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Ukufanekisa Nokuxilonga

Ithimba Le-Back Clinic Imaging & Diagnostics. UDkt. Alex Jimenez usebenza nabahloli abasezingeni eliphezulu nochwepheshe bezithombe. Ekuhlanganyeleni kwethu, ochwepheshe bezithombe bahlinzeka ngemiphumela esheshayo, enesizotha, kanye nekhwalithi ephezulu. Ngokubambisana namahhovisi ethu, sihlinzeka ngekhwalithi yesevisi egunyazwe iziguli zethu futhi eyifanele. I-Diagnostic Outpatient Imaging (DOI) isikhungo sesimanjemanje seRadiology e-El Paso, TX. Yisona kuphela isikhungo sohlobo lwayo e-El Paso, esiphethwe futhi sisetshenziswa i-Radiologist.

Lokhu kusho ukuthi uma ufika e-DOI uzohlolwa nge-radiologic, yonke imininingwane, kusukela ekwakhiweni kwamakamelo, ukukhetha kwezinto zokusebenza, ochwepheshe abakhethwe ngesandla, kanye nesoftware ephethe ihhovisi, ikhethwa ngokucophelela noma iklanywe i-Radiologist. futhi hhayi nge-accountant. Indawo yethu yemakethe iyisikhungo esisodwa sokwenza kahle. Izindinganiso zethu ezihlobene nokunakekelwa kwesiguli yilezi: Sikholelwa ekwelapheni iziguli ngendlela ebesiyophatha ngayo umndeni wethu futhi sizokwenza konke okusemandleni ethu ukuqinisekisa ukuthi uthola ulwazi oluhle emtholampilo wethu.

Ukuqinisekisa Ukuphepha Kwesiguli: Indlela Yomtholampilo Emtholampilo We-Chiropractic

Ukuqinisekisa Ukuphepha Kwesiguli: Indlela Yomtholampilo Emtholampilo We-Chiropractic

by | I-Chiropractic, Ukuhlolwa kwe-Chiropractic, Izindaba ze-Chiropractic, Ubuhlungu obungapheliyo, Ukufanekisa Nokuxilonga, Ukwelashwa

Ochwepheshe bezempilo emtholampilo we-chiropractic banikeza kanjani indlela yomtholampilo yokuvimbela amaphutha ezokwelapha kubantu abasezinhlungwini?

Isingeniso

Amaphutha ezokwelapha aholela ekufeni kwabantu baseMelika abangu-44,000–98,000 ezibhedlela minyaka yonke, futhi amaningi abangela ukulimala okuyinhlekelele. (Kohn et al., 2000) Lesi sasingaphezu kwenani labantu abafa minyaka yonke ngenxa yengculaza, umdlavuza webele, nezingozi zezimoto ngaleso sikhathi. Ngokocwaningo lwakamuva, inani langempela lokufa lingase lisondele ku-400,000, libeka amaphutha ezokwelapha njengesizathu sesithathu sokufa esivame kakhulu e-US. Imvamisa, la maphutha awawona umkhiqizo wochwepheshe bezokwelapha ababi ngokwemvelo; kunalokho, ziwumphumela wezinkinga zesistimu nohlelo lokunakekelwa kwezempilo, njengamaphethini wokuzijwayeza abahlinzeki abangahambisani, amanethiwekhi omshwalense ahlukene, ukusetshenziswa kancane noma ukungabikho kwezivumelwano zokuphepha, nokunakekelwa okungahlanganisiwe. Isihloko sanamuhla sibheka indlela yomtholampilo yokuvimbela iphutha lezokwelapha esimweni somtholampilo. Sidingida abahlinzeki bezokwelapha abahlobene abangochwepheshe ekwelashweni okuhlukahlukene ukusiza abantu abahlushwa izinkinga ezingapheli. Siphinde futhi siqondise iziguli zethu ngokuzivumela ukuthi zibuze abahlinzeki bazo bezokwelapha abahlobene nabo imibuzo ebaluleke kakhulu neyinkimbinkimbi. UDkt. Alex Jimenez, DC, usebenzisa lolu lwazi kuphela njengesevisi yezemfundo. Disclaimer

Ukuchaza Amaphutha Ezokwelapha

Ukunquma ukuthi yiliphi iphutha lezokwelapha okuyisinyathelo esibaluleke kakhulu kunoma iyiphi ingxoxo mayelana nokuvimbela amaphutha ezokwelapha. Ungase ucabange ukuthi lokhu kuwumsebenzi olula kakhulu, kodwa lokho kuphela kuze kube yilapho uhlola uhlu olukhulu lwamagama asetshenziswayo. Amagama amaningi asetshenziswa ngendlela efanayo (ngezinye izikhathi ngephutha) njengoba amanye amagama ashintshashintsha, futhi ngezikhathi ezithile, incazelo yegama incike kulokho okukhethekile okuxoxwa ngakho.

 

 

Ngisho noma umkhakha wezokunakekelwa kwempilo uthe ukuphepha kwesiguli kanye nokuqeda noma ukunciphisa amaphutha ezokwelapha kwakuyizinto eziza kuqala, u-Grober no-Bohnen baphawule muva nje ngo-2005 ukuthi baye bahluleka endaweni eyodwa ebalulekile: ukucacisa incazelo yokuthi "mhlawumbe umbuzo obaluleke kakhulu ... iphutha lezokwelapha? Iphutha lezokwelapha ukwehluleka ukuqedela isenzo esihleliwe esimweni sezokwelapha. (UGrober noBohnen, ngo-2005) Nokho, awekho amagama umuntu avame ukuwabona ngephutha lezokwelapha—iziguli, ukunakekelwa kwempilo, nanoma iyiphi enye into—okukhulunywa ngawo kule ncazelo. Naphezu kwalokhu, incazelo inikeza uhlaka oluqinile lwentuthuko eyengeziwe. Njengoba ubona, leyo ncazelo ethile iqukethe izingxenye ezimbili:

  • Iphutha lokwenza: Ukwehluleka ukuqedela isenzo esihleliwe njengoba bekuhlosiwe.
  • Iphutha lokuhlela: kuyindlela yokuthi, ngisho noma yenziwe ngokuphelele, ayikhiqizi imiphumela oyifunayo.

Imiqondo yamaphutha okwenziwa kanye namaphutha okuhlela ayanele uma sizochaza iphutha lezokwelapha ngokwanele. Lokhu kungenzeka noma kuphi, hhayi endaweni yezokwelapha kuphela. Ingxenye yokuphathwa kwezokwelapha kufanele yengezwe. Lokhu kuveza umqondo wezehlakalo ezingezinhle, ezaziwa njengezehlakalo ezimbi. Incazelo evame kakhulu yesigameko esibi ukulimala okungahlosiwe ezigulini ezilethwa ukwelashwa kwezokwelapha esikhundleni sesifo sazo esiyisisekelo. Le ncazelo iye yamukelwa emhlabeni wonke ngandlela thize. Isibonelo, e-Australia, igama elithi izehlakalo lichazwa ngokuthi ukulimala okubangele ukuthi umuntu athole usizo lwezempilo. Lokhu kuhlanganisa izifo, ukuwa okubangela ukulimala, nezinkinga zemithi kadokotela kanye nemishini yezokwelapha. Izehlakalo ezithile ezingezinhle zingagwemeka.

 

Izinhlobo Ezivamile Zamaphutha Ezokwelapha

Okuwukuphela kwenkinga ngalo mbono ukuthi akuzona zonke izinto ezingezinhle ezenzeka ngengozi noma ngamabomu. Ngenxa yokuthi isiguli singase sizuze ekugcineni, kungase kwenzeke isenzakalo esibi esilindelwe kodwa esibekezelelwa. Ngesikhathi sokwelashwa ngamakhemikhali, isicanucanu nokulahlekelwa izinwele yizibonelo ezimbili. Kulokhu, ukwenqaba ukwelashwa okutuswayo kungaba ukuphela kwendlela enengqondo yokuvimbela umphumela ongemuhle. Ngakho sifika emcabangweni wezehlakalo ezimbi ezingagwemeka nezingagwemeki njengoba siqhubeka siphucula incazelo yethu. Akulula ukuhlukanisa ukukhetha ukubekezelela umthelela owodwa uma kunqunywa ukuthi umphumela omuhle uzokwenzeka kanyekanye. Kodwa injongo iyodwa ayisona izaba. (Inethiwekhi Yokuphepha Yesiguli, 2016, isigaba.3) Esinye isibonelo sephutha elihleliwe kungaba ukunqunywa konyawo lwesokudla ngenxa yesimila esandleni sobunxele, okungaba ukwamukela isenzakalo esingesihle esaziwayo nesibikezelwe ngethemba lomphumela onenzuzo lapho kungakaze kuvele khona ngaphambili. Abukho ubufakazi obusekela ukulindela umphumela omuhle.

 

Amaphutha ezokwelapha abangela ukulimala esigulini ngokuvamile yiwona esigxile kuwo ucwaningo lwethu. Noma kunjalo, amaphutha ezokwelapha angenzeka futhi enzeka lapho isiguli singalinyazwanga. Ukwenzeka kokuphuthelwa eduze kungase kunikeze idatha ebalulekile lapho uhlela indlela yokunciphisa amaphutha ezokwelapha endaweni yokunakekelwa kwezempilo. Noma kunjalo, ukuvama kwalezi zenzakalo uma kuqhathaniswa nezikhathi odokotela ababika ngazo kufanele kuphenywe. Amaphutha aseduze amaphutha ezokwelapha abengadala umonakalo kodwa awenzanga esigulini, ngisho noma isiguli senza kahle. (U-Martinez et al., 2017) Kungani ungavuma okuthile okungase kuphumele ekuthatheni izinyathelo zomthetho? Cabangela isimo lapho umhlengikazi, nganoma yisiphi isizathu, esanda kubuka izithombe zemithi ehlukene futhi esezoyinikeza imithi. Mhlawumbe kukhona okusalibele enkumbulweni yakhe, bese enquma ukuthi akuyona indlela umuthi othile obukeka ngayo. Lapho ebheka, wathola ukuthi imithi engalungile yayinikezwe. Ngemva kokuhlola wonke amaphepha, uyalilungisa iphutha futhi anikeze isiguli incwadi kadokotela efanele. Ingabe kungenzeka ukugwema iphutha esikhathini esizayo uma irekhodi lokuphatha lihlanganisa nezithombe zomuthi ofanele? Kulula ukukhohlwa ukuthi kube nephutha nethuba lokulimaza. Lelo qiniso lihlala liyiqiniso kungakhathaliseki ukuthi sibe nenhlanhla yokulithola ngesikhathi noma sabhekana nemiphumela engemihle.

 

Amaphutha Wemiphumela Nenqubo

Sidinga idatha ephelele ukuze sakhe izixazululo ezithuthukisa ukuphepha kwesiguli futhi zehlise amaphutha ezokwelapha. Okungenani, lapho isiguli sisesikhungweni sezokwelapha, konke okungenziwa ukuvimbela ukulimala nokusibeka engozini kufanele kubikwe. Odokotela abaningi baye banquma ukuthi ukusebenzisa amaphutha emishwana nezenzakalo ezimbi kwakuphelele futhi kufanelekile ngemva kokubuyekeza amaphutha nezenzakalo ezimbi ekunakekelweni kwezempilo nokuxoxa ngamandla abo nobuthakathaka ngo-2003. Le ncazelo ehlanganisiwe izokwandisa ukuqoqwa kwedatha, okuhlanganisa amaphutha, izingcingo eziseduze, eduze. uyaphuthelwa, futhi amaphutha asebenzayo nacashile. Ukwengeza, igama elithi izehlakalo ezimbi lihlanganisa amagama avame ukusho ukulimala kwesiguli, njengokulimala kwezokwelapha kanye nokulimala kwe-iatrogenic. Okuwukuphela kwento esele ukunquma ukuthi ibhodi lokubuyekeza liwuhlaka olufanele yini lokusingatha ukuhlukaniswa kwezehlakalo ezimbi ezingagwemeka nezingagwemeki.

 

Umcimbi womlindi uyisigameko lapho kudingeka khona ukubika kuKhomishana Ehlangene. I-Joint Commission ithi umcimbi womlindi uyisigameko esingalindelekile esibandakanya ukulimala okubi ngokomzimba noma kwengqondo. ("Sentinel Events," 2004, p.35) Akukho ukukhetha, njengoba kufanele kubhalwe phansi. Izikhungo eziningi zokunakekelwa kwempilo, nokho, ziyawagcina amarekhodi azo achaza izehlakalo zabalindi nokuthi yini okufanele yenziwe uma kwenzeka umuntu eqinisekisa ukuthi izindinganiso zeKhomishini Ehlanganyelwe ziyafinyelelwa. Lesi ngesinye salezo zimo lapho kungcono ukuphepha kunokuzisola. Njengoba igama elithi “serious” liwumqondo ohlobene, kungase kube khona ukuklolodelana lapho uvikela osebenza naye noma umqashi. Ngakolunye uhlangothi, ukubika umcimbi womlindi ngokungalungile kungcono kunokwehluleka ukubika umcimbi womlindi. Ukwehluleka ukudalula kungaba nemiphumela emibi, okuhlanganisa ukunqanyulwa komsebenzi.

 

Uma kucatshangelwa amaphutha ezokwelapha, abantu bavame ukwenza iphutha lokugxila emaphutheni kadokotela. Amaphutha emithi ngokungangabazeki avamile futhi ahlanganisa amaphutha amaningi enqubo njengamanye amaphutha ezokwelapha. Ukwehlukana kwezokuxhumana, amaphutha enziwe ngesikhathi sokunikwa kukadokotela noma ukukhipha, nezinye izinto eziningi zingenzeka. Kodwa siyobe siyahlulela kabi kakhulu le ndaba uma sicabanga ukuthi amaphutha ezidakamizwa ayimbangela yokulimala esigulini. Inselele eyodwa enkulu ekuhlukaniseni amaphutha ezokwelapha ahlukene ukunquma ukuthi kufanele kuhlukaniswe iphutha ngokusekelwe kunqubo ehilelekile noma umphumela. Kuyamukeleka ukuhlola lezo zigaba lapha, uma kubhekwa imizamo eminingi eyenziwe yokuthuthukisa izincazelo zokusebenza ezihlanganisa kokubili inqubo nomphumela, eziningi zazo ezisekelwe emsebenzini ka-Lucian Leape kusukela ngawo-1990. 

 

Thuthukisa Indlela Yakho Yokuphila Namuhla- Ividiyo

Ukuhlaziya Nokuvimbela Amaphutha Ezokwelapha

Izigaba ezisebenzayo nezingasebenziseki kwakuyizigaba ezimbili eziyinhloko zezehlakalo ezimbi u-Leape nozakwabo abazihlukanisa kulolu cwaningo. (Leape et al., 1991) Izinkinga zokuhlinza zazihlanganisa ukungenwa yizilonda, ukwehluleka ukuhlinzwa, izinkinga ezingezona ezobuchwepheshe, izinkinga sekwephuzile, kanye nobunzima bokusebenza. Okungasebenzi: izihloko ezifana nemithi ehlobene nemithi, ukuxilonga, ukuphathwa kabi, okuhlobene nenqubo, ukuwa, ukuphuka, i-postpartum, i-anesthesia-related, neonatal, kanye nesihloko sokubamba-konke kwesistimu kufakwe ngaphansi kwalesi sigaba sezehlakalo ezimbi. I-Leape iphinde yahlukanisa amaphutha ngokukhomba iphuzu lokuhlukaniswa kwenqubo. Uphinde wahlukanisa lezi zihloko ngezihloko ezinhlanu, ezihlanganisa: 

  • System
  • Ukusebenza
  • Ukuphathwa kwezidakamizwa
  • kwesifo
  • Okuvikelayo

Amaphutha amaningi ezinqubo awela ngaphansi kwesihloko esingaphezu kwesisodwa, nokho wonke asiza ukukhomba imbangela yangempela yenkinga. Uma udokotela ongaphezu koyedwa ebambe iqhaza ekunqumeni izindawo eziqondile ezidinga ukuthuthukiswa, kungase kudingeke imibuzo eyengeziwe.

 

 

Ngokobuchwepheshe, iphutha lezokwelapha lingenziwa yinoma yisiphi isisebenzi esibhedlela. Ayigcini kochwepheshe bezokwelapha abafana nodokotela nabahlengikazi. Umqondisi angase avule umnyango, noma ilungu leqembu elihlanzayo lingashiya ikhemikhali lapho ingane ingalibamba. Okubaluleke ngaphezu kokwaziwa komenzi wephutha yisizathu salo. Kuthiwani ngaphambi kwayo? Futhi singaqinisekisa kanjani ukuthi lokho akwenzeki futhi? Ngemva kokuqoqa yonke idatha engenhla nokunye okuningi, yisikhathi sokuthola ukuthi ungawavimbela kanjani amaphutha afanayo. Mayelana nemicimbi yabalindi, iJoint Commission yagunyaza kusukela ngo-1997 ukuthi zonke lezi zigameko zenzeke ngenqubo ebizwa nge-Root Cause Analysis (RCA). Kodwa-ke, ukusebenzisa le nqubo yezehlakalo ezidinga ukubikwa kubantu bangaphandle kuzodinga ukulungiswa.

 

Iyini Ukuhlaziywa Kwembangela Yomsuka?

Ama-RCA "athwebule imininingwane kanye nombono wesithombe esikhulu." Benza amasistimu okuhlola abe lula, ukuhlaziya ukuthi isenzo sokulungisa siyadingeka yini, kanye nokulandelela amathrendi. (Williams, 2001) Nokho, iyini ngempela i-RCA? Ngokuhlola izehlakalo eziholele ephutheni, i-RCA ingagxila ezenzakalweni nasezinqubweni esikhundleni sokubuyekeza noma ukusola abantu abathile. (I-AHRQ, 2017) Yingakho kubaluleke kangaka. I-RCA ivamise ukusebenzisa ithuluzi elibizwa ngokuthi i-Five Whys. Lena inqubo yokuqhubeka uzibuza ukuthi “kungani” ngemva kokukholwa ukuthi unqume imbangela yenkinga.

 

Isizathu sokuthi kubizwe ngokuthi “izizathu ezinhlanu” yingoba, nakuba ezinhlanu kuyisiqalo esihle kakhulu, kufanele uzibuze ukuthi kungani kuze kube yilapho uthola imbangela eyinhloko yenkinga. Ukubuza ukuthi kungani ngokuphindaphindiwe kungase kwembule amaphutha ezinqubo eziningi ezigabeni ezihlukene, kodwa kufanele uhlale ubuza ukuthi kungani ngaso sonke isikhathi sodaba uze uphelelwe ezinye izinto ezingalungiswa ukuze unikeze umphumela ofiselekayo. Kodwa-ke, amathuluzi ahlukene ngaphandle kwaleli angasetshenziswa ophenyweni lwembangela. Baningi abanye abakhona. Ama-RCA kufanele abe nemikhakha eminingi futhi angaguquguquki futhi abandakanye bonke abathintekayo ephutheni ukuze kugwenywe ukungaqondi kahle noma ukubikwa okungalungile kwezehlakalo.

 

Isiphetho

Amaphutha ezokwelapha ezikhungweni zezempilo ayizehlakalo ezivamile futhi ezingabikwanga ezibeka impilo yeziguli engcupheni. Kucatshangwa ukuthi abantu abangafika engxenyeni yesine yesigidi bayafa unyaka ngamunye ngenxa yamaphutha ezokwelapha. Lezi zibalo azamukelekile esikhathini lapho ukuphepha kwesiguli kufanele kube yinto ehamba phambili, kodwa akukuningi okwenziwayo ukuze kushintshwe izinqubo. Uma amaphutha ezokwelapha echazwe kahle futhi umsuka wenkinga utholakala ngaphandle kokubeka icala kubasebenzi abathile, lokhu akudingekile. Izinguquko ezibalulekile zingenziwa uma izimbangela ezibalulekile zesistimu noma amaphutha enqubo zihlonzwa ngendlela efanele. Indlela engaguquguquki, enemikhakha eminingi yokuhlaziya imbangela esebenzisa izinhlaka ezinjengalezi ezinhlanu zokuthi kungani zicutshungulwa kuze kube yilapho kudalulwa zonke izinkinga nokukhubazeka kuyithuluzi eliwusizo. Nakuba manje sekudingekile ukuze kuqalwe izenzakalo zabalindi, Ukuhlaziywa Kwembangela Yomsuka kungase futhi kufanele kusetshenziswe kuzo zonke izimbangela zamaphutha, kuhlanganise nokuphuthelwa eduze.

 

Okubhekwayo

I-Ejensi Yocwaningo Lokunakekelwa Kwezempilo Nekhwalithi. (2016). Ukuhlaziya Imbangela. Ibuyiselwe ngomhla ka-Mashi 20, 2017, kusukela psnet.ahrq.gov/primer/root-cause-analysis

Grober, ED, & Bohnen, JM (2005). Ukuchaza iphutha lezokwelapha. Ingabe uJ Surg, 48(1), i-39-44. www.ncbi.nlm.nih.gov/pubmed/15757035

Kohn, LT, Corrigan, J., Donaldson, MS, & Institute of Medicine (US). IKomidi Lekhwalithi Yokunakekelwa Kwezempilo eMelika. (2000). Ukwenza iphutha kuwumuntu : ukwakha uhlelo lwezempilo oluphephile. National Academy Press. books.nap.edu/books/0309068371/html/index.html

Leape, LL, Brennan, TA, Laird, N., Lawthers, AG, Localio, AR, Barnes, BA, Hebert, L., Newhouse, JP, Weiler, PC, & Hiatt, H. (1991). Uhlobo lwezehlakalo ezingezinhle ezigulini ezilaliswe esibhedlela. Imiphumela ye-Harvard Medical Practice Study II. N Engl J Med, 324(6), i-377-384. doi.org/10.1056/NEJM199102073240605

I-Lippincott ® NursingCenter ®. Isikhungo sabahlengikazi. (2004). www.nursingcenter.com/pdfjournal?AID=531210&an=00152193-200411000-00038&Journal_ID=54016&Issue_ID=531132

U-Martinez, W., Lehmann, LS, Hu, YY, Desai, SP, & Shapiro, J. (2017). Izinqubo Zokuhlonza Nokubuyekeza Imicimbi Emibi kanye Nokuphuthelwa Okuseduze Esikhungweni Sezokwelapha Sezemfundo. I-Jt Comm J Qual Isiguli Saf, 43(1), i-5-15. doi.org/10.1016/j.jcjq.2016.11.001

Inethiwekhi Yokuphepha Yesiguli. (2016). Izehlakalo ezimbi, eduze kwamaphutha, namaphutha. Ibuyiselwe ngomhla ka-Mashi 20, 2017, kusukela psnet.ahrq.gov/primer/adverse-events-near-misses-and-errors

Williams, PM (2001). Amasu okuhlaziya imbangela yezimpande. I-Proc (Bayl Univ Med Cent), 14(2), i-154-157. doi.org/10.1080/08998280.2001.11927753

Disclaimer

I-Spinal Stenosis MRI: I-Back Clinic Chiropractor

I-Spinal Stenosis MRI: I-Back Clinic Chiropractor

by | Ukufanekisa Nokuxilonga, Care Spine

I-Spinal stenosis yilapho isikhala endaweni ethile noma ngaphakathi komgogodla siqala ukuncipha, sivala ikhono lokunyakaza okuvamile / okunethezeka kanye nokujikeleza kwezinzwa. Kungase kuthinte izindawo ezahlukene, kuhlanganise isibeletho/intamo, i-lumbar/back back, futhi, kancane kancane, izifunda ze-thoracic/phezulu noma phakathi nendawo emuva okubangela ukushoshozela, ukuba ndikindiki, ukuminyana, ubuhlungu, ubuthakathaka bemisipha, noma inhlanganisela ngemuva, umlenze/amathanga, nezinqe. Kungaba nezinto ezihlukahlukene ezibangela i-stenosis; ukuxilonga okulungile kuyisinyathelo sokuqala, nalapho i-spinal stenosis I-MRI uyangena.

I-Spinal Stenosis MRI: I-Chiropractor Yezokwelapha Elimazayo

I-Spinal Stenosis MRI

I-stenosis ingaba yinselele ukuxilonga njengoba ingaphezulu kwesibonakaliso / inkinga kunesimo, ngokuvamile esibangelwa ama-disc herniated, i-bone spurs, isimo sokuzalwa, ukuhlinzwa ngemuva kokuhlinzwa, noma ngemva kokutheleleka. I-Magnetic resonance imaging/MRI ukuhlolwa okuvamile okusetshenziselwa ukuxilongwa.

Sifo

  • Uchwepheshe wezokunakekelwa kwempilo, njenge-chiropractor, umelaphi womzimba, uchwepheshe womgogodla, noma udokotela, uzoqala ngokuqonda izimpawu nomlando wezokwelapha.
  • Ukuhlolwa komzimba kuzokwenziwa ukuze kufundwe kabanzi mayelana nendawo, ubude besikhathi, izikhundla, noma imisebenzi eyehlisa noma eyenza izimpawu zibe zimbi kakhulu.
  • Ukuhlola okwengeziwe kuhlanganisa amandla emisipha, ukuhlaziya inzuzo, nokuhlola ibhalansi ukusiza ukuqonda kangcono ukuthi ubuhlungu buvelaphi.
  • Ukuqinisekisa ukuxilongwa, ukuthwebula kuyodingeka ukubona ukuthi kwenzekani.
  • I-MRI isetshenziswa izithombe ezenziwe ngekhompyutha ukukhiqiza izithombe ezibonisa izicubu zamathambo nezithambile, njengemisipha, izinzwa, nama-tendon, futhi uma zicindezelwe noma zicasukile.
  • Uchwepheshe wezokunakekelwa kwempilo kanye Isazi se-MRI izodlula izidingo zokuphepha ngaphambi kwesithombe.
  • Ngenxa yokuthi umshini usebenzisa omazibuthe abanamandla, ngeke kube khona insimbi emzimbeni noma emzimbeni, njengama-prostheses afakiwe noma izisetshenziswa ezihlanganisa:
  • Amaphakethe
  • Izimpande ze-cochlear
  • Amaphampu okufakwa kwemithi
  • Imithi yokuvimbela inzalo
  • Ama-Neurostimulators
  • Iziqeshana ze-Intracranial aneurysm
  • Izikhuthazi zokukhula kwamathambo
  • Ukuhlolwa kwesithombe okuhlukile kungasetshenziswa uma umuntu engakwazi ukuba ne-MRI njenge CT scan.

I-MRI ingaba kusuka emaminithini ambalwa kuya ehoreni noma ngaphezulu, kuye ngokuthi zingaki izikhundla ezidingekayo ukuze uhlukanise indawo elimele futhi uthole isithombe esicacile. Ukuhlolwa akubuhlungu, kodwa ngezinye izikhathi abantu bayacelwa ukuthi bagcine isimo esithile esingase singakhululeki. Uchwepheshe/ochwepheshe bazobuza ukuthi ingabe kukhona ukungakhululeki futhi banikeze noma yiluphi usizo ukwenza ukuzizwisa kube lula ngangokunokwenzeka.

Ukwelashwa

Akuzona zonke izimo ze-stenosis ezidala izimpawu, kodwa kunezinketho zokwelashwa ezinganconywa uchwepheshe wezempilo.

  • Ukunakekelwa kwe-Conservative kuyisiphakamiso sokuqala esihlanganisa i-chiropractic, i-decompression, i-traction, nokwelashwa ngokomzimba.
  • Ukwelapha kukhulisa amandla emisipha, kuthuthukisa ukunyakaza okuhlukahlukene, kuthuthukisa ukuma nokulinganisela, kunciphisa izimpawu zokungaphatheki kahle, futhi kuhlanganisa namasu okuvimbela nokulawula izimpawu.
  • Imithi kadokotela ingaba yingxenye yohlelo olukhulu lokwelapha.
  • Ukuhlinza kungase kube inketho ezimweni ezinzima kakhulu lapho ukunakekelwa okuvamile kungasebenzi.

Ukuqina kwesisu

Okubhekwayo

Isizindalwazi Sokubukezwa Kwezibuyekezo Zemithelela (i-DARE): Ukubuyekezwa Okuhlolwe Ikhwalithi [I-inthanethi]. I-York (UK): Isikhungo Sokubuyekezwa Nokusabalalisa (UK); 1995-. Ukuxilongwa kwe-lumbar spinal stenosis: ukubuyekezwa okuhlelekile okubuyekeziwe kokunemba kokuhlolwa kokuxilonga. 2013. Itholakala ku: www.ncbi.nlm.nih.gov/books/NBK142906/

Ghadimi M, Sapra A. Magnetic Resonance Imaging Contraindications. [Kubuyekezwe 2022 May 8]. Ku: StatPearls [I-inthanethi]. I-Treasure Island (FL): I-StatPearls Publishing; 2022 Jan-. Itholakala ku: www.ncbi.nlm.nih.gov/books/NBK551669/

Gofur EM, Singh P. Anatomy, Back, Vertebral Canal Blood Supply. [Kubuyekezwe 2021 Jul 26]. Ku: StatPearls [I-inthanethi]. I-Treasure Island (FL): I-StatPearls Publishing; 2022 Jan-. Itholakala ku: www.ncbi.nlm.nih.gov/books/NBK541083/

U-Lurie, uJon, noChristy Tomkins-Lane. "Ukuphathwa kwe-lumbar spinal stenosis." BMJ (Clinical research ed.) vol. 352 h6234. 4 Jan. 2016, doi:10.1136/bmj.h6234

Stuber, Kent, et al. "Ukwelashwa kwe-Chiropractic ye-lumbar spinal stenosis: ukubuyekezwa kwezincwadi." Ijenali yemithi ye-chiropractic vol. 8,2 (2009): 77-85. doi:10.1016/j.jcm.2009.02.001

Ukulindela Umtholampilo Wezinhlungu Zomgogodla Okulindelekile

Ukulindela Umtholampilo Wezinhlungu Zomgogodla Okulindelekile

by | Ukufanekisa Nokuxilonga

Ama-Chiropractors kanye nochwepheshe bomgogodla basebenzisa i-imaging yomgogodla ngokusebenzisa ama-X-ray, ama-MRIs, noma ama-CT scans ukuze bathole ukuthi yini ebangela izinkinga nobuhlungu beqolo. Ukuthwebula izithombe kuvamile. Kungakhathaliseki ukuthi i-chiropractic noma ukuhlinzwa komgogodla, basiza kakhulu ukuthola izinkinga ezingemuva futhi bavumele umuntu ukuthi abone ukuthi kwenzekani. Izinhlobo zamacala zihlanganisa ubuhlungu beqolo lokho:

  • Ivela ukuhlukunyezwa
  • Ihlale amasonto amane kuya kwayisithupha
  • Ihambisana nomlando wa:
  • Cancer
  • Fever
  • Izithukuthuku ebusuku

Odokotela basebenzisa lezi zithombe uma ukuxilonga isimo somgogodla. Nakhu okunye ukuqonda ngezithombe zomgogodla.

 

Ukulindela Umtholampilo Wezinhlungu Zomgogodla Okulindelekile

X-ray

I-X-ray yobuhlungu beqolo ingaba usizo kakhulu. An I-X-ray isekelwe emisebeni futhi isetshenziselwa ukuhlola izimo zezakhiwo zamathambo. Ama-X-ray alungele izicubu zethambo noma izicubu ezenziwe nge-ossified noma zibalwe. Asebenza kahle kakhulu ngezicubu eziqinile, ikakhulukazi amathambo. Izicubu ezithambile ezifana nemisipha, imigqa, noma i-intravertebral discs azibonakali futhi.

Abantu abahlolwa i-X-ray ngemuva bazoskenwa ngomshini okhiqiza i-beam. Umamukeli ukhetha ukubhalisa i-beam ngemuva kokuthi idlule emzimbeni futhi ikhiqize isithombe. Kuthatha cishe imizuzu emihlanu ukuqeda kodwa kungase kube isikhathi eside kuye ngenombolo kadokotela yezithombe. Ama-X-ray ayasiza ngezinjongo zomshwalense futhi akhiphe izimo zamathambo njengokuphuka kokucindezelwa kanye/noma ama-bone spurs. Ama-X-reyi ahlelwa ngezizathu ezithile futhi ngokuvamile ayingxenye yocwaningo lokuxilonga umzimba wonke. Lokhu kuhlanganisa i-MRI kanye/noma i-CT scan.

I-CT Scan

I-CT imele i-tomography yekhompyutha. Iwuchungechunge lwamaX-ray afakwa kwidijithali abe yizithombe kusetshenziswa ikhompuyutha. Ubuhle be-CT scan ukuya kuma-X-ray ajwayelekile ukuthi inikeza imibono/ama-engeli ahlukene omzimba futhi ingaba ku-3D. Ama-CT scan avame ukusetshenziswa ezimeni zokuhlukumezeka noma abantu abake bahlinzwa. Bathatha cishe imizuzu emihlanu. Kuma-X-ray, abantu bayasukuma noma balale ngaphansi komshini we-X-ray njengoba uhlola umzimba. I-CT scan yenza umuntu alale phansi emshinini obukeka uyindilinga obheka idonathi oskena ngenkathi uzungezisa ngesikhathi sokuthwebula. Abantu ngabanye banconywa ukuthi bagqoke izingubo ezikhululekile, ezikhululekile. Ngezinye izikhathi udayi, noma ukugqama kwe-intravenous, kusetshenziselwa ukwenza izicubu zemithambo zigqame, ikhiqiza izithombe ezicace kakhudlwana.

I-MRI

I-MRI imfushane imaging magnetic resonance. Ama-MRIs asebenzisa omazibuthe ukwenza izithombe. I-MRI imaging ivame ukusetshenziswa kubantu abaye bahlinzwa. Zithatha isikhathi eside, ngokuvamile cishe imizuzu engama-30 kuya kwengama-45. Azikho izinto zensimbi ezivunyelwe ku-MRI. Iziguli zicelwa ukuthi zisuse izinto ezifana namabhande, ubucwebe, njll. Udayi wokuqhathanisa ungaba yingxenye ye-MRI. Umshini ufana nomhubhe. Lokhu kungaba yinselele kubantu abane-claustrophobia. Xhumana nodokotela futhi uthole ukuthi ungakhululeka kanjani phakathi nenqubo.

Ezinye Izinhlobo Zokuthwebula Umgogodla

Ezinye izinhlobo zezithombe zihlanganisa:

CT navigation

  • Ukuzulazula kwe-CT kubonisa izikena ze-CT zesikhathi sangempela phakathi nenqubo.

I-fluoroscopy

  • I-Fluoroscopy ihilela umsebe we-X-ray odlula ngokuqondile emzimbeni obonisa izithombe ezibukhoma, ezihambayo.

Zombili lezi zinhlobo zokucabanga komgogodla zisetshenziswa ngesikhathi sokuhlinzwa. Kwezinye izimo, isithombe se-intraoperative iyasetshenziswa. Lolu hlobo lwezithombe lusebenzisa amarobhothi obuchwepheshe obuphezulu ukusiza odokotela abahlinzayo bazulazule ezindaweni eziqinile phakathi nenqubo. Lokhu kwandisa ukunemba kukadokotela ohlinzayo futhi kunciphisa usayizi wokusikwa.

ultrasound

I-Ultrasound ingasetshenziselwa izimo zomgogodla. Lesi ukuhlolwa kwesithombe esisebenzisa amaza omsindo ukukhiqiza izithombe. Kodwa-ke, izivivinyo ze-imaging ezisetshenziswa ekucabangeni komgogodla ngokuyinhloko ama-X-ray nama-MRIs.

Ukuqokwa Kwezithombe

Khuluma nodokotela wakho noma isazi se-chiropractor ngaphambi kwesikhathi ukuze uqonde ukuthi yini ongayilindela phakathi nenqubo yokuthatha izithombe. Bazokwazisa ukuthi uzilungiselela kanjani kanye nanoma yimiphi imiyalelo ekhethekile ngaphambi kokuqokwa. Kanye nomlando wezokwelapha kanye nokuhlolwa ngokomzimba, ukucabanga komgogodla kuyingxenye ebalulekile yenqubo yokuxilonga ukuthola ukuthi yini ebangela ubuhlungu nokuthuthukisa uhlelo lokwelapha olungcono kakhulu.

Ukubunjwa komzimba

Imiphumela Yesikhathi Esifushane Yekhofi Nomfutho Wegazi

I-caffeine etholakala ekhofini iyisikhuthazi noma into ethokozisa amasistimu omzimba. Lapho i-caffeine idliwe, abantu baba nokwanda kwenjabulo, ikakhulukazi ohlelweni lwenhliziyo nemithambo yegazi. Lokhu kusasasa kubangela ukushaya kwenhliziyo nomfutho wegazi kukhuphuke bese wehla ubuyela ezingeni lesisekelo kubantu abanempilo. Ikhofi inyusa kancane umfutho wegazi wesikhashana. Ukusetshenziswa kwekhofi okumaphakathi kuphephile kubantu abangenazo izimo zenhliziyo ezikhona kakade.

Okubhekwayo

Ikhomishini Yokulawula Izikhali Zenuzi yase-United States. (May 2021) “Doses in Our Daily Lives” www.nrc.gov/about-nrc/radiation/around-us/doses-daily-lives.html

I-X-Ray Yobuhlungu Basemuva: Ukubuyekezwa Kwamanje Emithi Ye-Musculoskeletal. (April 2009) “Iyini indima yokuthwebula izithombe ebuhlungwini obukhulu obuphansi beqolo?” www.ncbi.nlm.nih.gov/pmc/articles/PMC2697333/

Izikhalazo Zezingane Izindlela Zokuhlonza Ukuxilonga | El Paso, TX.

Izikhalazo Zezingane Izindlela Zokuhlonza Ukuxilonga | El Paso, TX.

by | Ukufanekisa Nokuxilonga

  • Lokhu ukubuyekezwa okufushane kwezinye zezikhalazo ezibalulekile zezingane okuhlangatshezwana nazo ekusebenzeni komtholampilo.
  • I-Acute Trauma kuhlanganise nokuhlukumezeka kwekhanda okubuhlungu
  • Ukuhlukumezeka okungeyona ingozi ezinganeni (ingane eshayiwe)
  • Izikhalazo ze-Musculoskeletal (I-Juvenile Idiopathic Arthritis, scoliosis,
  • Ama-neoplasms ezingane ajwayelekile (CNS & nabanye)
  • Ukutheleleka
  • Isifo se-metabolic

I-Acute Pediatric Trauma:

izithombe zokuxilonga zezingane el paso, tx.
  • Ukulimala kwe-FOOSH (isb., ukuwa kwe-monkey-bar)
  • Supracondylar Fx, indololwane. Njalo d/t ukuhlukumezeka kwengozi. <10 iminyaka
  • I-Extra-articular Fx
  • Izigaba zezigaba ze-Gartland zokulimala okuncane okucashile zilashwe ngokungakwazi ukunyakazisa uma kuqhathaniswa nokugudluka kwendololwane ngemuva kwelashwa ngokuhlinza
  • Ingozi engaba khona ye-ischemic compromise uma ukunakekelwa kubambezelekile (inkontileka yeVolkmann)
  • Ukuhlolwa kwe-Radiological kubalulekile: uphawu lukaseyili & uphawu lwephedi yamafutha angasemva olunomugqa wangaphambili we-humeral wehlulekile ukuphambana phakathi/2/3 ne-Capitellum.

I-Fx yezingane engaphelele:

izithombe zokuxilonga zezingane el paso, tx.
  • Iningi leminyaka engu- <10 yeGreenstick, Torus, Plastic aka Bowing deformity
  • Ivamise ukuphulukisa kahle, yelashwe ngendlela eyongayo nge-immobilization
  • Ukukhubazeka kwepulasitiki uma i>20-degrees idinga ukuncishiswa okuvaliwe
  • Ukuphuka kogebhezi lwe-ping pong kungase kuthuthuke kulandela ukuhlukumezeka, ukulethwa kwe-forceps kanye nezinkinga zokuhlukumezeka kokuzalwa. Kungase kudingeke ukuthi kuhlolwe yi-pediatric neurosurgeo.n
izithombe zokuxilonga zezingane el paso, tx.
  • Izinhlobo ze-Salter-Harris zokulimala kwepuleti lokukhula kwe-physeal
  • Uhlobo 1-ukushelela. isb, Slipped Capital Femoral Epiphysis. Ngokuvamile akukho ukuphuka kwethambo okuphawuliwe
  • Thayipha i-2-M/C ene-prognosis enhle
  • Thayipha i-3- intra-articular, ngaleyo ndlela ithwala ingozi yokungakabi yisikhathi osteoarthritis futhi ingase idinge ukunakekelwa kokuhlinzwa ukuthi i-d/t ingazinzi
  • Thayipha 4- Fx kuzo zonke izifunda mayelana ne-physis. Ukubikezela okungekuhle kanye nokuncipha kwezitho
  • Thayipha 5- ngokuvamile abukho ubufakazi bokuphuka kwamathambo kwangempela. I-prognosis embi ilimaza ukulimala kanye nokulimala kwemithambo ngokuncipha kwezitho
  • Ukuhlolwa kwesithombe kubalulekile

Ukulimala Okungeyona Ingozi (NAI)ezinganeni

izithombe zokuxilonga zezingane el paso, tx.
  • Kunezinhlobo ezahlukene zokuhlukunyezwa kwezingane. Ukuhlukumeza ngokomzimba kungase kusuke ekulimaleni kwesikhumba kuya ekulimaleni okuhlukene kwe-MSK/okuhlelekile okuthinta amathambo nezicubu ezithambile. Ukuthwebula izithombe kubalulekile futhi kungase kuhlonze izimpawu eziqondile ezixwayisa abahlinzeki bezokwelapha kanye nokwazisa ngezinsizakalo zokuvikela izingane kanye nezikhungo zomthetho mayelana nokuhlukunyezwa ngokomzimba.
  • Enganeni: I-shaken baby syndrome ingase ivele nezimpawu ze-CNS d/t ukudabuka komthambo ongavuthiwe ovala ibhuloho kanye ne-subdural hematoma engabulala. I-retinal hemorrhage ngokuvamile iyinkomba. I-CT yekhanda ibalulekile.
  • Izimpawu ezibomvu ze-MSK Radiological:
  • 1) ithambo elikhulu Fx enganeni encane kakhulu engakwazi ukuhamba (0-12 mo)
  • 2) Izimbambo zangemuva Fx: ngokwemvelo azilokothi zenzeke izingozi ze-d/t. Izindlela ezingenzeka kakhulu: ukubamba nokucindezela ingane noma ukushaya okuqondile.
  • I-3) Ama-fracture amaningi anamazinga ahlukene okuphulukisa ngokulandelana kwesikhathi, okungukuthi, ama-callus yamathambo abonisa ukuhlukumezeka okuphindaphindiwe ngokomzimba.
  • I-4) Ikhona le-Metaphyseal Fx aka Isibambo seBhakede Fx, ngokuvamile i-pathognomonic ye-NAI ezinganeni. Kuvela uma umkhawulo othintekile ubanjiwe futhi usongwe ngobudlova.
  • I-5) Ukuphuka okuvunguzayo kwamathambo amade enganeni encane kungesinye isibonelo se-NAI.
  • Eminye imikhondo ebalulekile ye-NAI. Umlando ongahambisani ohlinzekwa ngababheki/abanakekeli. Abukho ubufakazi bokungajwayelekile kwamathambo okuzalwa/okumetabolism njenge-Osteogenesis Imperfecta noma i-Rickets/osteomalacia njll.
  • NB Uma ababheki bezingane besho umlando wokuthi imibiko yokuwa nezingozi endlini, Kubalulekile ukwazi ukuthi ngokusobala izingozi eziningi/ukuwa endlini akuvamile kakhulu noma akunakwenzeka ukuthi kubangele ukuphuka okukhulu kwamathambo.
  • Ukubika ukuhlukunyezwa kwezingane e-Illinois:
  • www2.illinois.gov/dcfs/safekids/reporting/pages/index.aspx

I-MSK Imaging Approach in Pediatrics

izithombe zokuxilonga zezingane el paso, tx.
  • I-Juvenile Idiopathic Arthritis (JIA)-kubhekwa isifo esingelapheki se-M/C ebuntwaneni. I-Clinical Dx: ubuhlungu obuhlangene / ukuvuvukala kwamaviki angu-6 noma ngaphezulu enganeni <16-yo Amafomu ahlukene akhona: I-Early Dx ibalulekile ukuvimbela izinkinga ezibambezelekile
  • Izinhlobo ezivame kakhulu ze-JIA:
  • I-1) Isifo se-Pauciarticular (40%)- m/c uhlobo lwe-JIA. Amantombazane asengozini enkulu. Ivezwa njenge-arthritis ku-<4 amalunga: amadolo, amaqakala, isihlakala. U-Elbow. Lolu hlobo lubonisa ukuhlobana okuphezulu nokubandakanyeka kwe-ocular njenge-iridocyclitis (25%) engase iholele ebumpumputheni. Amalebhu: RF-ve, ANA positive.
  • I-2) Isifo se-Polyarticular (25%): RF-ve. Amantombazane asengozini enkulu. Ithinta amalunga amancane namakhulu ngokuvamile athinta umgogodla wesibeletho
  • 3) Uhlobo oluhlelekile lwe-JIA (20%): luvame ukuvela ngokubonakala kwesistimu okunamandla njengemfiva yokukhonkotha, i-arthralgias, i-myalgias, i-lymphadeno[pathy, i-hepatosplenomegaly, i-polyserositis (i-pericardial/pleural effusion). I-Dx ebalulekile ifaka isici sokuqubuka kwe-salmon epinki evanescent emaphethelweni nasesiqu. Ifomu le-Systemic linokuntuleka okuhlukile kokubandakanyeka kwe-ocular. Amalunga ngokuvamile awekho ukuguguleka kwezicathulo uma kuqhathaniswa nezinye izinhlobo. Ngakho-ke ukubhujiswa okuhlangene akubonakali ngokuvamile

Ukufanekisa ku-JIA

izithombe zokuxilonga zezingane el paso, tx.
  • I-Joint effusion ithambo likhule kakhulu i-squaring ye-patella cartilage/ukuguguleka kwethambo okungaphezu kwe-DJD
  • Iminwe namathambo amade ukuvalwa kwangaphambi kwesikhathi kwe-physeal/ukufinyeza kwezitho
  • I-Rad DDx idolo/iqakala: I-Hemophilic arthropathy Rx: DMARD.
  • Izinkinga zingase zenzeke ukubhujiswa kwamalunga, ukukhubazeka ukukhula/ukuncipha kwezitho, ubumpumputhe, izinkinga zesistimu, ukukhubazeka.

Ama-Neoplasms Amathambo Ezingane Ezivamile Ezivamile

izithombe zokuxilonga zezingane el paso, tx.
  • I-Osteosarcoma (OSA) kanye ne-Ewing's sarcoma (ES) yi-1 st kanye ne-2nd M / C eyinhloko yama-neoplasms amathambo ayingozi ebuntwaneni (ukuphakama ku-10-20 yo) Ngomtholampilo: ubuhlungu bamathambo, ukuguqulwa komsebenzi, i-metastasis yokuqala ikakhulukazi ukuhlangana kwamaphaphu kungase kwenzeke. Ukubikezela okubi
  • Ama-Ewings angase abe nobuhlungu bamathambo, imfiva kanye ne-ESR/CRP ephakeme elingisa ukutheleleka. I-Dx yangaphambi kwesikhathi ngezithombe nesiteji ibalulekile.
  • Ukufanekisa kwe-OSA & ES: i-x-ray, ilandelwa yi-MRI, isifuba CT, i-PET/CT. Kuma-x-ray: I-OSA ingase ithinte noma yiliphi ithambo kodwa iningi likhona njengethambo elinolaka elidala ama-neoplasms edolweni (izimo ezingu-50%) ikakhulukazi njenge-osteoid eyenza isilonda esinamandla ku-metaphysis esicatshangelwayo/i-sunburst periostitis & nonxantathu we-Codman. Kumakwe ukuhlasela kwezicubu ezithambile.
  • I-ES ingase yethule ku-shaft futhi ibonise ukusabalala kwezicubu ezithambile zangaphambi kwesikhathi. I-MRI ibalulekile ukuveza izinga lokuhlasela kwethambo ne-ST, i-MRI edingekayo ekuhleleni ukuhlinzwa
  • I-OSA & ES Rx: Inhlanganisela yokuhlinzwa, imisebe, i-chemo. Izindlela zokuhlenga izitho ziyenziwa kwezinye izimo. Ukubikezela okubi uma kutholwa sekwephuzile.
izithombe zokuxilonga zezingane el paso, tx.
  • Isithombe se-Ewing's sarcoma
  • Ukuphazamiseka kwamathambo
  • Ukuhlasela kwezicubu ezithambile zakuqala nokubanzi
  • Ukusabela kwe-periosteal okunamandla okuphendula nge-laminated (isikhumba sika-anyanisi).
  • I-saucerisation ye-cortical bone (umcibisholo owolintshi)
  • Isilonda ngokuvamile siyi-diaphyseal enesandiso esithile se-metaphyseal
  • Eyaziwa ngokuthi i-Round cell tumor kanye ne-Multiple Myeloma ne-Lymphoma

Izifo Ezivamile Zezingane

izithombe zokuxilonga zezingane el paso, tx.
  • I-Neuroblastoma (NBL) Ubuhlungu be-M/C obusana. Itholakala kumaseli e-neural crest aka PNET tumors (isb, i-ganglia enozwela). Iningi lenzeka ezinganeni ezingaphansi kwezinyanga ezingama-24. Abanye bakhombisa ukubikezela okuhle kodwa izehlakalo ezibalelwa ku-50% ziba nezifo ezithuthukile. I-70-80% eneminyaka engu-18-izinyanga noma ngaphezulu ikhona ene-metastasis ethuthukisiwe. I-NBL ingase ithuthuke ku-adrenal medulla, i-ganglia enozwela nakwenye indawo. Iveza njengesisindo sesisu, ukuhlanza. > 50% uveza ubuhlungu bethambo d/t metastasis. Ngokomtholampilo: ukuhlolwa ngokomzimba, amalebhu, izithombe: isifuba nesisu ama-x-ray, isisu se-CT nesifuba kubalulekile ku-Dx. I-MRI ingase isize. I-NBL ingase imetastaze ogebhezini lwekhanda futhi ingene ezitsheni ezinophawu olubonisa njenge-pathological sutural diastasis.
  • I-Acute Lymphoblastic Leukemia i-m/c embi yobuntwana. I-Pathology: ukungena kwe-leukemic cell yomnkantsha okuholela ebuhlungu bethambo kanye nokushintshwa kwamanye amangqamuzana omnkantsha avamile ane-anemia, i-thrombocytopenia, i-neutropenia kanye nezinkinga ezihambisanayo. Amaseli e-leukemic angangena kwezinye izingosi ezihlanganisa i-CNS, ubende, amathambo nezinye izifunda. I-Dx: I-CBC, amazinga e-serum lactate dehydrogenase, i-Bone marrow aspiration biopsy iwukhiye. Ukuthwebula izithombe kungasiza kodwa kungabalulekile ekuxilongweni. Ku-radiography, ukungena kwe-leukemic kwethambo kungase kubonakale njengamabhande anemisebe ehambisana nepuleti lokukhula komzimba. I-Rx: ukwelashwa ngamakhemikhali kanye nezinkinga zokwelapha
izithombe zokuxilonga zezingane el paso, tx.
  • I-Medulloblastoma: I-M/C eyingozi ye-CNS neoplasm ezinganeni
  • Iningi likhula ngaphambi kweminyaka eyi-10
  • Indawo ye-M/C: i-cerebellum ne-posterior fossa
  • Ngokwe-histological imele isimila sohlobo lwe-PNET hhayi i-glioma njengoba kwakucatshangwa ekuqaleni
  • I-MBL, kanye ne-Ependymoma ne-CNS lymphoma, ingase iholele ekulahlekeni kwe-metastasis nge-CSF futhi ngaphezu kwalokho imele okuhlukile okungafani nezinye izimila ze-CNS ezibonisa ukusabalala kwe-metastatic ngaphandle kwe-CNS, m/c kuya ethanjeni.
  • Amaphesenti angu-50 we-MBL angase akhishwe kabusha ngokuphelele
  • Uma i-Dx nokwelashwa kuqala ngaphambi kwe-metastasis, ukusinda kweminyaka engu-5 yi-80%
  • Ukuthwebula kubalulekile: I-CT scanning ingasetshenziswa kodwa indlela yokucabanga yokuzikhethela i-MRI ezophinde inikeze ukuhlolwa okuphakeme kakhulu kwayo yonke i-neuraxis ye-metastasis.
  • I-MBL ivamise ukubonakala njenge-heterogenous hypo, iso kanye ne-hyperintense lesion ku-T1, T2 ne-FLAIR scans (izithombe eziphezulu) uma iqhathaniswa nezicubu zobuchopho ezizungezile. Ngokuvamile ukucindezela i-ventricle yesi-4 nge-obstructive hydrocephalus. Isimila ngokuvamile sibonisa ukugqama kokugqama ku-T1+C gad (isithombe esingezansi kwesokunxele). Yehlisa i-metastasis ukusuka ku-MBL nge-T1+C ethuthukisa isilonda entanjeni

Amagciwane Abalulekile Ezingane

izithombe zokuxilonga zezingane el paso, tx.
  • Enganeni esanda kuzalwa/usana <1month: fever>100.4 (38C) ingase ibonise ukutheleleka ngegciwane kanye nokunye. I-Strep B, i-Listeria, i-E. Coli ingase iholele ku-sepsis, i-meningitis. Indlela yokusondela: i-x-ray yesifuba, ukubhoboza i-lumbar ngesiko, isiko legazi, i-CBC, ukuhlaziya umchamo.
  • Ezinganeni ezincane, i-Hemophilus influenza type B (HIB) ingase iholele ku-Epiglottitis inkinga eyivelakancane kodwa engathi sína. Umuthi wokugoma wamanje usiza ekunciphiseni inani lezehlakalo ze-Epiglottitis nezinye izifo ezihlobene ne-HIB.
  • I-Parainfluenza noma i-RSV Igciwane lingaholela ku-Croup noma i-Laryngotracheobronchitis ebukhali.
  • I-Epiglottitis ne-Croup yi-Dx ngokomtholampilo kodwa i-AP kanye nentamo ethambile yethishu engemuva ama-x-ray ziwusizo kakhulu
  • I-Epiglottitis iveza isici �uphawu lwesithupha� oluhambisana nokujiya kwe-epiglottis d/t epiglottic edema. Lokhu kungaba isimo esiphuthumayo esibeka engcupheni imigudu yomoya (phezulu kwesokunxele)
  • Croup ingase ibonise uphawu lwebhodlela lewayini olune-hypopharynx ehlukanisiwe njengokuncipha okukhulu kwendlela yomoya engaphansi ku-AP kanye ne-x-ray yentamo ethambile yentamo (phezulu kwesokudla)
  • I-Syncytia Virus yokuphefumula (RSV) kanye nomkhuhlane kungase kuholele kunyumoniya ebangelwa yigciwane okungenzeka ibe nezinkinga ezisongela ukuphila kwabakhubazekile, abancane kakhulu kanye nezingane ezinemikhuhlane. I-CXR ibalulekile (maphakathi kwesokunxele)
  • I-Streptococcal pharyngitis Ukutheleleka nge-GABHS kungaholela ezinkingeni ezinzima noma ezibambezelekile (isb, i-Rheumatic fever)
  • Ithumba le-Peritonsillar (ngenhla kwesokudla esimaphakathi) Ingase ithuthuke kwezinye izimo futhi ibe yinkimbinkimbi ngokusabalala kwezicubu ezithambile entanyeni okungase kuholele ekusakazekeni ezindaweni ezingaphansi kolimi/submandibular (Ludwig Angina) lapho imigudu yomoya idinga ukulawulwa d/t isisekelo se-edema yolimi.
  • Ukuthuthukiswa kwethumba le-retropharyngeal kungase kuholele ekusabalaleni kwaleli gciwane ngokuxhumana ngokukhululekile ne-neck fascia okuholela ku-necrotizing mediastinitis, i-Lemmier syndrome kanye nokuhlasela kwezikhala ze-carotid (konke kuyizinkinga ezingase zibe yingozi empilweni)
  • I-Griesel syndrome- (ngenhla ngezansi kwesokunxele) inkinga engavamile yezifo zomlomo ze-tonsillar / pharyngeal zomlomo ezingasakazeka endaweni ye-prevertebral eholela ku-C1-2 ligaments laxity nokungazinzi
  • Ezinye izifo ezibalulekile ezinganeni yi-pneumonia ye-bacterial (Pneumococcal), i-Urinary tract infection kanye ne-Acute Pyelonephritis (ikakhulukazi emantombazaneni) kanye neMeningococcal Meningitis.
izithombe zokuxilonga zezingane el paso, tx.
  • Izifo Ze-Metabolic Yezingane
  • Amarikhethi: ibhekwa njenge-osteomalacia ekukhuleni kwamathambo. Indawo yokubala kwesikhashana kwepuleti lokukhula kwe-epiphyseal ithinteka kakhulu
  • Ngokomtholampilo iveza ukukhubazeka kokukhula, ukugoba komkhawulo, irosari e-rachitic, isifuba sejuba, izimbambo ezicindezelekile, izihlakala ezikhulisiwe nezivuvukele, namaqakala, ukukhubazeka kogebhezi
  • I-Pathology: I-Vit D ne-calcium engavamile yimbangela ye-m/c. Ukuntuleka kokuchayeka elangeni esp. umuntu onesikhumba esinsundu, izingubo ezivimbela ukuchayeka ekukhanyeni, ukuncelisa ibele kuphela isikhathi eside, i-veganism, i-malabsorption syndromes yamathumbu, ukulimala kwezinso nokunye.
  • Ukucabanga: i-metaphysis ephukile aka ibhulashi lokupenda elivutha umlilo, ukunwetshwa kwepuleti lokukhula, ukuhlangana kwe-costochondral okune-bulbous njengerosari e-rachitic, ukukhothama komkhawulo
  • I-Rx: phatha izimbangela eziyisisekelo, lungisa ukushoda kokudla okunomsoco, njll.

Okubhekwayo

Isisu: Indlela Yokuhlonza Imaging | El Paso, TX.

Isisu: Indlela Yokuhlonza Imaging | El Paso, TX.

by | Ukufanekisa Nokuxilonga

 

  • Ukuxilongwa kwezifo zesisu kungahlukaniswa ngezigaba ezilandelayo:
  • Ukungajwayelekile kwe- amathumbu ipheshana (umphimbo, isisu, amathumbu amancane namakhulu, kanye nesithasiselo)
  • Ukungajwayelekile kwezitho zokugaya ukudla (i-Hepatobiliary & pancreatic disorders)
  • Ukuphazamiseka kwe-genitourinary kanye nezitho zokuzala
  • Ukungajwayelekile kodonga lwesisu kanye nemikhumbi emikhulu
  • Le phrezentheshini ihlose ukunikeza ukuqonda okuyisisekelo okujwayelekile isithombe sokuxilonga indlela kanye nokuphathwa komtholampilo okufanele kweziguli ezinezifo ezivame kakhulu zesisu
  • Izindlela zokulinganisa ezisetshenziswa ngesikhathi sophenyo lwezikhalazo zesisu:
  • Isisu se-AP (KUB) kanye ne-CXR eqondile
  • Ukuskena kwe-CT yesisu (ngokungafani komlomo kanye ne-IV kanye nokugqama kwe-w/o)
  • Upper and Lower GI Barium izifundo
  • Ultrasonography
  • I-MRI (esetshenziswa kakhulu njenge-Liver MRI)
  • I-MRI enterography & enteroclysis
  • I-MRI rectum
  • I-Endoscopic Retrograde Cholangiopancreatography (ERCP) - ikakhulukazi i-hepatobiliary kanye ne-pancreatic ductal pathology
  • Isithombe senuzi

Kungani Uyala I-X-ray Yesisu?

isithombe sokuxilonga isisu el paso tx.

 

  • Faka nokuhlolwa kokuqala kwegesi yamathumbu esimweni esiphuthumayo. Isibonelo, ucwaningo olubi esigulini esinethuba eliphansi lungase lugweme isidingo se-CT noma ezinye izinqubo ezihlaselayo.
  • Ukuhlolwa kwamashubhu e-radiopaque, imigqa, nemizimba yangaphandle ye-radiopaque
  • Ukuhlolwa kwe-post-procedural evaluation intraperitoneal/retroperitoneal free gas
  • Ukuqapha inani legesi yamathumbu kanye nokulungiswa kwe-ileus yangemva kokuhlinzwa (adynamic).
  • Ukuqapha ukudlula kokuqhathanisa phakathi kwamathumbu
  • Izifundo zezokuthutha zamakholoni
  • Ukuqapha i-renal calculi

 

isithombe sokuxilonga isisu el paso tx.

 

Okufanele Ukuqaphele ku-AP Abdomen: I-Supine vs. Upright vs. Decubitus

  • Umoya Wamahhala (pneumoperitoneum)
  • Ukuvinjwa kwamathumbu: Izihibe ezinwetshiwe: SBO vs LBO (3-6-9 rule) SB-upper limit-3-cm, LB-upper limit-6-cm, Caecum-upper limit-9-cm. Qaphela ukulahlekelwa kwe-haustra, ukunwetshwa kwenothi (ukuba khona) kwe-valvule conivente (plica semilunaris) ku-SBO
  • I-SBO: qaphela ukuphakama okuhlukene kwamazinga oketshezi lomoya esitebhisini sefilimu esiqondile� ukubonakala, okujwayelekile kwe-SBO
  • Qaphela ukushoda kwegesi engemuva/ekoloni (ekhishiwe) ku-SBO

 

isithombe sokuxilonga isisu el paso tx.

 

  • Ukuskena kwe-CT yesisu -indlela yokuzikhethela ngesikhathi sophenyo lwezikhalazo ezinzima nezingapheli zesisu ikakhulukazi kubantu abadala. Isibonelo, ukugula kwesisu kungatholwa ngempumelelo futhi kubekwe esiteji kunikeze ulwazi lomtholampilo lokuhlela ukunakekelwa
  • I-ultrasound yesisu, izinso kanye ne-pelvic kungenziwa ukusiza ukuxilongwa kwe-appendicitis (isb. ezinganeni), i-acute & chronic vascular pathology, i-hepatobiliary engavamile, i-obstetric and gynecological pathology.
  • Ukusetshenziswa kwemisebe ye-ionizing (x-ray & CT) kufanele kuncishiswe ezinganeni nakwamanye amaqembu asengozini.

 

isithombe sokuxilonga isisu el paso tx.

 

Ukuxilonga Izifo Ezinkulu Zesistimu Yesisu

  • 1) Izinkinga ze-Esophageal
  • 2) I-Gastric carcinoma
  • 3) I-Gluten Sensitive Enteropathy
  • 4) Izifo Zamathumbu Ezivuvukalayo
  • 5) I-pancreatic ductal adenocarcinoma
  • 6) I-Colorectal carcinoma
  • 7) I-appendicitis eyingozi
  • 8) Ukuvinjwa kwamathumbu amancane
  • 9) I-volvulus

Izinkinga ze-Esophageal

  • Achalasia (primary achalasia): ukwehluleka kokuhleleka kwe-esophageal peristalsis d/t ukuphumula okuphazamisekile kwe-low esophageal sphincter (LOS) ngokunwebeka okuphawulekayo komminzo kanye nokusimama kokudla. Ukuvinjwa kommizo we-distal (ngokuvamile ngenxa yesimila) kuye kwabizwa ngokuthi “i-achalasia yesibili” noma “pseudoachalasia.� I-Peristalsis engxenyeni yemisipha ebushelelezi e-distal yomphimbo ingase ilahleke ngenxa yokungajwayelekile kwe-Auerbach plexus (enomthwalo wokuphumuza imisipha ebushelelezi) . Ama-vagus neurons nawo angathinteka
  • Okuyinhloko: 30 -70s, M: F kuyalingana
  • Isifo se-Chagas (ukutheleleka kwe-Trypanosoma Cruzi) ngokubhujiswa kwe-Myenteric plexus neurons yohlelo lwe-GI (megacolon & esophagus)
  • Nokho, inhliziyo iyisitho esithintekile se-M/C
  • Ngokomtholampilo: I-Dysphagia yakho kokubili okuqinile noketshezi, uma kuqhathaniswa ne-dysphagia yezinto eziqinile kuphela ezimeni ze-esophageal carcinoma. Ubuhlungu besifuba kanye nokuqunjelwa. I-M/C mid esophageal squamous cell carcinoma cishe ku-5% ngenxa yokucasuka okungapheli kolwelwesi lwamafinyila ngenxa yokugcwala kokudla nokuphuma kwegazi. I-aspiration pneumonia ingase ikhule. I-Candida esophagitis
  • Ukufanekisa: Uqhwaku lwenyoni ekugwinyeni kwe-GI engaphezulu kwe-barium, umminzo onwetshiwe, ukulahlekelwa yi-peristalsis. Ukuhlolwa kwe-endoscopic kubalulekile.
  • Rx: kunzima. Abavimbeli besiteshi seCalcium (isikhathi esifushane) .I-pneumatic dilatation, esebenza kahle ku-85% yeziguli ezine-3 -5% engozini yokopha / ukubhoboza. Umjovo we-botulinum ubuthi uhlala cishe kuphela. Izinyanga eziyi-12 ngokwelashwa ngakunye. Ingalimaza i-submucosa eholela engcupheni eyengeziwe yokubhobozwa phakathi ne-myotomy elandelayo. I-myotomy yokuhlinzwa (Heller myotomy)
  • I-10 -30% yeziguli ziba ne-reflux ye-gastroesophageal (GERD)

 

isithombe sokuxilonga isisu el paso tx.

 

  • I-Presbyesophagus: esetshenziselwa ukuchaza ukubonakaliswa kokuwohloka kokusebenza kwe-motor ku-esophagus yokuguga> 80-yo Ngenxa yokuphazamiseka kwe-reflex arc ngokuncipha kokuzwela kwe-distension kanye nokuguqulwa kwe-peristalsis.
  • Iziguli zingakhononda nge-dysphagia noma ubuhlungu besifuba, kodwa eziningi azibonakali
  • I-Diffuse/distal esophageal spasm (DES) wukuphazamiseka kokuhamba kommizo okungase kubonakale njenge-corkscrew noma i-rosary bead esophagus ku-barium swallow.
  • U-2% wezinhlungu zesifuba ezingezona ezenhliziyo
  • I-Manometry iyisivivinyo sokuxilonga esisezingeni eligolide.
isithombe sokuxilonga isisu el paso tx.

 

  • I-Zenker diverticulum (ZD) isikhwama se-pharyngeal
  • Ukuphuma kwamanzi ezingeni le-hypopharynx, eseduze nje ne-upper esophageal sphincter, eyaziwa ngokuthi i-Killian dehiscence noma unxantathu we-Killian
  • Iziguli zineminyaka engu-60-80 futhi zikhona ne-dysphagia, regurgitation, halitosis, i-globus sensation
  • Kungase kube nzima ukulangazelela kanye nokungajwayelekile kwamaphaphu
  • Iziguli zingase ziqongelele imithi
  • I-ZD- iyi-pseudodiverticulum noma i-pulsion diverticulum ebangelwa ukubola kwe-submucosa ngokusebenzisa i-Killian dehiscence, yakhe isaka lapho ukudla nokunye okuqukethwe kungase kunqwabelane.
isithombe sokuxilonga isisu el paso tx.

 

  • I-Mallory-Weiss syndrome isho izinyembezi ze-mucosal kanye ne-submucosal ye-distal esophageal venous plexus ehambisana nokuhlehla okunamandla/ukuhlanza kanye nokuqagela kokuqukethwe kwesisu ngokumelene nomminzo ongezansi. Izidakamizwa zisengozini enkulu. Amacala akhona nge-hematemesis engenabuhlungu. Ukwelashwa kuvame ukusekela.
  • I-Dx: ukucabanga kudlala indima encane, kodwa i-esophagram ehlukile ingase ibonise izinyembezi ze-mucosal ezigcwele umehluko (isithombe esingezansi kwesokudla). Ukuskena kwe-CT kungasiza ukukhipha ezinye izimbangela zokuphuma kwegazi eliphezulu kwe-GI
isithombe sokuxilonga isisu el paso tx.

 

  • I-Boerhaave syndrome: ukuqhuma kommizo okwesibili kuya ekuhlanzeni okunamandla
  • Isethulo: M>F, ukuhlanza, ubuhlungu besifuba, i-mediastinitis, i-septic mediastinum, i-pneumomediastinum, i-pneumothorax pleural effusion
  • Esikhathini esidlule, yayibulala njalo
  • Izindlela zibandakanya ukuxoshwa okunamandla kokuqukethwe kwesisu ikakhulukazi ngokudla okukhulu okungagayekile lapho umphimbo ufinyela ngamandla ngokumelene nama-glottis avaliwe futhi u-90% enzeka odongeni lwangakwesokunxele lwe-posterolateral.
isithombe sokuxilonga isisu el paso tx.

 

  • I-Hiatus hernias (HH): ukuhoxiswa kokuqukethwe kwesisu nge-hiatus esophageal ye-diaphragm ku-thoracic cavity.
  • Iziguli eziningi ezine-HH azibonakali kahle, futhi kuwukutholakala kwengozi. Kodwa-ke, izimpawu zingase zihlanganise ubuhlungu be-epigastric / esifubeni, ukugcwala kwangemuva kokudla, isicanucanu nokuhlanza.
  • Ngezinye izikhathi i-HH ibhekwa njengefana nesifo se-gastro-oesophageal reflux (GORD), kodwa kukhona ukuhlobana okungalungile phakathi kwalezi zimo ezimbili!
  • Izinhlobo ezi-2: i-hernia eshelelayo ephuma e-hiatus engu-90% kanye ne-hernia eginqikayo (i-paraoesophageal) engu-10%. Lokhu kwakamuva kungase kuklinywe okuholela ku-ischemia kanye nezinkinga.
isithombe sokuxilonga isisu el paso tx.

 

  • I-Esophageal Leiomyoma I-M/C ye-benign esophageal neoplasm. Ivamise ukuba nkulu kodwa nokho ayivimbi. Izimila ze-gastrointestinal stromal (GIST) yizona ezivame kakhulu kumminzo. Kufanele ihlukaniswe ne-Esophageal carcinomas.
  • Ukufanekisa: i-esophagram yokuqhathanisa, i-GI engaphezulu yokugwinya i-barium, ukuskena kwe-CT. I-Gastroesophagoscopy iyindlela ye-Dx yokukhetha.

isithombe sokuxilonga isisu el paso tx.

  • I-Esophageal carcinoma: okwethulwa ngokukhula kwe-dysphagia, ekuqaleni kokuqinile nokuqhubekela phambili oketshezini olunokuphazamiseka ezimeni ezithuthuke kakhulu
  • <1% yazo zonke izinhlobo zomdlavuza kanye ne-4-10% yazo zonke izifo ze-GI. Kukhona ukuxhashazwa kwabesilisa okubonwayo nge-squamous cell subtype ngenxa yokubhema notshwala. I-Barrett esophagus kanye ne-adenocarcinoma
  • M: F 4:1. Abantu abamnyama yibo abasengozini enkulu kunabantu abaMhlophe 2:1. Ukubikezela okubi!
  • Ukugwinya kwe-barium kungase kuzwele ekuboneni isisindo somphimbo. I-Gastroesophagoscopy (i-endoscopy) iqinisekisa ukuxilongwa nge-tissue biopsy
  • Sekukonke isifo esiyingozi esivame kakhulu i-2ndary gastric fundal carcinoma invading distal esophagus.
  • I-squamous cell ivame ukutholakala ku-mid esophagus, i-Adenocarcinoma esifundeni esikude
isithombe sokuxilonga isisu el paso tx.
  • I-Gastric carcinoma: isifo esiyinhloko se-epithelium yesisu. Akuvamile ngaphambi kweminyaka yobudala engama-40. Iminyaka emaphakathi yokuxilongwa e-United States iminyaka engama-70 kwabesilisa neminyaka engama-74 kwabesifazane. IJapan, iSouth Korea, iChile kanye namazwe aseMpumalanga Yurophu anezinga eliphezulu kakhulu lomdlavuza wesisu emhlabeni. Izinga lomdlavuza wesisu liyehla emhlabeni wonke. Umdlavuza wesisu uyimbangela yesi-5 yokufa okuhlobene nomdlavuza. Ukuhlotshaniswa nokutheleleka kwe-Helicobacter pylori 60- 80%, kodwa abantu abangu-2% kuphela abane-H. Pyloris ababa nomdlavuza wesisu. I-8-10% inengxenye yomndeni ezuzwe njengefa.
  • I-Gastric Lymphoma iphinde ihlotshaniswe nokutheleleka kwe-H. Pyloris. I-Gastrointestinal Stromal Cell Tumor noma i-GIST enye i-neoplasm ethinta isisu
  • Ngokomtholampilo: Azikho izimpawu uma zikha phezulu futhi zingelapheka. Kufika ku-50% weziguli zingase zibe nezikhalazo ze-GI ezingaqondile. Iziguli zingase zibe ne-anorexia nokuncipha kwesisindo (95%) kanye nobuhlungu besisu obungacacile. Isicanucanu, ukuhlanza, kanye nokuvimbela ukusutha kwangaphambi kwesikhathi kungase kwenzeke ngamathumba amakhulu noma izilonda ezingenelayo ezilimaza ukuvuvukala kwesisu.
  • Ukubikezela: Iningi lomdlavuza wesisu litholwa sekwephuzile futhi lingaveza ukuhlasela kwendawo nge-regional adenopathy, isibindi, nokusabalala kwe-mesenteric. Izinga lokusinda leminyaka engu-5 lika-20% noma ngaphansi. E-Japan nase-S. Korea, izinhlelo zokuhlola kusenesikhathi zandise ukusinda kwaba ngu-60%
  • Ukufanekisa: Ucwaningo lwe-Barium upper GI, ukuskena kwe-CT. Ukuhlolwa kwe-Endoscopic kuyindlela yokukhetha yokuxilongwa. Ekucabangeni, umdlavuza wesisu ungase ubonakale njengenqwaba ye-exophytic (polypoid) noma uhlobo lwe-Fungative, uhlobo lwe-Ulcerative noma Infiltrative/diffuse (Linitis Plastica). Ukuskena kwe-CT kubalulekile ukuhlola ukuhlasela kwendawo (ama-node, i-mesentery, isibindi, njll.)
isithombe sokuxilonga isisu el paso tx.
  • Isifo seCeliac esibizwa ngokuthi i-non-tropical sprue aka Gluten-sensitive enteropathy: Umonakalo we-mucosal we-autoimmune we-T-cell mediated autoimmune obangelwa yi-gluten okuholela ekulahlekelweni kwe-villi emathunjini amancane aseduze kanye ne-malabsorption yamathumbu (okungukuthi, i-sprue). Kucatshangelwa kwezinye izimo zokuntuleka kwe-iron anemia yembangela enganqunyiwe. Kuvamile eCaucasus (1 kwabangu-200) kodwa ayivamile kubantu base-Asia nabamnyama. Iziqongo ezimbili: iqoqo elincane ebuntwaneni. Ngokujwayelekile emashumini amathathu namane empilo.
  • Ngokomtholampilo: Ubuhlungu besisu uphawu lwe-m/c, ukungenwa kahle kwezakhamzimba/amavithamini: IDA kanye nendle ene-guaiac-positive, isifo sohudo, ukuqunjelwa, i-steatorrhea, ukuncipha kwesisindo, i-osteoporosis/osteomalacia, i-dermatitis herpetiformis. Ukwanda kobudlelwane ne-T-cell lymphoma, Ukwanda kobudlelwane ne-esophageal squamous cell carcinoma, i-SBO
  • I-Dx: I-endoscopy ye-GI ephezulu ene-duodenal biopsies eminingi ibhekwa njenge izinga lokuxilonga ngesifo se-celiac. I-Histology yembula ukungena kwe-T-cell kanye ne-lymphoplasmacytosis, i-Villi atrophy, i-Crypts hyperplasia, i-Submucosa, ne-Serosa zisindisiwe. I-Rx: ukuqedwa kwemikhiqizo equkethe i-gluten
  • Ukufanekisa: Akudingeki ku-Dx kodwa ku-Barium swallow fluoroscopy: i-mucosal atrophy kanye nokuqedwa kwama-mucosal folds (izimo ezithuthukisiwe kuphela). I-SB dilation iwukuthola okujwayelekile kakhulu. I-nodularity ye-duodenum (i-bubbly duodenum). Ukuguqulwa kokugoqa kwe-jejunal ne-ileal mucosal:
  • Ijejunamu ibukeka njenge-ileum, i-ileum ifana ne-jejunum, kanti i-duodenum ibukeka njengesihogo.
isithombe sokuxilonga isisu el paso tx.

Isifo Samathumbu Esivuvukalayo: Isifo sika-Crohn (CD) kanye ne-Ulcerative Colitis (UC)

  • CD: Ukuvuvukala kwe-autoimmune okungapheli okuphindaphindayo okuthinta noma iyiphi ingxenye yepheshana le-GI ukusuka emlonyeni ukuya endunu kodwa ekuqaleni ngokuvamile kuhilela i-ileum yokugcina. Isethulo se-M/C: ubuhlungu besisu/ukuluma kanye nesifo sohudo. Umzila: ukwakheka kwe-granulomata okungafani ne-UC okuguquguqukayo, okungase kuholele emikhawulweni. Izindawo ezihlaselwe ukuvuvukala ngokuvamile zinezibazi
  • Izinkinga ziningi: i-malabsorption yezakhi/amavithamini (i-anemia, i-osteoporosis, ukubambezeleka kokukhula kwezingane, ukuba sengozini ye-GI malignancy, ukuvaleka kwamathumbu, ukwakheka kwe-fistula, ukuvela ngaphandle kwesisu: uveitis, arthritis, AS, erythema nodosum nokunye. ingase idinge ukuhlinzwa kwesisu ngemva kweminyaka eyi-10 ye-CD ngokuvamile yokuqina, i-fistiluzation, i-BO.
  • I-Dx: umtholampilo, i-CBC, i-CMP, i-CRP, i-ESR, ukuhlolwa kwe-serological: i-DDx ye-IBD: ama-anti-Saccharomyces cerevisiae antibodies (ASCA), i-perinuclear antineutrophil cytoplasmic antibody (p-ANCA) ngokwe-histologically noma ku-serum. Ukuhlolwa kwe-Fecal Calprotectin kusiza ku-DDx IBS futhi kuhlole impendulo ekwelashweni, umsebenzi wesifo/ukubuyela emuva.
  • I-Dx yokukhetha: I-endoscopy, ileoscopy, nama-biopsies amaningi angase aveze izinguquko ze-endoscopic kanye ne-histological. I-Video capsule endoscopy (VCE), Ukufanekisa kungasiza nge-Dx yezinkinga. I-Rx: izidakamizwa ezivimbela ukuzivikela komzimba, imithi ehambisanayo, ukudla, ama-probiotics, ukuhlinza. Alikho ikhambi kodwa inhloso iwukunxenxa, ukulawula izimpawu kanye nokuvimbela/ukwelapha izinkinga
  • Ukufanekisa i-Dx: KUB kuya ku-DDx SBO, i-Barium enema (ukungafani okukodwa nokukabili), amathumbu amancane alandela. Okutholiwe: izilonda zeqiwa, izilonda ze-aphthous/ezijulile, i-fistula/amapheshana e-sinus, Uphawu lwezintambo, amafutha anwabuzelayo aphusha amalophu e-LB, ukubukeka kwe-cobblestone d/t imifantu/izilonda eziphusha ulwelwesi lwamafinyila, ukuskena kwe-CT ngokungafani komlomo kanye ne-IV.
isithombe sokuxilonga isisu el paso tx.
  • Ukuthwebula isithombe esivela esigulini sika-Crohn esasikhishwe amathumbu amancane ngenxa yokuvinjwa.
  • (A) I-CT scan ikhombisa ukuvuvukala okungaqondile kanti
  • (B) I-MRE yendawo efanayo ibonisa ukuqina kwe-fibrostenotic
isithombe sokuxilonga isisu el paso tx.
  • I-UC: Ngokuvamile kuhilela ikholoni kuphela kodwa i-backwash ileitis ingase ikhule. Ukuqala kuvame ukuvela ku-15-40s futhi kuvame kakhulu kwabesilisa, kodwa ukuqala ngemva kweminyaka engama-50 nakho kuvamile. Okuvame kakhulu eNyakatho Melika naseYurophu (hygiene hypothesis). I-Etiology: Inhlanganisela yezinguquko zemvelo, zofuzo kanye ne-gut microbiome iyabandakanyeka. Ukubhema kanye nokukhishwa kwe-appendectomy kwangaphambi kwesikhathi kuvame ukukhombisa ukuhlangana okungekuhle ne-UC, ngokungafani ne-CD kubhekwe ezinye zezinto eziyingozi.
  • Izici Zomtholampilo: Ukopha edongeni (okuvamile), isifo sohudo, ukukhishwa kwamafinyila, i-tenesmus (ngezinye izikhathi), ubuhlungu obuphansi besisu kanye nokuphelelwa ngamandla kwamanzi ngenxa yokukhishwa kwe-purulent rectal (ezimweni ezimbi kakhulu, ikakhulukazi kubantu asebekhulile), i-fulminant colitis kanye ne-megacolon enobuthi kungaba yi-fetus kodwa kuyizinkinga ezingavamile. . I-Pathology: Ayikho i-granulomata. Izilonda zithinta i-mucosa ne-submucosa. Ama-pseudopolyps atholakala njenge-mucosa ephakeme egciniwe.
  • Inqubo yokuqala ihlale ithinta i-rectum futhi ihlale iyisifo sendawo (proctitis) ku-(25%). I-30% ye-Proximal extension yesifo kungenzeka. I-UC ingase yethule njengohlangothi lwesobunxele (55%) kanye ne-pancolitis (10%). Amacala amaningi athambile kuye komaphakathi
  • I-Dx: i-colonoscopy ene-ileoscopy ene-biopsies eminingi iqinisekisa i-Dx. Amalebhu: CBC, CRP, ESR, Fecal calprotectin, Izinkinga: i-anemia, i-megacolon enobuthi, umdlavuza wekoloni, isifo sokuqaqamba kwamalunga, uveitis, AS, Pyoderma gangrenosum, Primary sclerosing cholangitis. Rx: 5-aminosalicylic acid oral or rectal topical therapy, corticosteroids, immunomodulatory drugs, colectomy is therapy.
  • Ukucabanga: akudingekile ku-Dx kodwa i-barium enema ingase iveze izilonda, ukuphrinta kwesithupha, ezimeni ezithuthukile ukulahlekelwa i-haustra nokuncipha kwekholoni ekhiqiza ikholoni yomthofu. � Ukuskena kwe-CT kungasiza nge-Dx ebonwa njengokuqina kwe-mucosal okutholakala kuphela lapho kuphakathi nendawo futhi kuqinile. amacala. I-CT ingasiza nge-Dx yezinkinga. Isithombe sefilimu esingenalutho sibonisa �ikholoni lomthofu� kanye ne-sacroiliitis njenge-Enteropathic arthritis (AS)
isithombe sokuxilonga isisu el paso tx.
  • I-Colorectal carcinoma (CRC) m/c umdlavuza wepheshana le-GI kanye ne-2nd evame kakhulu eyingozi kubantu abadala. I-Dx: i-endoscopy kanye ne-biopsy. I-CT iyindlela evame ukusetshenziswa kakhulu esiteji. Ukuhlinza kabusha kungase kwelaphe nakuba izinga lokusinda leminyaka emihlanu lingama-40- 50% kuye ngesiteji. Izici eziyingozi: i-fiber ephansi namafutha aphezulu kanye nokudla kwamaprotheni ezilwane, ukukhuluphala (ikakhulukazi emadodeni), i-ulcerative colitis engapheli. I-adenoma yekoloni (ama-polyps). I-Familial adenomatous polyposis syndromes (I-Gardener syndrome) kanye ne-Lynch syndrome njenge-polyposis engeyona yomndeni.
  • Ngokomtholampilo: ukuqala okucashile ngemikhuba yamathumbu eguquliwe, igazi elisha noma i-melena, ukuntuleka kwe-iron anemia kusuka ekulahlekelweni kwegazi okungapheli ikakhulukazi emathonjeni angakwesokudla. Ukuvaleka kwamathumbu, ukungenwa yisisu, ukopha kakhulu kanye nesifo se-metastatic ikakhulukazi esibindini kungase kube isethulo sokuqala. Indlela: Amaphesenti angu-98 ama-adenocarcinomas, avela kuma-colonic adenomas (ama-neoplastic polyps) anokuguqulwa okubi. Izinga lokusinda leminyaka emihlanu lingama-40-50%, futhi esigabeni sokusebenza into eyodwa ebaluleke kakhulu ethinta ukubikezela. I-M/C rectosigmoid tumors (55%),
  • Qaphela: Amanye ama-adenocarcinomas esp. izinhlobo ze-mucinous ngokuvamile ezethulwa sekwephuzile futhi ngokuvamile zithwala isifo esibi ngenxa yokwethulwa sekwephuzile nokuphuma komucu nokusabalala kwendawo/kude
  • Ukufanekisa: I-Barium enema izwela kuma-polyps > 1 cm, umehluko owodwa: 77-94%, umehluko ophindwe kabili: 82-98%. I-Colonoscopy iyindlela yokuzikhethela yokuvimbela, ukuhlonza, nokuhlonza i-colorectal carcinoma. Ukuskena kwe-CT okuthuthukisiwe okuthuthukisiwe kusetshenziselwa ukulinganisa kanye nokuhlolwa kwe-prognosis yama-mets.
  • Ukuhlolwa: i-colonoscopy: amadoda ama-50 yo-10-iminyaka uma ijwayelekile, iminyaka emi-5 uma i-polypectomy, i-FOB, isihlobo se-1st degree ne-CA iqala ukubhekwa eminyakeni engama-40
isithombe sokuxilonga isisu el paso tx.

 

isithombe sokuxilonga isisu el paso tx.
  • Umdlavuza wePancreatic: i-ductal epithelial adenocarcinoma (90%), ukubikezela okubi kakhulu nokufa okuphezulu. 3rd M/C umdlavuza wesisu. Ikholoni #1, isisu #2. Umdlavuza we-pancreas ubalelwa ku-22% wabo bonke abantu abafa ngenxa yezinkinga zesisu, kanye no-5% wabo bonke ababulawa umdlavuza. I-80% yamacala kuma-60+. Ukubhema ugwayi kuyisici esinamandla semvelo esiyingozi, ukudla okunothe ngamafutha ezilwane namaprotheni. Ukukhuluphala ngokweqile. Umlando womndeni. I-M/C itholwe ekhanda kanye nenqubo yokususa umchamo.
  • I-Dx: Ukuskena kwe-CT kubalulekile. Ukuhlasela kwe-Superior Mesenteric Artery (SMA) kubonisa isifo esingenakuvinjelwa. Amaphesenti angama-90 we-pancreatic adenocarcinomas awabangeli i-Dx. Iziguli eziningi zifa phakathi nonyaka ongu-1 we-Dx. Ngokomtholampilo: i-jaundice engenabuhlungu, abd. Ubuhlungu, i-Courvoisier's gallbladder: i-jaundice engenabuhlungu kanye ne-gallbladder ekhulisiwe, i-Trousseau's syndrome: i-migratory thrombophlebitis, isifo sikashukela esisha, i-metastasis yesifunda nekude.
  • I-CT Dx: i-pancreatic mass with strong desmoplastic reaction, isithuthukisi esingesihle, kanye nokuncipha kancane uma kuqhathaniswa nendlala evamile eseduze, ukuhlasela kwe-SMA.
isithombe sokuxilonga isisu el paso tx.
  • I-Appendicitis: isimo esivame kakhulu ekusebenzeni kwe-radiology evamile futhi iyimbangela enkulu yokuhlinzwa kwesisu ezigulini ezincane
  • I-CT iyindlela ebucayi kakhulu yokuthola i-appendicitis
  • I-Ultrasound kufanele isetshenziswe ezigulini ezincane nasezinganeni
  • I-KUB Radiographs akufanele idlale indima ekuxilongweni kwe-appendicitis
  • Esithombeni, i-appendicitis iveza isithasiselo esivuvukele esinodonga olujiyile, olunwetshiwe, kanye ne-periappendiceal fat stranding. Okutholwe okufanayo kokuqiniswa nokwandiswa kodonga kuyaphawulwa e-US. Uphawu olujwayelekile oluqondiwe luphawulwa endaweni yokuhlola yase-US ye-eksisi emfushane.
  • Uma i-appendix i-retro-caecal kune-US ingase yehluleke ukuhlinzeka nge-Dx enembile kanye nokuskena kwe-CT kungase kudingeke.
  • I-Rx: isebenza ukugwema izinkinga
isithombe sokuxilonga isisu el paso tx.
  • Ukuvinjwa kwamathumbu amancane (SBO) -80% wakho konke ukuvinjelwa kwamathumbu emishini; ama-20% asele aphuma ekuvinjweni kwamathumbu amakhulu. Inezinga lokufa elingu-5.5%
  • I-M/C imbangela: noma iyiphi i-Hx yokuhlinzwa kwesisu kwangaphambilini nokunamathela
  • Isethulo sakudala siwukuqunjelwa, ukwanda kwesisu esihambisana nesicanucanu nokuhlanza
  • Ama-Radiographs azwela ngo-50% kuphela ku-SBO
  • I-CT izokhombisa imbangela ye-SBO ku-80% wamacala
  • Kunemibandela eguquguqukayo yokuvinjelwa okukhulu kwamathumbu amancane, kodwa u-3.5 cm uyisilinganiso esivamile sokuvuleka kwamathumbu.
  • Ku-Abd x-ray: supine vs. upright. Amathumbu anwetshiwe, i-valvulae conivente enwetshiwe (ukugoqeka kwe-mucosal), amanye amazinga oketshezi lomoya �isitebhisi.� Igesi engekho ku-rectum/kholoni
  • Rx: ihlinzwa �isisu esibuhlungu.�
isithombe sokuxilonga isisu el paso tx.
  • I-Volvulus-m/c ku-Sigmoid colon esp. kwabadala. Isizathu esiyinhloko: ukuqunjelwa okungapheli nokusonteka okungafuneki kwe-sigmoid ku-sigmoid mesocolon. Kuholela ekuvinjweni kwamathumbu amakhulu (LBO). Ezinye izimbangela ezivamile: isimila sekholoni. I-Sigmoid vs. Caecum volvulus
  • Ngokomtholampilo: izimpawu ze-LBO ngokuqunjelwa, ukuqunjelwa kwesisu, izinhlungu, isicanucanu, nokuhlanza. Ukuqala kungase kube kubi noma okungamahlalakhona
  • Ngomsakazo: ukulahleka kwe-haustra ku-LB, LB distension (>6-cm), �uphawu lukabhontshisi wekhofi� isilayidi esilandelayo, isiphetho esiphansi sevolvulus sikhomba okhalweni
  • QAPHELA: Umthetho wesithupha wamathumbu anwetshiwe kufanele ube ngu-3-6-9 lapho 3-cm SB, 6-cm LB & 9-cm Coecum
  • I-Rx: ihlinzwa �njengesisu esibuhlungu.�
isithombe sokuxilonga isisu el paso tx.

Okubhekwayo

 

Izifo Zesifuba Indlela Yokuxilonga Imaging

Izifo Zesifuba Indlela Yokuxilonga Imaging

by | Ukufanekisa Nokuxilonga

I-Core Anatomy

  • Qaphela izizukulwane zesihlahla se-tracheal-bronchial, ama-lobes, amasegimenti, nama-fissures. Qaphela i-lobule yesibili yamaphaphu (1.5-2-cm)-iyunithi eyisisekelo yokusebenza kwamaphaphu ebonwa ku-HRCT. Qaphela ukuhlelwa kwesakhiwo esibalulekile sezikhala ze-alveolar nokuxhumana phakathi (izimbobo ze-Kohn & nemisele ye-Lambert) evumela ukukhukhuleka komoya nangendlela efanayo evumela uketshezi oluphumayo noma oluguquguqukayo ukuba lusakazekele ephashini futhi lume lapho kuqhekeka khona. Qaphela i-anatomy ye-pleura: i-parietal eyingxenye ye-endothoracic fascia kanye ne-visceral eyakha unqenqema lwamaphaphu � isikhala sokubhoboza phakathi.

 

isifuba sokuxilonga imaging el paso tx.

 

  • I-Mediastinum: izungezwe i-pleura nephaphu. Ihlalisa izakhiwo ezinkulu iqukethe ama-lymph nodes amaningi (bheka umdwebo obonisa ama-mediastinal node kanye nokubandakanyeka kwawo ku-Lymphoma

 

isifuba sokuxilonga imaging el paso tx.

 

Indlela Ejwayelekile Yokuphenya Ngezikhalazo Zesifuba

  • Ukuhlolwa kwe-Radiographic (Isifuba X-ray CXR); omuhle kakhulu isinyathelo 1st. Izindleko eziphansi, ukuchayeka emisebeni ephansi, ukuhlolwa kwezikhalazo eziningi zomtholampilo
  • I-CT scanning: isifuba CT, i-High-Resolution CT (HRCT)
  • Indlela ye-Pathology yesifuba:
  • ukuhlukumezeka
  • Ukutheleleka
  • Ama-Neoplasms
  • I-edema yepulmonary
  • Emphysema yepulmonary
  • I-Atelectasis
  • I-Pleural pathology
  • Mediastinum

I-PA & Lateral CXR

isifuba sokuxilonga imaging el paso tx.

 

  • Ukubuka okwengeziwe kungasetshenziswa:
  • Ukubuka kwe-Lordotic: kusiza ukuhlola izifunda ze-apical
  • I-Decubitus ibuka kwesokudla nesobunxele: usizo lokuhlola ukukhishwa kwe-pleural ecashile, i-pneumothorax nezinye izifo

 

isifuba sokuxilonga imaging el paso tx.

 

isifuba sokuxilonga imaging el paso tx.

 

  • Okujwayelekile kwe-CXR PA kanye nokubukwa kwe-Lateral. Qinisekisa ukuchayeka okuhle: ama-T-spine discs kanye nemithambo edlula enhliziyweni ibonakala ngeso lengqondo ekubukeni kwe-PA. Bala 9-10 izimbambo ezingemuva kwesokudla ukuze uqinisekise umzamo owanele wokukhuthaza. Qala ucwaningo olunzulu usebenzisa le ndlela elandelayo: Ingabe Ziningi Izilonda Zamaphaphu A-isisu/i-diaphragm, i-T-thorax wall, i-M-mediastinum, i-L-lungs ngayinye, Amaphaphu-kokubili. Yakha iphethini yokusesha enhle

 

isifuba sokuxilonga imaging el paso tx.

 

  • 1) Isifo se-Airspace aka isifo samaphaphu e-alveolar? Ukugcwaliswa kwe-alveoli yamaphaphu, i-acini bese kamuva i-lobe yonke ngoketshezi noma into yanoma yikuphi ukwakheka (igazi, ubomvu, amanzi, izinto ezinephrotheni noma amaseli imbala) Ngomsakazo: ukusabalalisa kwe-lobar noma izigaba, amaqhuqhuva emkhathini angaqashelwa, ukuthambekela kokuhlangana, umoya. Kukhona ama-bronchograms kanye nezimpawu ze-silhouette. Ukusabalalisa kwe-Batwing (butterfly) kuphawulwe njengaku-(CHF). Ukushintsha ngokushesha ngokuhamba kwesikhathi, okungukuthi, ukwanda noma ukunciphisa (izinsuku)
  • 2) Isifo se-Interstitial: ukungena kwe-interstitium yamaphaphu (i-alveoli septum, i-lung parenchyma, izindonga zomkhumbi, njll.) ngokwesibonelo ngamagciwane, amagciwane amancane, ama-protozoan. Futhi ukungena ngamaseli afana namaseli avuthayo/abulalayo (isb, ama-lymphocyte) Kwethulwa njengokugqamisa kwe-lung interstitium enephethini ye-reticular, nodular, exubile ye-reticulonodular. I-etiologies ehlukene: ukuvuvukala izifo ezizimele, isifo se-fibrosing lung, isifo samaphaphu esisebenza emsebenzini, ukutheleleka ngegciwane/i-mycoplasma, i-TB, i-sarcoidosis lymphoma/leukemia nezinye eziningi.

 

isifuba sokuxilonga imaging el paso tx.

 

  • Ukubona amaphethini ahlukene wesifo samaphaphu kungasiza nge-DDx. IMisa vs. Consolidation (kwesokunxele). Qaphela amaphethini ahlukene esifo samaphaphu: isifo se-airspace njenge-lobar consolidation ekhombisa inyumoniya, ukuhlanganisa okusabalalisayo okubonisa i-pulmonary edema. I-Atelectasis (ukuwa nokulahlekelwa kwevolumu). Amaphethini we-Interstitial of pulmonary disease: i-reticular, nodular noma exutshwe. I-SPN iqhudelana nokuhlanganisa okuningi okugxilwe kukho (ama-nodule) okungenzeka amele ukungena kwe-mets vs.

 

isifuba sokuxilonga imaging el paso tx.

 

  • A = intraparenchymal
  • B = i-pleural
  • C = extrapleura
  • Qaphela indawo ebalulekile yezilonda zesifuba

 

isifuba sokuxilonga imaging el paso tx.

 

  • Izimpawu ezibalulekile: Uphawu lwe-Silhouette: usizo ngokwenza kwasendaweni kanye ne-DDx. Isibonelo: Isithombe esingezansi kwesokunxele: i-radiopacity ephashini elingakwesokudla, itholakala kuphi? I-MM yesokudla ngenxa yokuthi umngcele wenhliziyo ongakwesokudla oseduze nelobe emaphakathi kwesokudla ayibonwa (efakwe i-silhouetted) Ama-air bronchogram: umoya oqukethe i-bronchi/bronchioles ezungezwe uketshezi

 

isifuba sokuxilonga imaging el paso tx.

 

I-Chest Trauma

  • I-Pneumothorax (PTX): umoya (igesi) esikhaleni se-pleural. Izimbangela eziningi. Izinkinga:
  • I-Tension PTX: ukwanda okuqhubekayo komoya endaweni ye-pleural ecindezela ngokushesha i-mediastinum namaphaphu kunciphisa ngokushesha ukubuya kwe-venous enhliziyweni. Ingabulala uma ingelashwa ngokushesha
  • I-PTX ezenzekelayo: eyinhloko (intsha endala (30 -40) ikakhulukazi amadoda amade, azacile. Izimbangela ezengeziwe: i-Marfan's syndrome, i-EDS, i-Homocystinuria, ukuntuleka kwe-antitrypsin engu-1. , i-lung fibrosis kanye ne-honeycombing, i-PTX d/t endometriosis ye-catamenial nokunye.
  • I-traumatic pneumothorax: ukuphuka kwamaphaphu, ukuhlukumezeka okufiphele, iatrogenic (amashubhu esifubeni, njll.) ukutshopa, njll.
  • I-CXR: phawula umugqa we-visceral pleural aka unqenqema lwamaphaphu. Ukungabikho kwezicubu/imithambo yamaphaphu ngale komugqa we-visceral pleural. I-Pneumothorax ecashile ingagejwa. Endaweni eqondile, umoya uyakhuphuka futhi i-PTX kufanele ifunwe phezulu.
  • Ukuphuka kwezimbambo: v.common. I-traumatic noma pathological (isb, i-mets, MM) Uchungechunge lwe-Rib x – imisebe ayiwusizo kakhulu ngoba i-CXR kanye/noma ukuskena kwe-CT kubaluleke kakhulu ukuhlola i-PTX yangemva kwe-traumatic (phansi kwesokunxele) ukuqhuma kwamaphaphu kanye nenye indlela enkulu.

 

isifuba sokuxilonga imaging el paso tx.

 

Ukutheleleka

  • Inyumoniya: ibhaktheriya uma iqhathaniswa negciwane noma isikhunta noma kumuntu ongenamasosha omzimba (isb., Cryptococcus in HIV/AIDS) I-TB yamaphaphu

 

isifuba sokuxilonga imaging el paso tx.

 

  • Inyumoniya: okutholwa umphakathi uma kuqhathaniswa nokutholwa esibhedlela. Inyumoniya yebhaktheriya evamile noma i-Lobar (non-segmental) inyumoniya enempahla ekhukhulayo egcwalisa i-alveoli futhi isakazekela engxenyeni yonke. I-M/C organismStreptococcus Pneumonia noma iPneumococcus
  • Abanye: (Staph, Pseudomonas, Klebsiella esp. ezidakeni ezingase ziholele ku-necroSIS/lung gangrene) I-Mycoplasma (20-30s) aka inyumoniya ehambayo, njll.
  • Ngokomtholampilo: ukukhwehlela okukhiqizayo, imfiva, ubuhlungu besifuba se-pleuritic ngezinye izikhathi i-hemoptysis.
  • I-CXR: ukukhanya kwe-airspace okuhlangene kuvalelwe kuyo yonke i-lobe. I-Air bronchograms. Usizo lwezimpawu ze-silhouette ngendawo.
  • I-Viral: Umkhuhlane, i-VZV, i-HSV, i-EBV, i-RSV, njll. iveza njengesifo samaphaphu esihlanganayo esingaba sezinhlangothi zombili. Kungase kuholele ekuyekeni ukuphefumula
  • I-Atypical pneumonia kanye ne-Fungal Pneumonia: I-Mycoplasma, isifo sika-Legionnaire, kanye ne-fungal/Cryptococcus pneumonia kungase kube nesifo se-interstitial lung.
  • Ithumba lamaphaphu: iqoqo elithelelanayo lezinto eziphuphumayo emaphashini ezivame ukwenza ama-necrotizing. Kungase kuholele ezinkingeni ezinkulu zamaphaphu nesistimu/okusongela ukuphila.
  • Ku-CXR noma ku-CT: iqoqo eliyindilinga elinemingcele ewugqinsi kanye ne-necrosis emaphakathi equkethe ileveli yoketshezi lomoya. I-DDx evela ku-empyema ehlanekezela amaphaphu kanye ne-pleural-based
  • I-Rx: ama-antibiotic, ama-antifungal, ama-antiviral agents.
  • Inyumoniya idinga ukulandelwa ngokuphinda i-CXR ukuze kuqinisekiswe ukuxazulula okuphelele
  • Ukuntuleka kokuthuthukiswa kwe-radiographic kwenyumoniya kungase kubonise ukuncipha kokuzivikela komzimba, ukumelana nama-antibiotic, umdlavuza wamaphaphu ongaphansi noma ezinye izici eziyinkimbinkimbi.

I-TB yamaphaphu

isifuba sokuxilonga imaging el paso tx.

 

  • Ukutheleleka okuvamile emhlabeni wonke (amazwe omhlaba wesithathu). Umuntu oyedwa kwabathathu emhlabeni wonke uhlaselwe yi-TB. I-TB ibangelwa i-Mycobacterium TB noma i-Mycobacterium Bovis. I-bacillus ye-intracellular. I-Macrophage idlala indima ebalulekile.
  • I-Primary Pulmonary TB & Post-primary TB. Idinga ukuchayeka kaningi ngokuhogela. Kumahostela amaningi angenakuzivikela, ukutheleleka okusebenzayo akuthuthuki
  • I-TB ivela njengoku-1) kusulwe ngumsingathi, 2) icindezelwe ku-Latent Tuberculosis Infection (LTBI) 3) kubangele isifo esisebenzayo i-TB. Iziguli ezine-LTBI aziyisabalalisi i-TB.
  • Ukufanekisa: CXR, HRCT. I-TB eyinhloko: ukuhlanganiswa kwendawo yomoya yamaphaphu (60%) ama-lobe aphansi, i-lymphadenopathy (95%- hilar & paratracheal), i-pleural effusion (10%). Ukusabalala kwe-TB eyinhloko okungenzeka kakhulu ku-immunocompromised nasezinganeni.
  • I-Milliary TB: ukusatshalaliswa kwezinkinga zamaphaphu nohlelo okungabulala
  • Ukutheleleka kwe-post-primary (yesibili) noma ukuvuselela kabusha: Ikakhulukazi kuma-Apices kanye nezingxenye ezingemuva ze-lobes ephezulu )i-PO2 ephezulu), izilonda ze-40% -cavitating, isifo se-patchy noma esihlangene somoya, i-fibrocalcific. Izici ezicashile: izibalo ze-nodal.
  • I-Dx: I-Acid-fast bacilli (AFB) smear kanye nesiko (isikhwehlela). I-HIV serology kuzo zonke iziguli ezine-TB kanye nesimo esingaziwa se-HIV
  • I-Rx: uhlobo lwezidakamizwa ezi-4: i-isoniazid, i-rifampin, i-pyrazinamide, kanye ne-ethambutol noma i-streptomycin.

I-Pulmonary Neoplasms (umdlavuza wamaphaphu oyinhloko vs. i-metastasis yamaphaphu)

  • Umdlavuza wamaphaphu: umdlavuza we-m/c emadodeni kanye nomdlavuza wesi-6 ovame kakhulu kwabesifazane. Ukuhlangana okuqinile ne-carcinogens inhalation. Ngokomtholampilo: ukutholakala sekwephuzile, kuya ngendawo yesimila. I-Pathology (izinhlobo): Iseli elincane (SCC) vs. Non-small cell carcinoma
  • Iseli elincane: (20%) likhula lisuka kuseli ye-neuroendocrine aka Kultchitsky, ngaleyo ndlela ingase ikhiphe izinto eziphilayo ezisebenza nge-paraneoplastic syndrome. Ivamise ukutholakala phakathi nendawo (95%) eduze noma eduze kwe-mainstem/lobar bronchus. Iningi likhombisa ukubikezela okubi nokungahoxiki.
  • Iseli elingelona elincane: I-Lung adenocarcinoma (40%) (Umdlavuza wamaphaphu we-M/C), i-M/C kwabesifazane nakwabangabhemi. Abanye: I-squamous cell (ingase ivele ne-cavitating lesion), iseli elikhulu nabanye
  • Ifilimu engenalutho (CXR): isilonda esigxilile esisha noma esandisiwe, i-mediastinum eyandisiwe ephakamisa ukubandakanyeka kwe-lymph node, i-pleural effusion, i-atelectasis, nokuhlanganiswa. I-SPN-ingase imele umdlavuza wamaphaphu ongaba khona ikakhulukazi uma iqukethe imingcele engavamile, imikhumbi yokudla, udonga oluwugqinsi, emaphashini angaphezulu. Amaqhuqhuva amaningi wamaphaphu kungenzeka amele i-metastasis.
  • Indlela Engcono Kakhulu: I-HRCT ngokuqhathanisa.
  • Amanye ama-neoplasms esifubeni: I-Lymphoma i-v. evamile esifubeni ikakhulukazi kumanothi e-mediastinal kanye nangaphakathi kwe-mammary.
  • Sekukonke ama-neoplasms amaphaphu e-M/C ayi-metastasis. Amanye amathumba akhombisa ukuqagela okuphezulu kokuhlangana kwamaphaphu, isb, iMelanoma, kodwa noma yimuphi umdlavuza ungametastaze uye emaphashini. Amanye ama-mets abizwa ngokuthi �Cannonball� metastasis
  • I-Rx: imisebe, i-chemotherapy, ukukhishwa kabusha

 

isifuba sokuxilonga imaging el paso tx.

 

  • I-pulmonary edema: igama elivamile lichaza ukunqwabelana koketshezi okungavamile ngaphandle kwezakhiwo zemithambo. Ihlukaniswe kabanzi ibe yi-Cardiogenic (isb, i-CHF, i-mitral regurgitation) kanye ne-Non-cardiogenic enenqwaba yezimbangela (isb., ukugcwala koketshezi, ngemva kokumpontshelwa, izimbangela zemizwa, i-ARDS, eduze nokuminza/ukuphefumula, ukweqisa kwe-heroin, nokunye)
  • Izimbangela: ukwanda kwengcindezi ye-Hydrostatic vs. yehla ku-oncotic pressure.
  • Ukufanekisa: I-CXR ne-CT: Izinhlobo ezi-2 ze-Interstitial kanye nezikhukhula ze-Alveolar. Ukwethulwa kwesithombe kuncike ezigabeni
  • Ku-CHF: Isigaba 1: ukusabalalisa kabusha kokugeleza kwemithambo (10- 18-mm Hg) okuphawulwe ngokuthi �cephalization� ye-pulmonary vasculature. Isiteji sesi-2: I-Interstitial edema (18-25-mm Hg) I-edema yangaphakathi: i-peribronchial cuffing, imigqa ye-Kerley (ama-lymphatics agcwele uketshezi) A, B, C imigqa. Isiteji sesi-3: I-alveolar edema: isifo se-airspace: ukuhlanganisana okungamabala kuthuthuka kube yisifo se-airspace: I-Batwing edema, i-air bronchogram
  • I-Rx: 3 imigomo eyinhloko: I-O2 yokuqala ukugcina i-O2 iku-90%.
  • Okulandelayo: (1) ukunciphisa ukubuya kwe-venous pulmonary (ukunciphisa ukulayisha kuqala), (2) ukunciphisa ukuphikiswa kwe-systemic vascular (ukunciphisa ukulayisha), kanye (3) nokusekelwa kwe-inotropic. Yelapha izimbangela eziwumsuka (isb., CHF)

 

isifuba sokuxilonga imaging el paso tx.

 

  • I-atelectasis yamaphaphu: ukunwetshwa okungaphelele kwe-pulmonary parenchyma. Igama elithi “iphaphu eligoqekile” ngokuvamile ligcinelwa lapho lonke iphaphu ligoqekile
  • 1) I-atelectasis ye-Resorptive (obstructive) yenzeka ngenxa yokuvinjwa ngokuphelele kwendlela yokuphefumula (isib. isimila, izinto ezihogeliwe, njll.)
  • 2) I-Parietal (ukuphumula) i-atelectasis yenzeka lapho ukuthintana phakathi kwe-parietal kanye ne-visceral pleura kuphazamiseka (i-pleural effusion & pneumothorax)
  • I-3) I-atelectasis ecindezelayo yenzeka ngenxa yanoma yisiphi isilonda esithatha isikhala se-thoracic esicindezela amaphaphu futhi sikhiphe umoya ku-alveoli.
  • 4) I-Cicatricial atelectasis: kwenzeka ngenxa yokulimala noma i-fibrosis enciphisa ukwanda kwamaphaphu njengesifo se-granulomatous, i-necrotizing pneumonia, kanye ne-radiation fibrosis.
  • I-5) I-atelectasis yamaphaphu enamathela ivela ngenxa yokuntuleka kwe-surfactant kanye nokuwa kwe-alveolar
  • I-6) I-Plate-like noma i-discoid ivame ukuthuthukiswa ngemva kokulandela i-anesthesia evamile
  • 7) Izici zokucabanga: ukuwa kwamaphaphu, ukufuduka kwemifantu yamaphaphu, ukuchezuka kwe-mediastinum, ukukhuphuka kwe-diaphragm, ukwehla kwamandla emali kwamaphaphu aseduze angathinteki.

 

isifuba sokuxilonga imaging el paso tx.

 

  • I-Mediastinum: I-pathology ingahlukaniswa ibe yileyo eholela ekugxilweni kwesisindo noma lezo eziholela ekusakazekeni kwezifo ezibandakanya i-mediastinum. Ukwengeza, umoya ungase ulandelele ku-mediastinum ku-pneumomediastinum. Ulwazi lwe-mediastinal anatomy lusiza i-Dx.
  • Ubuningi be-anterior mediastinal: i-thyroid, i-thymus, i-teratoma / i-germ cell tumors, i-lymphoma, i-lymphadenopathy, i-aortic aneurysms ekhuphukayo.
  • Ubuningi be-mediastinal ephakathi: i-lymphadenopathy, i-vascular, izilonda ze-bronchial njll.
  • Ubuningi be-posterior mediastinal: izimila ze-neurogenic, i-aortic aneurysms, izicubu zommizo, izixuku zomgogodla, i-aortic chain adenopathy.

 

isifuba sokuxilonga imaging el paso tx.

 

  • I-Pulmonary emphysema: ukulahlekelwa kwezicubu ezinwebekayo ezivamile/ukuhlehla kwe-elastic kwephaphu ngokubhujiswa kwama-capillaries kanye ne-alveolar septum/interstitium.
  • Ukubhujiswa kwe-parenchyma yamaphaphu ngenxa yokuvuvukala okungapheli. Ukubhujiswa kwe-elastin-mediated protease. Ukubanjwa komoya/ukwandiswa kwendawo yomoya, i-hyperinflation, i-pulmonary hypertension, nezinye izinguquko. Umtholampilo: i-dyspnea eqhubekayo, engenakuhlehliswa. Ngesikhathi ivolumu yokuphelelwa umoya ephoqelekile kusekhondi elingu-1 (FEV1) sehlele ku-50% isiguli siyaphefumula lapho sisebenza kanzima futhi sivumelana nendlela yokuphila.
  • I-COPD iyimbangela yesithathu ehamba phambili yokufa emhlabeni jikelele. Kuthinta u-1.4% wabantu abadala e-US. M:F = 1 : 0.9. Pts iminyaka engu-45 nangaphezulu
  • Izimbangela: Ukubhema kanye nokuntuleka kwe-a-1-Antitrypsin (ihlukaniswe yaba i-centrilobular (ukubhema) kanye ne-panacinar.
  • Ukufanekisa; izimpawu ze-hyperinflation, ukubanjwa komoya, i-bullae, i-pulmonary hypertension.

 

isifuba sokuxilonga imaging el paso tx.

 

I-Head Trauma Kanye Nezinye Izindlela Zokuthwebula I-Intra-cranial Pathology

I-Head Trauma Kanye Nezinye Izindlela Zokuthwebula I-Intra-cranial Pathology

by | Ukufanekisa Nokuxilonga

Ukuhlukumezeka Ekhanda: Ukuphuka Kwekhanda

I-head trauma imaging el paso tx.
  • I-SKULL FX: IVAMILE EZILUNGISENI ZOKULIMALA EKHANDA. I-SKULL FX IVAMISE KHOMBA EZINYE IZINTO EZIYINKINGA: I-INTRA-CRANIALHEMORRHAGING, UKUVALWA KOKULIMALA OKUTHUTHUKILE BUCHOPHO KANYE NEZINYE IZINKINGA EZILINZI
  • I-X-RAY YENKOLO ASEYIPHI CISHE AYISEKHO EKUHLOLWENI UKULIMALA EKHANDA. I-CT SCANNING W/O CONTRAST ISINYATHELO SOKUQALA ESIBALULEKE KAKHULU SOKUHLOLA INHLOKO EBUHLUNGU I-TRAUMA. I-MRI HASA AMAKHONO AMAMPOFU OKUMBUZA UKUphuka UKHAKHA, FUTHI AKUVAMISILE UKUSETSHENZISWA I-DX YOKUQALA YEKHANDA LE-ACUTE I-TRAUMA.
  • I-SKULL FX YIKHOMBA NJENGAMA-FXS E-SKULL VAULT, I-SKULL BASE KANYE NE-FACIAL SKELETON NGAYINYE Ehlotshaniswa Nezici EZITHILE KANYE NOSIZO LOKUCIKELELA IZINKINGA.
  • I-LINEAR SKULL FX: I-SKULL VAULT. I-M/C FX. I-CT SCANNING NGUKHIYE WOKUHLOLA I-ARTERIALEXTRADURAL HEMORRHAGING
  • I-X-RAY DDX: SUTURES VS. I-LINEAR SKULL FX. I-FX THINNER, �BLACKER� Ie LUCENT ENINGI, AMA-CROSSESSUTURE,�NAMA-VASCULAR grooves, LACKSSERRATIONS
  • I-RX: UMA AKUKHO OKOPHA NGAPHAKATHI EKHIZINI LOKHO UKWELASHWA. UKUNAKEKELWA NGOKUHLANGANISA KWEZINHLELO UMA IKOPHA KUBONWA NGE-CT SCANNING
I-head trauma imaging el paso tx.
  • UKHAKHA OLUDIDEKILE FX: 75% EMVAWENI. INGABULALA. Icatshangelwe NGE-FX EVULIWE. AMAKHAYA AMANINGI ADINGA I-NEUROSURGICALEXPLORATION Ikakhulukazi IFFRAGMENTS ECINDEZELELWE >1-CM.IZINKINGA: UKULIMALA KWE-VASCULAR/HEMATOMAS, PNEUMOCEPHALUS, MENINGITIS, TBI, CSF LEAK, BRAIN HERNIATION ETC.
  • I-IMAGING: CT SCANNING W/O CONTRAST
I-head trauma imaging el paso tx.
  • I-BASILAR SKULL FX: INGABULALA. IVAMISE KANYE OKUNYE UKUHLUKANA KWENHLIZIYO OKUMKHULU KWE-VAULT KANYE NE-FACIALSKELETON, EVAMISE NE-TBI KANYE NOKOPHA OMKHULU OKUKHULU. IVAMISE UKWENZA INHLOKO UMPHUMELA WOMTHELELA KANYE NOKUBANDA KWEMAKEKETHINI PHAKATHI KOKUSEBENZA NAMATHAMBO ETHUSANA NGE-SPHENOID KANYE NEZINYE IZIsekelo ZAMATHAMBO OKHAKHA. NGOKWEMITHETHO: I-RACCOON EYES, UPHAWU LWE-BATTEL, CSFRHINO/OTORRHEA.

Ukuphuka Kobuso

I-head trauma imaging el paso tx.
  • NASAL AMATHAMBO FX: U-45% WOMTHELELA WE-ALLFACEFXM/C UNGOWASEMUVA(ISIQINISEKISO ETC.) UMA UKWELASHWA KWE-UNDISPLACEDNO, UMA KUKHISHWA KUNGENZA KANTI KANTI KOKUGUBHA KOMOYA KANYE NEKUPHUMULA, INGAHLANGANISA NOKUNYE UKULIMALA EBUSWENI/UKHAPHO. I-X-RAYS 80%KUNOZWA, KULANDELWA ABALIMALA BE-CT INCOMPLEX.
  • I-ORBITAL BLOW OUT FX: UKULIMALA OKUJWAYELEKILE I-D/T UMTHELELA EMHLABENI KANYE/NOMA ITHAMBO LE-ORBITAL. I-FX YE-ORBITAL FLOOR INTOMAXILLARY SINUS VS. UDONGA LWEMEDIAL KU-ETHMOID SINUS. IZINKINGA: I-ENTRAPEDINFERIOR RECTUS M, AMAFUTHA E-PROLAPSEORBITAL,� NEZITHUBA EZILILE, UKUSHIYA KWE-HEMORRHAG KANYE NOKONAMANDLA KWEMIZWA YE-OPTIC. I-RX: IZIKHATHAZO NGOKULIMALA KWE-GLOBE KUBALULEKILE, NGOKUVAMILE KULASHWA NGOKUGCINWA NGOKUGCINWA UMA ZIKHO IZINKINGA EZIkhona
I-head trauma imaging el paso tx.
  • I-TRIPOD FX: 2ND M/C FACIAL FX#AFTER NASAL (40% OF MIDFACEFX) 3-AMAPHUZU FX-ZYGOMATICARCH, INQUBO YE-ORBITAL YE-ZYGOMATIC BONE KANYE NOHLANGO LWE-MAXILLARY SINUS WALL, INQUBO EBUKHULU YE-ZYGOMATIC BONE.COMPLICATED BY NERPOTED BY NERPOTED BY NERPOTED BY. I-CT SCANNING IYAZISA KAKHULU UKUTHI I-X-RAYS (UKUBUKA KWAMANZI).
  • LEFORT FX: I-SERIOUS FX IHLALA IHLANGANISA AMAPLATES E-PTERYGOID, OKUNGENZEKA AHLUKANISE UMBUNGAZI KANYE NENKQUBO YE-ALVEOLAR NGEZINYO ESUKA OKHAKHANI. IZIKHATHAZO: I-AIRWAYS, I-HEMOSTASIS, UKULIMALA KWEZINKATHA. I-CT SCANNING IYADINGEKA. INGOZI Engaba khona YE-BASILAR SKULL FX
I-head trauma imaging el paso tx.
  • I-PING-PONG FX: KAMAZINGANE KUPHELA. I-FX D/T ENGAPHELELE I-FOCALDEPRESSION: FORCEPS DELIVERS, IMISEBENZI ENZIMA ETC. I-FOCALTRABECULAR MICROFRACTURIINGEYAKHIPHA UKUCINDEZELEKA IFANA NE-APING-PONG. U-DX UBONWA KAKHULU NJENGE-FOCAL DEFECT DEPRESSION ESKULL. NGOKUJWAYELEKILE NEUROLOGICAL INTACT. I-CT ingase isize UMA KUSOLWA UKULIMALA OBONGO. I-RX: I-OBSERVATIONAL VS. UKUHLINZWA EZILIMENI EZINGXAKI. I-SPONTANEOUSREMODELING IBIkiwe
I-head trauma imaging el paso tx.
  • I-LEPTOMENINGEAL CYST (GROWING SKULL FX)- IYAKHULA UKHAKHA LWENKINGA ELIQHUBEKA EDUZE NE-POSTTRAUMATIC ENCEPHALOMALACIA.
  • AKUYONA I-CYST, KODWA UKWANDISA KWE-THEENCEPHALOMALACIA ESIBONA IZINYANGA EZINGALUMBALWA NGEMVA KOKUHLUKUMEZEKA NGE-SKULL FX ESENGAPHAMBILI ESILANDELA I-HERNIATION YAMA-MENINGES KANYE NE-ADJACENTBRAIN NOKUPHUMA KWE-CSF. I-CT IZINHLE I-ATDX LE-PATHOLOGY. IKHOMBISA: IYAKHULA I-FX KANYE NE-ENCEPHALOMALACIA ESEDUZE NJENGE-FOCALHYPOATTENUATING LESION.
  • NGOKWEMITHETHO: UKUKHULISA KWE-CALVARIAL OKUPHAPHEMEYO, UBUHLUNGU, IZIMPAWU/UKUTHINJWA KWEMIZWA. I-RX: KUDINGEKA UKUBONISWA KWE-NEUROSURGICAL
  • I-DDX: I-INFILTRATING CELLS/METS/OTHER NEOPLASMSINTO SUTURES, EG, INFECTION ETC.
I-head trauma imaging el paso tx.
  • I-MNDIBULAR FXS: OKUJWAYELEKILE. OKUNGENZEKA KUCABANGANE NGE-OPEN FX D/T INTRA-ORALEXTENSION. 40% UKUPHUMULA OKUQONDILE NAKUBA UYINDANDATHO. I-DIRECT IMPACT(ASAULT) IMECHANISM ye-M/C
  • I-PATHOLOGICAL FX D/T BONE NEOPLASMS, UKUNGENA ETC. I-IATROGENIC NGESIKHATHI SOKUHLANGANISA UMLOMO (UKUKHIWA IZINYO)
  • I-IMAGING: MANDIBLE X-RAYS, PANOREX, CT SCANNING ESP. EZIMABENI ZOKUHLUKANA KOBUSO/KUKAKHANDA
  • IZINKINGA: UKUVIMBELA UMOYA, I-HEMOSTASIS AYIKUCABANGA OKUKHULU, UKULIMALA KU-MANDIBULAR N, OSTEOMYELITIS/CELLULITIS KANYE OKUNGENZEKA KUSAKAZEKE PHAKATHI KOMLOMO (LUDWIGANGINA) KANYE NENTAMO FASCISUES I-SOFTIMED TINOFT. AWUKWAZI UKUNJWA IZILINGANISO ZOKUFA EZINGAPHEZULU KA-D/T.
  • I-RX: I-CONSERVATIVE VS. UKUSEBENZA

I-Acute Intracranial Hemorrhage

I-head trauma imaging el paso tx.
  • I-EPI AKA EXTRADRAL: (EDH) UKUhlwithwa Okudabukisayo KWEMISHIYA YE-MENINGEAL (MMA CLASSIC) OKWAKHEKA NGOKUSHESHA I-HEMATOMA PHAKATHI KOKHAKHA LWANGANGAPHAKATHI KANYE NE-DURA NGAPHANDLE. I-CT SCANNING INGUKHIYE WE-DX: YETHULA NJENGOBA �LENTIFORM� okungukuthi i-BICONVEX COLLECTION OF ACUTE (HYPERDENSE) IGAZI ELINGEMBAMBANO FUTHI LISIZE NGE-DDX YE-HEMATOMA YASE-SUBDURAL. NGOMTHOLAMPILO: HA, ISIQEPHU SESI-LUCID EKUQALENI FUTHI SIYAWOHALA EMAHORANI ABmbalwa.IZINKINGA: I-BRAIN HERNIATION, CN PALSY. I-O/I-PROGNOSI ESIHLE UMA EPHUMA NGOKUSHESHA.
  • I-SUBDURAL HEMATOMA (SDH): UKUhlwithwa KWEMIBONGO PHAKATHI KWE-DURA YANGANGAPHAKATHI NE-ARACHNOID.KOPHA KANJANI KODWA OKUQHUBEKAYO. INGASE ITHINTE KAKHULU ABAncane KAKHULU NABADALA KANYE KUYO YONKE Iminyaka (MVA, FALLS ETC.) INGATHUTHUKELA �I-SHAKEN BABY SYNDROME�. I-DX INGASE Ibambezelekile FUTHI IBE YIKUBI UKUQALA NGOKUBULAWAYO OKUPHEZULU. EMKHANDWENI WABADALA UKUHLUKUMEZEKA KUNGEKUNCANE NOMA AKUKHUMBULWA. UKUQALA NGE-CT KUBALULEKILE. YETHULA NJENGOKUQOQELEKA KWE-CRESCENTSHAPED ENGEQA I-SUTURES KODWA KUME EZWENI ZEZIBONAKALISO. UMEHLUKO KU-CT D/T IZIGABA EZIHLULEKILE ZOKUCHITHWA KWEGAZI: I-ACUTE, SUBACUTE,� KANYE NE-CHRONIC.INGENZA I-COLLECTION-CYSTICHYGROMA ENGAPHILA. NGOMTHOLAMPILO: Iphrezentheshini EHLUKENEYO, 45-60% IKHONA ESIMO SE-CNS ESIcindezele kakhulu, UKUNGALINGANI KOMPHAKATHI. NGOKUVAMILE NGOKUQHUBEKA OKUQALA KOBUCHOPHO, BESE KUBE ISIQEPHU SE-LUCID NGAPHAMBI KOKUBI KAKHULU. EZINGENI Ezingu-30% ZOKULIMALA OKUBULAYO ​​BUCHOPHO IZIGULI ZINE-SDH. I-RX: I-URGENT NEUROSURGICAL.
I-head trauma imaging el paso tx.
  • I-SUBARACHNOID HEMORRHAGE (SAH): IGAZI ESIKHALA SE-SUB-ARACHNOID NJENGOMPHUMELA WE-ETIOLOGY YESOLEZWE NOMA ONGEKUTHUTHUKILEYO: BERRY ANEURYSMS AROUND CIRCLE OF WILLIS.SAH 3% OF STROKES, 5% OF FETAL STROKES: ♡ IKHAYA� ICHAZWE �I-HA ENGAPHILA KAKHULU�. I-PT IGOQA MAY NOMA INGABUYISI UKWAZI. I-PATHOGY: DIFFUSE BLOOD INSA SPACE 1)SUPRASELLAR CISTERN WITH DIFFUSE PERIPHERAL EXTENSION, 2)�PERIMESENEPHALIC, 3) BASAL CISTERNS. IGAZI ELICHAPHAZELEKA KU-SA SPACE UNDERARTERIAL CRESSURE DONGA UKWANDA KOMHLABA WONKE OKUSHIYELELA NGAPHANDLE KWE-INTRACRANIAL, I-ACUTE GLOBAL ISCHEMIA EYABI KABI NGE-VASOSPASM KANYE NEZINYE IZINGUQUKO.
  • I-DX: I-IMAGING: I-CT SCANNING EPHUTHUMAYO W/O CONTRAST, I-CT ANGIOGRAPHY INGASE ISIZE UKUKHIPHA 99% KA-SAH. I-LUMBAR PUNCTURE MAY USIZO EKUTHULWENI ILIBAZEKILE. NGEMVA KOKUQALA KWE-DX: UMN ANGIOGRAPHY USIZA UKUTHOLA IMBANGELA KANYE NEZINYE IZICI EZIBALULEKILE
  • IZICI EZINGAKUMBI: IGAZI LE-ACUTE LIYI-HYPERDENSE KU-CT. ITHOLAKALA KU-DIFFERENTCYSTERNS: PERIMESENEPHALIC, SUPRASELLA, BASAL, VENTRICLES,
  • I-RX: AMA-ANTIHYPERTENSIVE MEDS ESINGAPHI, AMA-OSMOTIC AGENTS (MANNITOL) TO DECREASEICP. UKUKHIPHA KWE-NEUROSURGICAL KANYE NEZINYE IZINDLELA.

CNS Neoplasms: Benign vs. Malignant

I-head trauma imaging el paso tx.
  • IZIMULA ZOBUCHOPHO IMELE 2% WAYO YONKE IMIKHANKAZA. EYODWA KWESITHATHU AYIMBI, LAPHO IZILINDE ZE-METASTATIC BRAIN EZIVAME KAKHULU
  • NGENXA YOMTHOLAMPILO IKHONA OKUNGEJWAYELEKILE KWE-CNS, I-ICP EKHUPHUKILEYO, UKWEPHA KWE-INTRACEREBRAL ETC. I-FAMILIALSYNDROMES: VON-HIPPEL-LANDAU, TUBEROUS SCLEROSIS, TURCOT SYNDROME, NF1 & NF2 YAKHULA INGOZI. EZINGANE: M/C ASTROCYTOMAS, EPENDYMOMAS, PNETNEOPLASMS (ISIB. MEDULLOBLASTOMA) ETC. DX: OKUSEKELWE EKUHLANGANENI KWABANI.
  • ABADALA: M/C BENIGN NEOPLASM: MENINGIOMA. I-M/C PRIMARY: I-GLIOBLASTOMA MULTIFORME (GBM)IMETSE KAKHULU KUSUKA KULUNG, MELANOMA,� KANYE NEBELE.ABANYE: CNS LYMPHOMA
  • UKUCABANGA KUBALULEKILE: IZIMPAWU ZOKUQALA ZINGASE ZETHULE NJENGOBA UKUBAMBA, I-ICP IZIMPAWU HA. IYAHLOLWA NGE-CT KANYE NE-MRI NGE-IV GADOLINIUM.
  • UKUCABANGA KUYANOMA: I-INTRA-AXIAL VS. EXTRA-AXIALNEOPLASMS. IHLANGANA KUSUKA PRIMARY BRAIN NEOPLASMS MAYO CCUR NGE-CSF NOKUHLASELA IMIKHUBA YAsendaweni
  • QAPHELA I-AXIAL CT SLICE YASE-MENINGIOMA ENE-AVIDCONTRAST UKUTHUTHUKISWA.
  • I-AXIAL MRI KU-FLAIR PULSE SEQUENCE YEMBUZA I-NEOPLASM ENKULU KANYE FUTHI IMAKA I-CYTOTOXIC EDEMA YE-BRAIN PARENCHYMA CHARACTERISTIC OF GRADE IV GLIOMA (GBM) ENE-PROGNOSIS EBUMBI KAKHULU. PHEZULU ISITHOMBE ESEKUDLA KWESOKUDLA: I-AXIAL MRI FLAIR: IMETASTASIS YOBUCHOPHO ESUKA KUMDLAVUZA WEBELE. I-IMELANOMA IVAMILE I-METASTASIZESTO THE BRAIN (BONA UMCUZI WENDLELA) I-MRI INGABE YI-DIAGNOSTIC D/T ISIGNALI ESIPHEZULU KU-T1 KANYE NOKUTHUTHUKISWA KOKUHLUKANISIWE.
  • I-RX: I-NEUROSURGICAL, RADIATION, CHEMOTHERAPY, IZINKINGA ZE-IMMUNOTHERAPY IYASUKA

I-Inflammatory CNS Pathology

I-head trauma imaging el paso tx.

I-CNS Infections

  • AMABHAKTHILI
  • I-MYCOBACTERIAL
  • FUNGAL
  • VIRAL
  • I-PARASITIC