye unyango. Oku kubandakanya:
- Unyango olushushu kunye nokubanda
- Unyango lwe-ultrasound
- ukuphulula umzimba womntu ngobunono
- Ukuvuselela imisipha
- Ukulungiswa komzimba
- Unyango
Ukunciphisa uxinzelelo
Lolonga
I-aerobics yamanzi okanye ukwenza ukuhambahamba ngepaki / kwindawo yommelwane yendlela yemihla ngemihla, njengoko kunjalo ikhuthaza ingqondo esempilweni ngokunciphisa uxinzelelo kunye noxinzelelo. Ukuzivocavoca ngobumnene njengomthambo we-aerobic kugqibelele kuba kuphucula ukuhamba kwaye kunceda ukuphosa iipawundi ezimbalwa ukuthatha uxinzelelo kumalungu. Ukuzivocavoca kudala ii-endorphins, ezinciphisa iintlungu kunye nokuphakamisa imo yeemvakalelo.
Amaqela enkxaso
Ngalo naluphi na uhlobo lwe meko ebuhlungu, kulula ukuba uzive ulilolo. Ukujoyina iqela lenkxaso kunokukunxibelelanisa nabantu abaqondayo ukuba kuqhubeka ntoni kunye neemvakalelo ohlangabezana nazo. Uluntu lunceda ukunciphisa umbono wokuba yedwa.
Unyango lokuphumla
Oku kugxile ekuzoliseni umzimba nengqondo ngokwenza umzamo wokuphumla. Nokuba imizuzu embalwa, unokufumana obu buchule busebenzayo ukulawula impendulo yoxinzelelo. Qala ngokugxila kwilungu elinye lomzimba njengezandla, iinyawo, njl.
Gxila kude kufike indawo ojonga kuyo ikhululekile ngokupheleleyo kuxinzelelo okanye uxinzelelo. Emva koko khawube nomfanekiso-ngqondweni wokungabikho komzimba emzimbeni. Vala amehlo akho, ulale phantsi, ucime izibane, kwaye ucinga ngento ethambisayo. Akukho zikhokelo zingqongqo zokuphumla. Nokuba yintoni ekubeka kwimeko yokuhlaziyeka kwengqondo yindlela yokwenza.
Ukuhlamba okushushu
Ubushushu obufumileyo obufudumeleyo obuvela kwigumbi lokuhlambela, ebhafini, okanye kwigumbi elinomphunga linokuthi ukuncitshiswa kwemfihlo yamahhala koxinzelelo kwaye phakamisa amanqanaba e-endorphins, njengoko kuchazwe ngaphambili kubabulisi bentlungu yendalo.
Zinike ixesha
Xa kufikwa ekunciphiseni uxinzelelo, ukulungelelana kubalulekile. Ukuhlala usebenza, kunye nokuphumla / ukulala rhoqo kubalulekile kunyango oluphumelelayo. Umlinganiso kufuneka ube kuyo yonke into oyenzayo. Ke, yenza ixesha lwezinto ofuna ukuzenza.
iziphumo
Izifo ezinokuvuvukala ezifana ne-arthritis zibonakalise ezona ziphumo zihle zifikelelekayo ngokuzikhusela kuzo zonke ii-angles. Ukusebenza kunye chiropractor kunye ne-rheumatologist yokudibanisa unyango inokwenza wonke umahluko. Inkqubo yokutya esempilweni kunye nenkqubo yokuzivocavoca esebenzayo iya kukusa kwindlela elungileyo eya kwindlela yokuphila esempilweni. Ukuba wena okanye umntu omthandayo unesifo samathambo, musa ukuthandabuza, tsalela umnxeba. Silapha ukunceda nangayiphi na indlela!
Uxinzelelo kunye nobuhlungu obungapheliyo
Izibonelelo zeNCBI
by UGqr Alex Jimenez | Arthritis
Okuninzi Uhlobo oluqhelekileyo lwesifo samathambo ebantwaneni nakwishumi elivisayo Juvenile idiopathic arthritis aka (JIA) luhlobo lwesifo samathambo esosulelayo ukuba ichaphazela abantwana abaneminyaka eli-16 nangaphantsi. Yi imeko enqabileyo, echaphazela umntu om-1 kubantwana abayi-1,000 XNUMX. Inga unobangelaedibeneyo Intlungu kunye nokuqina komzimba wonke, ngakumbi amalungu ajongene namalungu omzimba.
Iindidi zesifo samathambo esiwele phantsi kweJIA
UJuvenile Idiopathic arthritis wayesaziwa ngokuba abaselula irheumatoid arthritis, kodwa ayisiyo inguqulelo yomntwana / yolutsha kwisifo samathambo esidala. UJuvenile Idiopathic samathambo liwela kwiqela leentlobo ezahlukeneyo zesifo samathambo. Xa ugqirha efumanisa isifo i-JIA, baya kumisela uhlobo.
Iindidi ezahlukeneyo zibandakanya:
- Inkqubo
- I-Oligoarticular
- IPolyarticular
- Akabinazinga
- Ngobungangamsha
- I-enthesitis enxulumene I-JIA echaphazela umqolo yi-enthesitis enxulumene.
Ukuchaphazela njani i-Spine
Ukuqonda ngcono ukuba ichaphazela njani ithambo lomqolo, kunceda ukwazi isigama.
- I-enthesitisUkuvuvukala kwe iingcango yindawo apho i-tendon kunye ne-ligaments zixhuma khona kwithambo / s.
- ISpondyloarthritis: Isifo samathambo esihlasela ukufakwa komgogodla. I-Ankylosing spondylitis ngumzekelo we-spondyloarthritis.
Amalungu entamo ngawona axhaphake kakhulu okuhlaselwa ngu-JIA. Kanti, I-spondyloarthritis ibangela iintlungu kunye nokuqina kumqolo ophantsi.
Iimpawu eziqhelekileyo
I-arvenile idiopathic arthritis yenzeka kubantwana abaneminyaka eli-16 nangaphantsi. Iimpawu ziquka:
- intlungu Joint
- Ukuvuvukala
- Ubunzima
- ukuthantamisa
- Ubushushu obuthambileyo okanye ubushushu obukhoyo kangangeeveki ezintandathu.
Ezinye iimpawu zingabandakanya izihlunu kunye nezicubu ezithambileyo ziyaqina, ukhukuliseko kwethambo, edibeneyo ukuqhutywa gwenxa, kunye neepateni zokukhula okungaqhelekanga.
Ukuqonda isifo kunokuba ngumceli mngeni
Uxilongo ayisosoloko ithe ngqo, kwaye kukho Inkqubo yokufumanisa isifo samathambo idiopathic. Ugqirha uya kwenza uvavanyo lomzimba kunye novavanyo lwe-odolo. Baza kujonga iimpawu zomntwana ubuncinci iiveki ezintandathu, emva koko kwiinyanga ezi-6 emva kokuqala kwesi sifo. Ngeli xesha, ukuqikelela inani lamajoyina abandakanyekayo kunceda ukumisela isifo. Njengoko ukubandakanyeka ngokudibeneyo kungahluka ngohlobo lwesifo samathambo, kwaye iimpawu zinako kwaye zitshintshe rhoqo.
Esi sifo samathambo sihlasela ukudibana komgogodla, ngakumbi entanyeni. Nangona kunjalo, nge iintlobo ezithile ze-spondyloarthropathy, umva ongezantsi ungaba kukujolisa.
Ukuchonga isifo samathambo kubandakanya uvavanyo olupheleleyo noluchanekileyo. Ukuba i-chiropractor ingenisiwe ukuba incedise kwimeko leyo, kunokunyusa unyango kunyango lwe-rheumatologist. Oku kubandakanya radiology / X-ray okanye i-MRI, umchamo, uhlalutyo lwegazi kunye neemviwo zomzimba.
impatho
A Ugqirha unokucebisa ngendlela eyahlukileyo ukunyanga i-JIA. Banokukunika iindlela ezahlukeneyo zonyango / unyango ejolise ekuyekeni ukuqhubela phambili kwesi sifo. Isicwangciso sonyango siya kubandakanya ukufundisa imikhwa enempilo yokuthintela iintlungu zangasemva.
Unyango / s
Unyango luhlala luqala anti-nonsteroidal anti-inflammatory's. Ugqirha unokumisela a icorticosteroid ukulawula ukuvuvukala. Uninzi luphendula kakuhle kunyango olungelulo olukuchasayo, nangona kunjalo, la mayeza awanyangi isifo esingaphantsi okanye imbangela.
Ukuvuvukala kwamathambo kunye nokuqhubeka kwayo inokulawulwa ngamayeza athile. Kukho ukuguqulwa kwesifo i-antirheumatic amayeza anoku ukucothisa ukuqhubela phambili kwesi sifo. Kukho kwakhona I-TNF-ibhloko amayeza anokunceda ukuvimba iproteni ethile eyaziwa ngokuba isimilo necrosis factor ebangela ukuvuvukala. I-Etanercept eyaziwa kwintengiso njenge-Enbrel kunye adalimumab I-aka Humira ziyimizekelo ye-TNF-blockers ezinokuthi zithintele isifo ukuba siqhubeke.
Chiropractic
Qonda ukuba amayeza e-chiropractic akakwazi ukunyanga isifo samathambo, kodwa anokunceda ukunciphisa iimpawu kunye nokucothisa ukuqhubela phambili. Baza kusebenzisa uhlengahlengiso lomgogodla ngokudibana nolunye unyango. Oku kunokubandakanya:
- Unyango olushushu kunye nokubanda
- omoya
- ukuphulula umzimba womntu ngobunono
- Ukuvuselela imisipha
- Unyango
- Ukulungiswa komzimba
Ukuzivocavoca ngokunyanga umzimba
Gxila ku:
- Ukulungiswa okufanelekileyo
- Ukuhamba kunye
- Ukuphefumla
- Uqheliso lomsebenzi
- Isifundo sempilo esiphilayo
Izigulana zinokuhlakulela a ukuzimela ngaphambili oko kunokukhokelela ekuzingeleni umva kunye nentlungu yentamo. Uqeqesho lwasemva kwexesha kunye nokuzilolonga kwe-back back ziluncedo. Ukuzolula kunye neendidi zemisebenzi yokunyakaza gcina i-facet kunye nejoyi yamalungu isebenza kunye neselfowuni. Ukuphefumla ngokunzulu kunabisa isifuba esandisa amalunga ebambo kunye nokusebenza kwemiphunga. Kuxhomekeka kudidi nobukhali, ugqirha unokuzama ezinye iindlela ezinje utyando lomqolo.
Iziphumo ezilungileyo
Ukuba wena okanye umntu othile ufumaniseke ukuba unesifo samathambo esisencinci kumqolo,Fundani kangangoko ngesi sifo nangeendlela zaso. Ukwazi malunga nesi sifo okanye nasiphi na isifo kukhuthaza ukuxhotyiswa kunye nokuzibandakanya kuyo yonke inkqubo yonyango.
Iziphumo ezilungileyo zifezekiswa ngokuyihlasela kuzo zonke ii-angles. Ukusebenza kunye ne-chiropractor kunye ne-rheumatologist ngokudibeneyo. A I-chiropractor iya kuqeqesha umntu malunga nendlela yokugcina ukutya okunempilo kunye nokugcina inkqubo yokuzivocavoca esebenzayo ukunceda ngokunyakaza. Oku kwenzelwe ukufikelela kwisiphumo esisempilweni.
Ukhathalelo lweChiropractic e-Back Back kunye ne-Neck
Izibonelelo zeNCBI
by UGqr Alex Jimenez | Arthritis
I-rheumatoid arthritis (RA) yimeko ebangela ukuba ungakhathazeki kakhulu xa ufumene nesifo esizimele. Yilapho isistim somzimba sakho sokuzivikela sisqala ukuhlasela amanxeba akho, endaweni yabahlaseli bamanye amazwe, oko kubangela ukuvuvukala.
Okubi kakhulu kwi-RA, ngakumbi iimpawu ziba nzima. Ukuba izinto ziba zibi ngokwaneleyo unakho ukulahlekelwa ukuhamba ngokupheleleyo, kungenxa yoko kubalulekile ukuba unyango. Ngethamsanqa, i-chiropractic iphezulu kakhulu ekunciphiseni ukuvutha nokuphucula ukuhamba. Ukwelashwa kwe-Chiropractic inokukwenza okuninzi ukuze unciphise intlungu yakho kwaye ubuyele ekuhambeni ngendlela omele uyenze ngayo.
RA kunye neChiropractic
I-Chiropractic yindlela ephumelelayo yeYAR yokwenza izizathu ezininzi. Unyango lwe-Chiropractic:
Ngonyango
Umfanekiso uninzi lwabantu abanokulungiswa kwe-chiropractic ngenye yezinto ezihamba phambili kunye nobunzima, ukuxhamla. Ngoxa iinguqulelo zingabandakanya ngokuqinisekileyo ezi zinto, azinako. Ngokutsho kwe Arthritis Foundation, ii-chiropractors zinamacebo angaphezulu kwe-150 angayisebenzisa ukulungisa umzimba wakho.
Bazabalazela ukunika unyango olungqalileyo kwiimfuno zesigulana ngasinye, nto leyo ethetha ukulungisa umzimba ngobunono njengoko kuyimfuneko ukuvelisa umphumo ofunekayo. Ukuba amalungu akho adumbile kwaye abuhlungu i-chiropractor iya kusebenza ngononophelo ukulungelelanisa ilungu - elinciphisa ukudumba kunye nokuphucula intshukumo - ngelixa unciphisa naziphi na iintlungu okanye ukungonwabi ozivayo kuhlengahlengiso.
Ukuvutha kokunciphisa
Nge-RA ngokuqhelekileyo iimpawu ezimbi kakhulu zibangelwa ukuvuvukala. Ukwelashwa kwe-Chiropractic kungenzeka ukuba ungakwazi ukutshintsha indlela indlela yokuzivikela yakho yokuzivikela engenakusebenza ngayo, kodwa inokwenza okuninzi ukukunceda iindawo ezibuhlungu zingabi ncinane.
Unyango oluthola kwi-chiropractor yakho luya kuqinisekisa ukuba amanxeba akho ashukunyiswa ngokufanelekileyo njengoko kunikwe imeko yakho. Ngokubuyisa umzimba ngokulungelelanisa, i-chiropractic ithuthukisa indlela inkqubo ye-nervous isebenza ngayo kwaye iyanciphisa ukuvuvukala.
Ukuhamba ngokuPhuculo
Enye yezona zinto zinzima kuninzi kwa-RA kukulahlekelwa ukuhamba okuza kufika xa amalunga abo ekhula. Xa intlungu iba yinto eninzi kuqhelekileyo kubaxhamli be-RA ukuphepha ukunyakaza kuba buhlungu.
Kodwa kubalulekile ukukhumbula ukuba ukunyakaza, nangona xa kukho intlungu, kuyimfuneko ukugcina ukuhamba ngokubambisana. Ukude ubalekele ukuhambisa umdibaniso ngakumbi ukuba uya kulahleka umsebenzi.
Into ebalulekileyo ye-chiropractic kukuba unokufumana uncedo ngokuhamba, ngoko awuhlali wedwa kunye nethemba elixakekayo lokuhambisa amanxeba ukuze baqale ukusebenza kangcono. I-chiropractor yakho yintsebenziswano yakho, inceda ekukhombiseni umzimba wakho ukuze ihambe njengoko kunokwenzeka. Iziphumo zahluke kuwo wonke umntu ngokusekelwe kwiimeko ezizodwa, kodwa unokuqiniseka ukuba i-chiropractic iya kuba yinto enamandla yokugcina umzimba wakho usebenze ngokunokwenzeka.
Isandla esilungisiwe kwiRheumatoid Arthritis
Iimveliso eziMahla kunye neziNdawo ezingenasidlangalaleni
Kwi-chiropractic, kugxininisekile kukunceda umzimba uziphilise ngokwawo, oku kuthetha ukuphepha utyando kunye neyeza zeyeza kangangoko kunokwenzeka. Utyando kunye namayeza akholisa ukuba neziphumo ebezingalindelekanga ezingafunwayo maxa wambi ezimbi ngakumbi kunengxaki ebezijonge ukuyisombulula. Ngeempembelelo ezimbi ze-chiropractic azinakwenzeka. Unokufumana isiqabu esikhulu kunyango oluthambileyo, olusebenzayo olungayi kukwenza uzive umbi ngakumbi kunokuba wawuqala.
Umthombo wakho weChiropractic Source
Iqela lethu le-chiropractic linamava anceda izigulane ze-RA, kwaye sinomdla ukwenza okufanayo kuwe. Siyaqonda ukuba kunzima kangakanani ukuba ne-RA. Masikuncedise ukuba ufumane uncedo olufanelekileyo.
Nceda uqhagamshelane neofisi yethu ukulungiselela iseshoni. Silindele ukuthetha nawe!
Opioid Addiction Alternative
I-opioids (njenge-hydrocodone, i-oxycodone, i-codeine kunye ne-morphine) iimpawu ze-mask kwaye ungenzi nto ukulungisa imbangela yentlungu.
Kukho ingxaki ye-opioid egqubayo.� Enye indlela enengqondo nekhuselekileyo ye-opioids: I-orthotics eyenziwe ngokwezifiso inceda ukuthomalalisa iintlungu ezisezantsi zomqolo kwakunye neentlungu zenyonga nentamo ngokususa ukungalingani kwenkqubo ye-musculoskeletal, eqala ezinyaweni.
Ngaphambi kokuqwalasela ukuthatha i-opioid ekulawuleni ubuhlungu, kunika ukunyamekela kwe-Chiropractic kunye neenyawo zonyawo. Ukudibaniswa kweChiropractic kunye ne-orthotics kuboniswe kwizifundo zonyango.
Kwi-2015, malunga ne-2 yezigidi zaseMelika zazinokuphazamiseka kweziyobisi izidakamizwa ezinxulumene namayeza opioid.
Kwi-2012, i-80 kwi-100 yaseMelika yamiselwa i-opioids. Oko kumalunga nezigidi ezingama-259 zemimiselo � ngaphezulu kokwaneleyo ukunika wonke umntu omdala waseMelika ibhotile yakhe yeepilisi.
Intlungu encinci kunye nokuthuthuzela okungakumbi
Amathambo angokwezifiso anceda ngaphezu kweenyawo zakho! Imizimba yokuzinzisa izisa impilo kunye nokuphilisa kuwo wonke umzimba ngokulinganisa inkqubo ye-musculoskeletal system.
El Paso Emva kweklinikhi
Nazi ezinye iividiyo ezixubusha indlela ukunakekelwa kwe-chiropractic kunokunceda ngayo i-arthritis, i-fibromyalgia, abantu abadala kunye nomzimba wonke.
Izibonelelo zeNCBI
Nazi ezinye iindatshana zokujonga ulwazi olongezelelweyo kwi-arthropathies.
by UGqr Alex Jimenez | Arthritis, I-Arthropathies, Chiropractic, Uvavanyo lweChiropractic, Ubuhlungu obungapheliyo, Iimeko eziPhathwayo, impilo, Ukujonga kunye nokuchonga, Izifundo zoPhando, Uvavanyo lweSkrini, Unyango, Ukuphila
Mayelana nabantu abayi-1.5 abantu base-United States bane-arthritis ye-rheumatoid.
Irheumatoid arthritis, okanye i-RA, isifo esingasigxina, esizimeleyo esichazwe intlungu kunye nokuvuvukala kwamalungu. Nge-RA, isimiso somzimba sokuzivikela, esikhusela impilo yethu ngokuhlasela izinto zangaphandle njengebhaktheriya kunye neentsholongwane, ukuhlaselwa ngamacandelo ngamacandelo. I-rheumatoid arthritis ixhaphaza kakhulu izihlanganisi zezandla, iinyawo, izibonda, izibonda, amadolo kunye namaqaqa. Uninzi lwezonyango zonyango lucebisa ukuxilongwa kwangaphambili kunye nokwelashwa kwe-RA.
Abstract
Isifo samathambo sesona sifo sixhaphakileyo esihlasela isifo. Abasetyhini, abatshayayo, kunye nabo banembali yosapho yesi sifo bahlala bechaphazeleka. Iikhrayitheriya zokuchonga isifo zibandakanya ukuba lilungu elinye okungenani kunye nokudumba okungacaciswanga sesinye isifo. Amathuba okuchongwa kwesifo samathambo anyuka ngenani lamalungu amancinci abandakanyekayo. Kwisigulana esinesifo samathambo esidumbisayo, ubukho bento ebangela irheumatoid okanye iprotein antibody ye-anti-citrullinated, okanye inqanaba eliphezulu le-C-esebenzayo leprotein okanye inqanaba le-sedryation ye-erythrocyte iphakamisa ukufumanisa isifo samathambo. Uvavanyo lokuqala lwelebhu kufuneka lubandakanye ukubala okupheleleyo kwegazi ngokungafaniyo kunye nokuvavanywa kokusebenza kwezintso kunye ne-hepatic function. Izigulana ezithatha iiarhente zebhayiloji kufuneka zivavanyelwe i-hepatitis B, hepatitis C, kunye nesifo sephepha. Ukuchongwa kwangoko kwe-rheumatoid arthritis kuvumela unyango lwangaphambili ngezifo ezinokuguqula isifo. Ukudityaniswa kwamayeza kuhlala kusetyenziswa ukulawula isifo. I-Methotrexate ngesiqhelo sisiyobisi kumqolo wokuqala kwisifo samathambo. Iiarhente zebhayoloji, ezinjenge-tumor necrosis factor inhibitors, zihlala zithathwa njengeearhente zodidi lwesibini okanye zinokongezwa kunyango olubini. Iinjongo zonyango zibandakanya ukunciphisa iintlungu ezidibeneyo kunye nokudumba, ukuthintela ukonakaliswa kwemitha kunye nokukhubazeka okubonakalayo, kunye nokuqhubeka komsebenzi kunye nemisebenzi yobuqu. Ukutshintshwa okuhlangeneyo kubonisiwe kwizigulana ezinomonakalo omkhulu ngokudibeneyo onempawu ezilawulwa gwenxa ngabaphathi bezonyango. (NdinguGqirha weNdawo. 2011; 84 (11): 1245-1252. Ilungelo lokushicilela 2011 American Academy of Family Physicians.)
I-rheumatoid arthritis (RA) yiyona nto ixhaphakileyo isifo se-arthritis, esinexesha lokuphila elide ukuya kuma-1 ekhulwini emhlabeni wonke. I-1 Inset ingafumaneka nanini na ubudala, kodwa iphakama phakathi kwe-30 kunye ne-50 yeminyaka. Ukukhubazeka kwe-2 kuqhelekile kwaye kubalulekile. Kwiqela elikhulu lase-United States, i-35 ipesenti yezigulane ezine-RA zazikhubazekile emsebenzini emva kweminyaka eyi-10.3
Etiology kunye nePathophysiology
Njengezifo ezininzi ezizimeleyo, i-etiology ye-RA i-multifactorial. Ukuchaphazeleka kwemfuza kuyabonakala ekuhlanganiseni usapho kunye ne-monozygotic yamawele, kunye neepesenti ezingama-50 zomngcipheko we-RA obangelwa zizinto zofuzo. Izifundo zomanyano ngokubanzi ziye zachonga utyikityo lwemfuzo olongezelelekileyo olonyusa umngcipheko we-RA kunye nezinye izifo ezizimele, kubandakanya i-STAT4 gene kunye ne-CD45 locus. 1 Ukutshaya yeyona nto ibangela imeko ye-RA, ngakumbi kwabo banofuzo. Inokuthi ichaze impendulo yokuzimela, akukho nto ibonakalisiweyo ibangela ukuba i-RA.6,7 RA ibonakaliswe ngeendlela ezivuthayo ezikhokelela ekwandeni kweeseli ze-synovial kumalungu. Ukuqulunqwa kwepannus emva koko kunokukhokelela ekutshatyalalisweni kwe-cartilage kunye ne-bony erosions. Ukuveliswa ngaphezulu kwee-cytokines zepro-inflammatory, kubandakanya i-tumor necrosis factor (TNF) kunye ne-interleukin-4, eqhuba inkqubo etshabalalisayo.40
Izinto zobungozi
Ubudala obudala, imbali yentsapho yesifo, kunye nesondo sesifazana zidibaniswa nomngcipheko wokwanda kwe-RA, nangona ukuhlukana kwesondo kungabonakali kakhulu kwizigulane ezidala. = 1, ukuya kuthi ga kwi-1.4 kwiminyaka engaphezu kwe-2.2 ye-pack-pack-years) .40 Ukukhulelwa kudla ngokubangela ukuxolelwa kwe-RA, mhlawumbi ngenxa yokunyamezela kwe-immunologic.11 I-Parity ingaba nefuthe elide elide; I-RA ayinakwenzeka ukuba ifunyanwe kubasetyhini be-parous kunabasetyhini abangenayo (RR = 12) .0.61 Ukuncancisa kunciphisa umngcipheko we-RA (RR = 13,14 kubasetyhini abancancisayo ubuncinane kwiinyanga ezingama-0.5), kanti ukuqala kokuya esikhathini�(RR = 24 kwabo bahamba kwi-mearche kwiminyaka eyi-1.3 ubudala okanye encinci) kunye nexesha elingaqhelekanga kakhulu lokuya esikhathini (RR = 10) kwandisa umngcipheko.1.5 Ukusetyenziswa kweepilisi zokukhulelwa komlomo okanye i-vitamin E ayichaphazeli umngcipheko we-RA.14
Ukuqondwa
Ukunikezelwa Kwendlela
Izigulane ezine-RA zikhona ngokubuhlungu kunye nokuqina kumalungu amaninzi. Izibonda, amanxeba aphakathi kwe-interphalangeal joints, kunye nama-metacarpophalangeal joints athile abandakanyekayo. Ukuqina koMasa okuhlala ngaphezu kweyure enye kubonisa i-etiology evuthayo. Ukuthumba kwe-Boggy ngenxa ye-synovitis inokubonakala (Umfanekiso we-1), okanye ukunyaniseka kwe-synovial kungabonakaliswa kwiimviwo ezidibeneyo. Izigulana zingabonisa nge-indulent arthralgias ngaphezulu kokuqala kokuvuvukala komzimba ngokubonakalayo. Iimpawu eziqhelekileyo zokukhathala, ukulahleka kwesisindo, kunye ne-fever-grade-fever iyakwenzeka ngezifo ezisebenzayo.
Iimpawu zokuxilonga
Ngo-2010, i-American College of Rheumatology kunye ne-European League Against Rheumatism zasebenzisana ukuyila iikhrayitheriya ezintsha zokwahlulahlula i-RA (1 Table) .16 Iikhrayitheriya ezintsha ziinzame zokuchonga i-RA ngaphambili kwizigulana ezingenakho ukuhlangabezana nohlelo lwe-1987 lweKholeji yaseMelika yeRheumatology iikhrayitheriya. Iikhrayitheriya zika-2010 azibandakanyi ubukho bamaqhuqhuva e-rheumatoid okanye utshintsho lwe-radiographic erosive, zombini ezo zinqabileyo kwi-RA yokuqala. Ububanzi be-symmetric abufuneki kwiikhrayitheriya zika-2010, ukuvumela ukuboniswa kwangoko kokulinganisa. Ukongeza, abaphandi baseDatshi baphuhlisile kwaye baqinisekisa umthetho wokuxelwa kwangaphambili kweklinikhi yeRA (Itheyibhile 2) .17,18 Injongo yalo mthetho kukunceda ekuchongeni izigulana ezinesifo samathambo esingachazwanga ekunokwenzeka ukuba siqhubele phambili ukuya kwiRA, kunye nokukhokela ukulandela- phezulu kunye nokuthunyelwa.
Uvavanyo lweNgcaciso
Izifo ezizimelayo ezifana ne-RA zihlala zibonakaliswa bubukho be-autoanti- body. I-Rheumatoid factor ayingqalanga kwi-RA kwaye inokubakho kwizigulana ezinezinye izifo, ezifana ne-hepatitis C, nakubantu abadala abasempilweni. I-anti-citrullinated protein antibody ibaluleke ngakumbi kwi-RA kwaye inokudlala indima kwi-pathogenesis yesifo.6 Malunga nama-50 ukuya kuma-80 ekhulwini abantu abaneRA bane-rheumatoid factor, anti-citrullinated protein antibody, okanye zombini.10 Izigulane ezineRA zisenokuba nazo. iziphumo zovavanyo lwe-antinuclear antibody, kwaye uvavanyo lubalulekile kwi-prognostic kwiindlela zolutsha zesi sifo. Imilinganiselo yokuhlelwa kwe-RA.19 Amanqanaba eprotheyini asebenzayo kunye ne-erythrocyte sedimentation rate ingasetyenziselwa ukulandela umsebenzi wesifo kunye nokuphendula kumayeza. Isiseko sobalo lwegazi olupheleleyo olunokwahluka kunye novavanyo lwezintso kunye nomsebenzi wesibindi luluncedo kuba iziphumo zinokuchaphazela iindlela zonyango (umzekelo, isigulana esinokusilela kwezintso okanye i-thrombocytopenia ebalulekileyo ekunokwenzeka ukuba ayinakumiselwa ichiza elichasene nokudumba [NSAID]). I-anemia encinci yesifo esingapheliyo yenzeka kwi-16 ukuya kwi-33 ipesenti yazo zonke izigulane ezine-RA, i-60 nangona ukulahleka kwegazi kwesisu kufuneka kuqwalaselwe kwizigulane ezithatha i-corticosteroids okanye i-NSAID. I-Methotrexate ichasene nezigulane ezine-hepatic disease, ezifana ne-hepatitis C, kunye nezigulane ezinokukhubazeka okukhulu kwezintso.20 Unyango lwe-Biologic, olufana ne-TNF inhibitor, ludinga uvavanyo olubi lwe-tuberculin okanye unyango lwe-tuberculosis efihliweyo. Ukuvuselelwa kwe-Hepatitis B kunokuphinda kwenzeke ngokusetyenziswa kwe-TNF inhibitor.21 I-Radiography yezandla kunye neenyawo kufuneka yenziwe ukuvavanya iimpawu ze-periarticular erosive change, �enokuthi ibonise i-RA encinci ye-RA.22
Ukuxilongwa ngokungafani
Iziphumo zolusu zibonisa ukuba i-systemic lupus erythematosus, i-systemic sclerosis, okanye i-psoriatic arthritis. I-Polymyalgia rheumatica kufuneka ithathelwe ingqalelo kwisigulane esikhulileyo kunye neempawu eziphambili egxalabeni nasesinqeni, kwaye isigulane kufuneka sibuzwe imibuzo enxulumene ne-arteritis yesikhashana. I-radiography yesifuba iluncedo ukuvavanya i-sarcoidosis njenge-etiology ye-arthritis. �Izigulane ezineempawu ezivuthayo zangasemva, imbali yesifo sesibindi esivuthayo, okanye isifo samehlo esivuthayo sinokuba ne-spondyloarthropathy. Abantu abangaphantsi kweeveki ezintandathu zeempawu banokuba nenkqubo yentsholongwane, njenge-parvovirus. Iziqendu eziphindaphindiweyo zokudumba ngokudibeneyo zicebisa i-crystal arthropathy, kwaye i-arthrocentesis kufuneka yenziwe ukuvavanya i-monosodium urate monohydrate okanye i-calcium pyrophosphate dihydrate crystals. Ubukho bamanqaku amaninzi e-myofascial trigger kunye neempawu ze-somatic zinokucebisa i-fibromyalgia, enokuthi ihlale kunye ne-RA. Ukunceda ukukhokela ukuxilongwa kunye nokumisela isicwangciso sonyango, izigulane ezine-arthritis ezivuthayo kufuneka zithunyelwe ngokukhawuleza kwi-rheumatology subspecialist.16,17
I-rheumatoid arthritis, okanye i-RA, uhlobo oluqhelekileyo lwe-arthritis. I-RA iyisifo esingenakuzimela, esibangelwa xa isistim somzimba, isistim somzimba wokhuselo lomzimba, sihlasela iiseli zayo kunye nezicubu, ngokukodwa amajoyina. I-rheumatoid arthritis idlalwa rhoqo ngeempawu zentlungu kunye nokuvuvukala, okuhlala kuthintela amaqela amancinci ezandla, izibonda kunye neenyawo. Ngokutsho kweengcali ezininzi zonyango, ukuxilongwa kwangaphambili kunye nokwelashwa kwe-RA kubalulekile ukukhusela umonakalo ohlangeneyo kunye nokunciphisa iimpawu ezibuhlungu. UDkt Alex Jimenez DC, i-CCST Insight
impatho
Emva kokuba i-RA ifunyenwe kwaye uhlolo lokuqala luyenziwe, unyango lufanele luqale. Izikhokelo zakutsha zijongene nolawulo lwe-RA, i-21,22 kodwa ukhetho lwesigulane ludlala indima ebalulekileyo. Kukho iingqwalasela ezikhethekileyo kubasetyhini bexesha lokubeletha ngenxa yokuba amaninzi amayeza aneempembelelo ezingekho phantsi kokukhulelwa. Iinjongo zonyango ziquka ukunciphisa intlungu kunye nokuvuvukala, ukuthintela ukubola (njengokuphambuka kwe-ulnar) kunye nomonakalo we-radiographic (njengemibhobhozo), ukugcina umgangatho wobomi (umntu kunye nomsebenzi), nokulawula imbonakalo eyongezelelweyo. Izidakamizwa zokuguqula izifo (anti-hyheumatic drugs) (i-DMARD) yiyona nto ephambili ye-RA.
DMARD
I-DMARD ingaba yi-biologic okanye i-nonbiologic (Itheyibhile 3) .23 i-Biologic agents ziquka i-antibodies ye-monoclonal kunye ne-recombinant receptors ukuvimba i-cytokines ekhuthaza i-cascade evuthayo ejongene neempawu ze-RA. I-Methotrexate inconywa njengonyango lokuqala kwizigulane ezine-RA esebenzayo, ngaphandle kokuba iphikisana okanye ayinyamezelwanga. I-Sulfasalazine (Azulfidine) okanye i-hydroxychloroquine (i-Plaquenil) i-pro-inflammatory njenge-monotherapy kwizigulana ezinezifo eziphantsi-umsebenzi okanye ezingenazo iimpawu zokubikezela (umzekelo, i-seronegative, i-RA engasebenziyo). ngaphezu kwe-monotherapy; nangona kunjalo, iziphumo ezibi nazo zingaba zikhulu.21 Ukuba i-RA ayilawulwa kakuhle nge-DMARD engeyona i-biologic, i-DMARD ye-biologic kufuneka iqalwe. Ukuba i-TNF inhibitors ayisebenzi, unyango olongezelelweyo lwebhayoloji lunokuqwalaselwa. Ukusetyenziswa ngaxeshanye ngaphezu konyango lwebhayoloji enye (umz., adalimumab [Humira] ene-abatacept [Orencia]) ayikhuthazwa ngenxa yezinga elingamkelekanga lemiphumo emibi.21,22
IiNSAID kunye neCorostosteroids
Ukusetyenziswa kweziyobisi kwi-RA kunokubandakanya ii-NSAID kunye ne-oral, intramuscular, okanye intraticular corticosteroids yokulawula intlungu kunye nokuvuvukala. Ngokufanelekileyo, i-NSAID kunye ne-corticosteroids zisetyenziselwa ukuphathwa kwexesha elifutshane. I-DMARD yonyango olukhethiweyo.21,22
Iinkqubo eziPheleleyo
Ukungenelela kokutya, kubandakanywa nokutya kwemifuno kunye neMeditera, kufundwe kunyango lwe-RA ngaphandle kobungqina obukholisayo benzuzo. kunye ne-RA.25,26 Ukongeza, i-thermotherapy kunye ne-ultrasound yonyango ye-RA ayizange ifundwe ngokwaneleyo.27,28 Ukuhlaziywa kwe-Cochrane yonyango lwe-herbal ye-RA yagqiba ukuba i-gamma-linolenic acid (ukusuka kwi-primrose ngokuhlwa okanye ioli ye-currant emnyama) kunye ne-Tripterygium. i-wilfordii (i-thunder god vine) ineenzuzo ezinokubakho.29,30 Kubalulekile ukwazisa izigulane ukuba iziphumo ezibi kakhulu ziye zaxelwa ngokusetyenziswa kwonyango lwe-herbal.31
Ukuzivocavoca kunye noTyhila
Iziphumo zezilingo ezilawulwa ngononophelo zixhasa ukuzivocavoca umzimba ukuze kuphuculwe umgangatho wobomi kunye namandla omzimba kwizigulane ezine-RA.32,33 Iiprogram zokuqeqesha uqeqesho azibonakalanga zineempembelelo ezingathandekiyo kwimisebenzi yesifo se-RA, amanqaku eentlungu okanye umonakalo odibeneyo we-radiographic.34 Tai i-chi iboniswe ukuphucula uluhlu lwezandla lwabantu abane-RA, nangona iilingo ezingenangqiqo zilinganiselwe. I-35 izilingo ezilawulwa ngokungaqhelekanga ze-Iyengar yoga kubantu abadala abase-RA bayaqhubeka.36
Ubude bonyango
Ukuxolelwa kuyafumaneka kwiipesenti ezili-10 ukuya kwezi-50 zezigulane ezine-RA, kuxhomekeke kwindlela ukuxolelwa okuchazwe ngayo kunye nokunyanzeliswa kwonyango. 10 Ukuxolelwa kunokwenzeka kakhulu kubantu besilisa, abangatshayiyo, abantu abangaphantsi kweminyaka engama-40, nakwabo abanezifo zokuqala emva kwexesha ( abaguli abadala kuneminyaka eyi-65), benesifo esifutshane, sinesifo esibukhali, ngaphandle kwesigulo se-acute, kwaye ngaphandle kwesifo se-rheumatoid okanye iiprotein anti-citrullinated protein antibody. kwelona xabiso liphantsi liyimfuneko. Izigulana ziya kufuna ukubekwa esweni rhoqo ukuqinisekisa ngeempawu ezizinzileyo, kwaye ukonyuka ngokukhawuleza kwamayeza kuyacetyiswa ngezifo ezothusayo.37
Ukutshintshwa okuhlangeneyo
Ukutshintshwa okuhlangeneyo kuboniswe xa kukho umonakalo omkhulu kunye nokulawulwa okungenakuqinisekiswa kweempawu kunye nolawulo lwezonyango. Iziphumo zexesha elide zixhasa, nge-4 kuphela kwipesenti ze-13 zengxowankulu ezinkulu ezifakelwayo ezifuna ukuhlaziywa phakathi kwe-10 iminyaka.38 I-hip kunye namadolo ngamalungu amaninzi afanelekileyo.
Ukujonga ilanga elide
Nangona i-RA ithathwa njengesifo samalungu, ikwasisifo senkqubo esikwaziyo ukubandakanya iinkqubo ezininzi zamalungu. Izibonakaliso ezongezelelweyo ze-RA zibandakanyiwe kwiThebhile 4.1,2,10 Izigulane ezine-RA zinengozi ephindwe kabini eyongeziweyo ye-lymphoma, ekucingelwa ukuba ibangelwa yinkqubo yokuvuvukala ephantsi, kwaye kungekhona umphumo wonyango.39 Izigulane ezine-lymphoma I-RA nayo isengozini enkulu ye-coronary artery disease, kwaye oogqirha kufuneka basebenze kunye nezigulane ukuguqula izinto ezinobungozi, ezifana nokutshaya, uxinzelelo lwegazi oluphezulu, kunye ne-cholesterol ephezulu. ukuchasana nokusebenzisa i-TNF inhibitors, enokuthi ibangele iziphumo ze-CHF zibe zibi nakakhulu. Ii-DMARD ze-Biologic, i-methotrexate, kunye ne-leflunomide akufanele ziqaliswe kwizigulane ezine-herpes zoster esebenzayo, ukusuleleka kwefungal ephawulekayo, okanye ukusuleleka kwebhaktheriya kufuna i-antibiotics.40,41 Iingxaki ze-RA kunye nonyango zidweliswe kwiThebhile 21
Prognosis
Iziguli ezine-RA zihlala ezintathu ukuya kwi-12 iminyaka engaphantsi kobonke abantu .40 Ukufa okuphezulu kwezi zi gulane kubangelwa kakhulu ngokukhawuleza kwezifo zengqondo, ngokukodwa kulabo abanesifo esiphakamileyo somzimba kunye nokuvuvukala okungapheliyo. Iindlela ezintsha zokwelapha ze-biologic ziyakunqanda ukuqhubela phambili kwe-atherosclerosis kunye nokwandisa ubomi kulabo abane-RA.41
Imithombo yolwazi: Uphando lwe-PubMed lugqityiwe kwiiNkcazo zeZliniki usebenzisa amagama asemqoka i-rheumatoid arthritis, imbonakalo eyongeziweyo, kunye ne-anti-thermatic agents. Ukukhangela kwakuquka ukuhlaziywa kweemitha, ukuhlolwa okungahleliwe, ukuvavanywa klinikhi kunye nokuhlolwa. Kwakhona kuphandwe yiArhente yeeNgxelo zoPhando lwezeMpilo kunye noBungqina bemiGangatho, ubungqina bezonyango, inkcazelo yaseCchrane, Ubungqina obuBalulekileyo kunye ne-UpToDate. Umhla wosesho: Septemba 20, 2010.
Ukubhaliweyo kombhali: Akukho manyano lwemali olufanelekileyo olunokuchazwa. Ukuqukumbela, isifo samathambo sisifo esingapheliyo, isifo esizimelayo esibangela iimpawu ezibuhlungu, ezifana nentlungu kunye nokungahambi kakuhle, ukuvuvukala kunye nokuvuvukala kwamalungu, phakathi kwabanye. Umonakalo odibeneyo obonakaliswe njenge-RA ulingana, oku kuthetha ukuba uchaphazela macala omabini omzimba. Ukuxilongwa kwangoko kubalulekile kunyango lwe-RA. Ubungakanani bolwazi lwethu lukhawulelwe kwi-chiropractic kunye nemiba yempilo yomgogodla. Ukuxoxa ngalo mbandela, nceda uzive ukhululekile ukubuza uGqr. Jimenez okanye uqhagamshelane nathi apha
915-850-0900�. Uphethwe nguDkt 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.
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Ucaphulo
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by UGqr Alex Jimenez | Arthritis, Ukujonga kunye nokuchonga
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.
Ukujonga i-Ankle kunye neenyawo
by UGqr Alex Jimenez | Arthritis, I-Arthropathies, Chiropractic, Uvavanyo lweChiropractic, Ubuhlungu obungapheliyo, Iimeko eziPhathwayo, impilo, Ukujonga kunye nokuchonga, Uvavanyo lweSkrini, Ukulimala kwezemidlalo, Unyango, Ukuphila
I-arthritis ibonakala njengokuvuvukala kwelungu elinye okanye amaninzi. Iimpawu eziqhelekileyo ze-arthritis ziquka intlungu kunye nokungahambi kakuhle, ukuvuvukala, ukuvuvukala, kunye nokuqina, phakathi kwabanye. I-arthritis inokuchaphazela nayiphi na idibeneyo emzimbeni womntu, nangona kunjalo, ihlala ikhula emadolweni. � Isifo samathambo edolo sinokwenza imisebenzi yomzimba yemihla ngemihla ibe nzima. Ezona ntlobo zixhaphakileyo ze-arthritis yi-osteoarthritis kunye ne-rheumatoid arthritis, nangona kukho ngaphezulu kwe-100 iintlobo ezahlukeneyo ze-arthritis, ezichaphazela abantwana kunye nabantu abadala ngokufanayo. Nangona kungekho unyango lwe-arthritis, iindlela ezininzi zonyango zinokunceda ukunyanga iimpawu ngamathambo emadolweni.
I-Anatomy ye-Knee
� Idolo lelona lungu likhulu nelinamandla emzimbeni womntu. Yenziwe ngencam engezantsi yethambo lethanga, okanye i-femur, isiphelo esiphezulu sethambo le-shin, okanye i-tibia, kunye ne-kneecap, okanye i-patella. Iziphelo zamathambo amathathu zigqunywe nge-articular cartilage, isakhiwo esigudileyo, esithambileyo esikhusela kwaye sikhusela amathambo xa egoba kwaye elungisa idolo.
� Iindawo ezimbini zecartilage ezimile okwe wedge, ezaziwa ngokuba yimeniscus, zisebenza njengezinto ezifunxa ukothuka phakathi kwamathambo edolo ukunceda ukuqinisa ilungu kunye nokubonelela uzinzo. Idolo elidibeneyo likwajikelezwe ngumgca omncinci owaziwa ngokuba yi-synovial membrane. Le inwebu ikhupha ulwelo oluthambisa intlala kwaye ikwanceda ekunciphiseni ukukhuhlana edolweni. Iindidi ezibalulekileyo ze-arthritis ezichaphazela idolo - ziquka i-osteoarthritis, i-rheumatoid arthritis, kunye nesifo samathambo sasemva kwe-traumatic.
Osteoarthritis
� IOsteoarthritis lolona hlobo luxhaphakileyo lwesifo samathambo esichaphazela idolo. Olu hlobo lwesifo samathambo ngumba wempilo owohlokayo, onxitywayo kunye nokukrazula okwenzeka kakhulu kubantu abaneminyaka engama-50 ubudala nangaphezulu, nangona kunjalo, inokuphuhla nakubantu abancinci.
� Kwi-osteoarthritis, intlala ekwijoyinti yedolo ngokuthe ngcembe iyaphela. Njengoko intlala iphela, umgama phakathi kwamathambo uyehla. Oku kunokukhokelela ekuhlikihleni amathambo kwaye kunokwenza i-spurs ebuhlungu yamathambo. I-osteoarthritis ikhula ngokucothayo kodwa iintlungu zinokuba mandundu ngokuhamba kwexesha.
Irheumatoid arthritis
� I-Rheumatoid arthritis ngumba wezempilo ongapheliyo ochaphazela amalungu amaninzi emzimbeni wonke, ngakumbi amadolo. I-RA iphinda ilingane, oku kuthetha ukuba ihlala ichaphazela ilungu elinye kwicala ngalinye lomzimba womntu.
� Kwi-rheumatoid arthritis, inwebu ye-synovial egquma idolo elihlangeneyo iyadumba kwaye idumbe, ibangele iintlungu zedolo, ukungakhululeki, kunye nokuqina. I-RA sisifo esizilawulayo, nto leyo ethetha ukuba inkqubo yomzimba yokuzikhusela ihlasela izicubu zayo ezithambileyo. Amajoni omzimba ahlasela izicubu ezisempilweni, eziquka imisipha, imithambo kunye nerhalaxa, kwakunye nokuthambisa ithambo.
I-Arthritis engapheliyo
� I-posttraumatic arthritis luhlobo lwesifo samathambo esikhula emva komonakalo okanye ukwenzakala edolweni. Ngokomzekelo, idolo elihlangeneyo linokulimala ngethambo eliphukileyo, okanye ukuphuka, kwaye kubangele emva kweminyaka ebuhlungu emva kokulimala kokuqala. Iinyembezi ze-meniscal kunye nokulimala kwe-ligament kunokubangela ukugqoka okongeziweyo kwi-joint joint, ekuhambeni kwexesha kunokukhokelela kwi-arthritis kunye nezinye iingxaki.
Iimpawu ze-Knee Arthritis
� Ezona mpawu zixhaphakileyo ze-knee arthritis ziquka iintlungu kunye nokungakhululeki, ukudumba, ukudumba, kunye nokuqina. Nangona ukuqalisa ngequbuliso kunokwenzeka, iimpawu ezibuhlungu zihlala zikhula ngokuthe ngcembe ekuhambeni kwexesha. Iimpawu ezongezelelweyo ze-knee arthritis zinokuqatshelwa ngolu hlobo lulandelayo:
- Umdibaniso unokuba lukhuni kwaye uvuthe, okwenza kube nzima ukugoba nokuguqa ngamadolo.
- Ukuvuvukala nokuvuvuka kunokuba kubi nakusasa, okanye xa uhleli okanye uphumla.
- Umsebenzi onamandla unokubangela ukuba intlungu ivuke.
- Iziqhekeza ezilahlekileyo ze-cartilage kunye nezinye izicubu ezithambileyo zingaphazamisa ukunyakaza okuhambelanayo kwamalungu, okubangela ukuba idolo livale okanye linamathele. Iyakwazi kwakhona ukukrafaza, nqakraza, yenza i-snap okanye wenze isandi esisikiweyo, esaziwa njenge-crepitus.
- Ubuhlungu bunokubangela ingxaki yokukhathala okanye ukuguqa emadolweni.
- Abantu abaninzi abane-arthritis bangaphinda bachaze intlungu edibeneyo yokwanda kunye nesimo sezulu nesimo sezulu.
Ukuxilongwa kwe-Knee Arthritis
� Ngexesha lokutyunjwa kwesigulana sokuxilongwa kwe-arthritis yamadolo, ingcali yezempilo iya kuthetha ngeempawu kunye nembali yonyango, kunye nokwenza uvavanyo lomzimba. Ugqirha unokuphinda aodole iimvavanyo zokuxilonga, ezifana ne-X-reyi, iMRI okanye iimvavanyo zegazi ukwenzela ukuxilongwa ngakumbi. Ngexesha lovavanyo lomzimba, ugqirha uya kukhangela:
- Ukuvuvukala okuhlangeneyo, ukuvuvukala, ukufudumala, okanye ubomvu
- Ukunyamezela ngeenxa zonke emadolweni
- Ukuxhaswa kwempahla yokunyusa nokusebenza
- Ukukhubazeka kwamadolo
- I-Crepitus, i-grating sensation ngaphakathi kwendibano, ngokunyakaza
- Ubuhlungu xa isisindo sifakwa emadolweni
- Iingxaki ezinobungozi, okanye indlela yokuhamba
- Nayiphi na imiqondiso yomonakalo okanye ukulimala kwiimisipha, iintambo, kunye nemigqa ejikeleze idolo
- Ukubandakanywa kwamalungu angaphezulu (isalathisi se-rheumatoid arthritis)
Ukujonga iilingo zokuhlola
- X-ray. Ezi mvavanyo zengqondo yokuxilonga zivelisa imifanekiso yezakhiwo ezihlanganisiweyo, ezifana namathambo. Banganceda ukuhlula phakathi kweendlela ezahlukeneyo zesifo samathambo. I-X-ray ye-knee arthritis ingabonisa inxalenye yomgama odibeneyo, utshintsho kwithambo kwakunye nokwakhiwa kweethambo zethambo, ezaziwa njenge-osteophytes.
- Uvavanyo olongezelelweyo. Ngamanye amaxesha, i-imaging resonance magnetic, okanye i-MRI, i-scans, i-computed tomography, okanye i-CT, i-scans, okanye i-bone scans iyafuneka ukuze kuqinisekiswe imeko yethambo kunye nezicubu ezithambileyo zamadolo.
Uvavanyo lweGazi
� Ugqirha wakho unokucebisa ukuba kuhlolwe igazi ukuze kubonwe ukuba loluphi na uhlobo lwesifo samathambo onaso. Ngeentlobo ezithile ze-arthritis, ezifana ne-rheumatoid arthritis, iimvavanyo zegazi zinokunceda ngokuchongwa ngokufanelekileyo kwesi sifo.
Nangona idolo lihlangene linye lamanyathelo aqine kakhulu kwaye anamaqela amaninzi emzimbeni womntu, ngokuqhelekileyo ulungele ukulimala okanye ukulimala, okubangelwa kwiimeko ezahlukeneyo. Ukongeza, nangona kunjalo, ezinye izinto zempilo, ezinjenge-arthritis, zinokuchaphazela uxolo oluhlangeneyo. Kwi-intanethi yenkoliso ye-El Paso, TX, ukunakekelwa kwe-chiropractic kunokunceda ukuphucula iimpawu ezibuhlungu ezinxulumene ne-arthritis ye-knee, phakathi kwezinye izinto zempilo. UDkt Alex Jimenez DC, i-CCST Insight
Unyango lwe-Knee Arthritis
Unyango olunganyangekiyo
� Iindlela zonyango ezingasebenzisi utyando zihlala zicetyiswa phambi kokuba kuqwalaselwe unyango lotyando lwesifo samathambo. Abaqeqeshi bezempilo banokuncoma iindlela ezahlukeneyo zonyango, kubandakanywa ukunakekelwa kwe-chiropractic, unyango lomzimba, kunye nokuguqulwa kwendlela yokuphila, phakathi kwabanye.
Indlela yokuphila yokuguqula. Okunye ukuguqulwa kwendlela yokuphila kunokunceda ukukhusela idolo kunye nokuthintela inkqubela ye-arthritis. Ukunciphisa imisebenzi emzimbeni eyenza ukuba imeko ibe nzima, iya kubeka ingxaki emancinci emadolweni. Ukulahlekelwa isisindo kunokuncedisa ukunciphisa uxinzelelo kunye noxinzelelo emadolweni, kubangele iimpawu ezibuhlungu kunye nokunyuka komsebenzi.
Ukhathalelo lwe-Chiropractic kunye nonyango.Ukhathalelo lweChiropractic lusebenzisa uhlengahlengiso olupheleleyo lomzimba we-chiropractic ukubuyisela ngononophelo nakuphi na ukungahambi kakuhle komqolo, okanye ukuxutywa, okunokubangela iimpawu, kubandakanya isifo samathambo. Ugqirha unokucebisa unyango lomzimba ukwenza umthambo womntu ngamnye kunye nenkqubo yokuzivocavoca umzimba kwiimfuno zesigulane ngasinye.�Umthambo okhethekileyo uya kunceda ukwandisa uluhlu lwentshukumo kunye nokunyamezela, kunye nokunceda ukuqinisa imisipha kwiindawo ezisezantsi.
Izixhobo zokuncedisa. Ukusebenzisa izixhobo zokuncedisa, ezifana nenqanawa, izicathulo zokumangalisa okanye ukufaka izinto, okanye i-brace okanye umtya wamadolo, kunokunciphisa iimpawu ezibuhlungu. I-brace inceda ngomsebenzi nozinzo, kwaye inokuba luncedo ngakumbi xa i-arthritis isekelwe kwicala elinye lamadolo. Kukho iintlobo ezimbini zeebhonti eziqhelekileyo zisetyenziselwa ukuguqulwa kwamathambo: "Ukukhupha umthwalo" ukuguqula isisindo kwisigaba esichaphazelekayo sodolo, ngoxa i "bracket" brace inceda ukuxhasa yonke idolo.
Iziyobisi kunye / okanye amayeza. Zininzi iintlobo zamachiza zincedo ekuphatheni i-arthritis yamadolo. Ekubeni abantu baphendula ngokungafaniyo kumachiza, ugqirha uya kusebenza kunye nawe ukufumanisa amayeza kunye namayeza aphephile kwaye asebenzayo kuwe.
Utyando loPhando
� Igcisa lezempilo lingacebisa unyango lotyando ukuba isifo samathambo esibangela ukhubazeko olumandla kwaye kuphela ukuba ingxaki ayilungiswanga ngonyango olungaphangeliyo. Njengalo lonke utyando, kukho imingcipheko embalwa kunye neengxaki ngonyango lotyando lwe-arthritis yamadolo. Ugqirha uya kuxubusha iingxaki ezinokubakho nomguli.
Arthroscopy. Ngethuba le-arthroscopy, oogqirha basebenzisa izixhobo kunye neziphumo ezincinci zokuxilonga nokuphatha iingxaki zomdolo. Utyando lwe-Arthroscopic alisoloko lisetyenziselwa unyango lwe-arthritis yegama. Kwiimeko apho i-osteoarthritis ihamba kunye neendlebe ezidambisayo, utyando lwe-arthroscopic lungabulumko ukuphatha i-meniscus eqhekekileyo.
I-cartilage ukuxhoma. Iimpawu eziqhelekileyo zesikhumba zingathathwa kwibhanki yamathambo okanye kwiindawo ezihlukeneyo zamadolo ukuze zizalise umgodi kwi-cartilage ye-articular. Le nkqubo ibhekwe kuphela kwizigulane ezincinane.
Synovectomy. Ubuncwane obonakaliswe yimfuyo ye-rheumatoid isuswe ukunciphisa ukuvuvukala nentlungu.
Osteotomy. Kwi-knee osteotomy, mhlawumbi i-tibia (i-shinbone) okanye i-femur (ithambo lomlenze) liyasikwa emva koko libunjwe ngokutsha ukukhulula uxinzelelo kunye noxinzelelo kwi-joint joint. I-Knee osteotomy isetyenziswa xa i-osteoarthritis yesigaba sokuqala yonakele inxalenye enye yedolo. Ngokutshintsha ukusabalalisa ubunzima, oku kunokunciphisa kunye nokuphucula umsebenzi wamadolo.
Ukutshintshwa kwegama elipheleleyo okanye elincinane (i-arthroplasty).�Ugqirha uya kususa ithambo elonakeleyo kunye ne-cartilage, emva koko abeke iplastiki entsha okanye imigangatho yesinyithi ukubuyisela ukusebenza kwedolo kunye nezakhiwo ezijikelezileyo.
� Ukulandela naluphi na uhlobo lotyando lwedolo�yamathambo kuya kubandakanya ixesha lokuchacha. Ixesha lokubuyisela kunye nokuvuselelwa kuya kuxhomekeka kuhlobo lotyando olwenziweyo. Kubalulekile ukuthetha nengcali yakho yezempilo ukumisela olona khetho lonyango lwesifo samathambo edolo. 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 .
Ibhalwe nguGqr. Alex Jimenez �
Ingongoma eyongezelelweyo Ingxoxo: Ukuxoxisa ubuhlungu be-Knee Pain ngaphandle kokuPhenywa
� Iintlungu zedolo luphawu olwaziwayo olunokuthi lwenzeke ngenxa yokulimala kwamadolo 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.
by UGqr Alex Jimenez | Arthritis, Ukujonga kunye nokuchonga
Sagittal Fluid Sensitivity
- I-Sagittal Fluid Sensitive Sensitive MR slice ebonisa iNetovial popliteal popliteal (i-Baker's) cyst (ngentla yemifanekiso ephezulu) kunye nesiphumo esivumelanayo sesinxibelelaniso esingaphezulu (umfanekiso ongezantsi)
- Qaphela iindawo ezininzi ezimnyama ezibonisa ubumnyama kwimifanekiso yomibini, emele ukubekwa kwemibhobho yokufakelwa kwi-fibrinoid aka aka "imizimba yerayisi" uphawu lwe-MRI ebonakalisa uphawu lweRA
Ukuhanjiswa kweRheumatological Referral kunye ne-DRM
- Ulawulo lokugcinwa kwemilondolozo olulandelwa lulondolozo lwentsebenziswano kwiimeko zamathambo ezihlukumezayo kunye namaqela ahlukeneyo
- Ukufunda okunye:
- Ukuxilongwa nokuLawula iRumatoid Arthritis -AAFP
- www.aafp.org/afp/2011/1201/p1245.html
ISeptic Arthritis (SA)
- Isifo samathambo - d / t ibhaktiriya okanye ukungqubana kokungunda kokudibeneyo. I-SA inokubangela ukutshatyalaliswa okuhlanganyelweyo okukhawulezayo kwaye ifuna ukuba i-Dx kunye nolawulo lwe-antibiotic ngokukhawuleza
- Amalungu achaphazelekayo: amalunga amakhulu anegazi elityebileyo (idolo i-50%> iinyonga> amagxa).
- Iirhuts of Infection:
- I-1) I-memo yodwa i-m / c
- 2) Sasaza kwiziko elikufutshane
- I-3) Ukufakwa ngokuthe ngqo (umz., Ukwenzakala, iatrogen)
- Izigulana ezisemngciphekweni: abantwana, isifo seswekile, ukugonywa, umonakalo odibeneyo / usulelo, umzekelo, RA, njl.
- Abasebenzisi beziyobisi ze-IV basengozini enkulu kwaye banokuthi bangcolise ukudibanisa ii-atypical joints "SI joints" SIJ, SCJ, Symphysis pubis, ACJ, njl.
- Klinikhi: ziyahluka kwaye kuxhomekeke kwimpendulo ye-immune response kunye ne-bacterial virulence. Inokuthi ivele ngokukhawuleza kokuqala okanye ukunyanzeliswa kweentlungu ezidibeneyo zangaphambili, ukuvuvukala, ukunciphisa iROM. Imiqondiso jikelele ye-malaise, umkhuhlane, ukukhathala nokuphakama kwe-ESR, i-CRP, i-Leucocytosis inokuba khona.
- Isifo seswekile se-NB kunye ne-immunocompromised sinokuthi sivelise ukubonakaliswa okumbalwa kunye nokungabikho komkhuhlane
- I-Dx: ikliniki, i-radiological kunye nebhubhoratri. I-Arthrocentesis ingafuneka ukuba inkcubeko, isibalo seeseli kunye nokuhlolwa kwe-synovial
- Ulawulo: IV antibiotics
- Ukujonga iDx: iqala nge-radiogra kodwa kwinqanaba lokuqala uninzi olunokubakho alunakuba lolwazelelekileyo. I-MRI inokuba nolwazelelelo kwaye incede ekuchongeni kwangoko kokudityaniswa kwamadlala, i-edema yamathambo, njl. I-US kunokuba luncedo kumalungu adibeneyo nabantwana. I-US inceda ngokukhokela ngenaliti. I-scintigraphy yethambo inokusetyenziswa ngokwasemoyeni ukuba i-MRI ichasene
Imizila yeContactination Joint
- 1. Uhlobo (M / C)
- 2. Ukusasaza kwisiza esiseduze
- 3. Inoculation ngqo
- I-M / C yendalo-iStaph aureus
- I-NB Intsholongwane ye-Gonococcal ingaba yintlukwano ephezulu kwezinye iimeko
- Abasebenzisi beziyobisi ze-IV: I-Pseudomonas, i-candida
- Isilya seSickle: i-Salmonella
- Izilwanyana (iikati / izinja) ziluma: Pasteurella
- Ngamaxesha athile ungcoliseko lokungunda lunokwenzeka
Yezigulanaa
- Ekuqaleni ayingacaciswanga nge-ST / ukufakwa ngokudibeneyo, ukubonwa / ukugqobhoza kweenqwelomoya. Kuba kuthatha i-30% ye-compact kunye ne-50-75% ithambo le-trabecular ukuba litshatyalaliswe ngaphambi kokuba kubonwe kwi-x-ray, i-radiography ayikhathaleli kwezinye zeenguqu zokuqala. Ukucingela i-MR yeyona ndlela ikhethiweyo
- Ukuba i-IRM ayifumaneki okanye iyaphikiswa. I-Bone scintigraphy kunye ne-Tc-99 MDT inokunceda
- Kubantwana, e-US bakhetha ukuphepha i-ionizing radiation. Kubantwana, i-US inokuba nobuthathaka ngakumbi kunabantu abadala ngenxa yokunqongophala kwamathambo
Radiographic Dx
- Iziphumo zakuqala azinamvuzo. Iimpawu zakuqala zingabandakanya ukwandiswa okuhlanganisiweyo kwe d / t. Ukudumba kwezicubu ezithambileyo kunye nokuchaphaza / ukungcungcuthekiswa kweenqwelomoya
- Iiveki ze-1-2: i-periarticular and adjacent osseous changes zibonakalisa njengokutsalwa kwesinambuzane, ukudliwa kwenundu, ukuvumela ukutshutshiswa kwamathambo, ukulahleka, kunye nokungaqondakali kwe-epiphyseal "cortical line" ekhulayo kunye nokunyuka kokuvuvukala kwezicubu. I-MRI inokuba luncedo ekuqaleni kuka-Dx.
- Iimpawu ezisezantsi: ukuzaliswa kokuhlanganiswa kunye kunye ne-anloloses
- I-NB ye-arthritis ye-Septic ingaphuthuka ngokukhawuleza ngaphakathi kweentsuku kwaye idinga i-antibiotic yakudala ye-IV ukukhusela ukutshabalalisa okukhulu
I-T1 kunye ne-T2 Knee MRI
- I-T1 (ngasentla ngasekhohlo) kunye ne-T2 i-sagittal knee ii-MRI izilayi zibonisa ukulahleka kwesiginali eqhelekileyo yomqondiso kwi-T1 kunye nokunyuka kwi-T2 ngenxa yeedema ye-septic. Ithambo le-sequestrum d / t osteomyelitis eqhubela phambili kwi-septic arthritis iyaphawulwa. Ukumakishwa kokudityaniswa okudibeneyo kunye needema ezikufuphi nezicubu ziyabonakala. I-Dx: i-OSM kunye ne-septic arthritis
- Ukuxeliswa kunganceda i-Dx ye-septic yokudibanisa. Nangona kunjalo, i-Dx yokugqibela isekwe kwi-Hx, uvavanyo lomzimba, uvavanyo lwegazi kwaye okubaluleke kakhulu kukunqweneleka ngokufana (arthrocentesis)
- I-Synovial umthambo kufuneka ithunyelwe kwi-Gram staining, inkcubeko, ukuhlolwa kwe-glucose, isibalo se-leukocyte, kunye nokuzimisela
- ISR / CRP inokuphakanyiswa
- I-Synovial fluid: I-WBC ingaba yi-50,000-60,000 / ul, ne-80% ye-neutrophils enezinga le-glucose echanekileyo I-Gram stain: kwi-75% ye-co-accin cocci. Ukuguqulwa kwegram kuncinci kwiintsholongwane ze-gonococcal nge-25% yeenkcubeko kuphela
- Kwi-9% yamatyala, iikholeji zegazi ziphela zivela kumthombo we-pathogen kwaye kufuneka zifunyenwe ngaphambi kokuba unyango lwe-antibiotic
- Amanqaku: www.aafp.org/afp/2011/0915/p653.html
- www.aafp.org/afp/2016/1115/p810.html
I-Crystal-Induced Knee Arthritis
- I-crystalline arthritis: iqela lezinto ezibangelwa yi-crystal deposition kunye neenxa zonke.
- 2-m/c: Iikristale zeMonosodium urate (MSU)� kunye neCalcium Pyrophosphate Dehydrate crystals (CPPD) arthropathy
- Igawuthi: Ukubekwa kwe-MSU kumalungu ajikeleze kunye nezicubu ezithambileyo. Amanqanaba aphakamileyo e-serum uric acid (UA) (> 7mg / dL) ebangelwa kukuveliswa ngokugqithisileyo okanye ukukhutshwa okungaphantsi kwe-uric acid
- Nje ukuba i-UAU ifikelele / idlule kwi-7mg / dL, iya kufaka kwizicubu zomzimba. I-gout eyintloko: ukuphazamiseka kwe-metabolism ye-nucleic acids kunye ne-purines iyaphule. Ukuphuma kwesibini: Ukunyuka kweseli okunyukayo: I-Psoriasis, i-leukemia, i-myeloma emininzi, i-hemolysis, ichemotherapy, njl.
- I-Gout ibonisa ngezigaba ze-5:
- 1) i-hyperuricemia (iminyaka / iminyaka emininzi)
- Ukuhlaselwa ngokukrakra kwe-arthritis ye-gouty (i-wax kunye neyadala kwaye idlulela iminyaka emininzi)
- Isigaba sesithuba phakathi kokuhlaselwa
- Isifo se-tophaceous esingapheliyo
- Gouty nephropathy
Ukunikezelwa kwezonyango
- Kuxhomekeke kumanqanaba
- Uhlaselo olusebenzayo: iintlungu ezidityanisiweyo ezinobukrakra "zokuqala kunye ezimbi" kude kube buhlungu ukubamba ukukhanya
- I-DDx: ukuhlanganiswa kwe-septic (zombini inokuthi ikhona) i-bursitis njl
- I-gouty arthritis ibonisa nje nge-monoarthropathy
- Inqanaba lokunyanga okungapheliyo: idiphozithi kumalungu, i-pinna yendlebe, iioyile, kunye neminye imimandla. I-Nephrolithiasis njl. Amadoda> abafazi. Ukutyeba kakhulu, ukutya kunye nobudala> 50-60.
- Iimpawu zengxowankulu: Ukuhlaselwa kwangethuba kungekhona kwaye kungabonakalisa ukuxhatshazwa okuthe ngqo
- I-radiography ye-ging tophaceous engapheliyo: ihlikiwe ngaphandle kwe-peri-articular, para-articular kunye ne-intraosseous yukhukuliseko olunemiphetho engaphezulu. Umphetho obonakalayo wes sclerosis kunye nokubalwa kwangaphakathi, itouti ethambileyo yecuthi. Indawo ekujoliso kuzo: isiphelo esisezantsi m / c
- I-Rx: allopurinol, colchicine (esp ukuthintela iziqalo ezikhulu kunye nolondolozo)
Synovial Aspiration
- I-Synovial aspiration kunye ne-microscopy ephazamisayo ibonakalisa i-MSU enokungahambi kakuhle kweenaliti ezinobungqina obukhulu be-PMN. I-DDx: ama-crystals (CPFD) angaphantsi kwe-CPPD (ngenhla ngasekunene) abonwa kwi-Pseudogout ne-CPPD
Enkulu ST
- Ubungqingqwa kunye nokudityaniswa okuhlanganyelweyo kukhuphe ukhukuliseko lomhlaba ngokuguguma, ukugcinwa okugcwele koxinano lwethambo, ukubalwa kwangaphakathi Dx: isifo esingapheliyo esifumbileyo
Iimpawu zeMRI Gout
- Ukhukuliseko olunemida engaphezulu, umqondiso ophantsi kwi-T1 kwaye uphezulu kwi-T2 kunye nemifanekiso egxinwa ngamafutha. Ukuphucuka kokungafani kokuphuculwa kwe-tophaceous deposits d / t izicubu zokugcoba
- Dx: yokugqibela Dx; i-synovial aspiration kunye ne-microscopy ephazamisayo
Amanqaku angaphezulu
Knee Arthritis
