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Ukuhlola Ukuhlola

Ukuhlolwa Kokuhlolwa Komtholampilo Emuva. Izivivinyo zokuhlola ngokuvamile ziwukuhlola kokuqala okuqediwe futhi kusetshenziselwa ukunquma ukuthi kungase kudingeke yini okunye ukuhlolwa kokuxilonga. Ngenxa yokuthi ukuhlolwa kokuhlola kuyisinyathelo sokuqala esiholela ekuxilongweni, kuklanyelwe ukuthi kube namathuba amaningi okucabangela ngokweqile izehlakalo zeqiniso zesifo. Idizayinelwe ukuthi yehluke ekuhlolweni kokuxilonga ngoba ingase ibonise imiphumela emihle kakhulu kunokuhlolwa kokuxilonga.

Lokhu kungaholela kukho kokubili okuhle okuyiqiniso kanye nokuhle okungamanga. Uma ukuhlolwa kokuhlolwa kutholakala ukuthi unayo, ukuhlolwa kokuxilonga kuyabe sekuqediwe ukuze kuqinisekiswe ukuxilongwa. Okulandelayo, sizoxoxa ngokuhlolwa kokuhlolwa kokuxilonga. Izivivinyo eziningi zokuhlola ziyatholakala ukuze odokotela kanye nabasebenzi be-chiropractic abathuthukisiwe bakusebenzise ekusebenzeni kwabo. Kwezinye izivivinyo, kunocwaningo oluncane olubonisa inzuzo yokuhlolwa okunjalo ekuxilongweni nasekulashweni kusenesikhathi. UDkt. Alex Jimenez wethula amathuluzi okuhlola afanelekile namathuluzi okuxilonga asetshenziswa ehhovisi ukuze kuqhutshekwe nokucacisa nokwabiwa kokuhlolwa kokuxilonga.

Ukuhlolwa kwezinyembezi ze-Hip Labral: I-El Paso Back Clinic

Ukuhlolwa kwezinyembezi ze-Hip Labral: I-El Paso Back Clinic

by | I-Hip Pain & Ukuphazamiseka, Ukuhlola Ukuhlola

I-hip joint yi-ball-and-socket joint ehlanganiswe nekhanda le-femur kanye nesokhethi, okuyingxenye ye-pelvis. I-labrum iyindandatho ye-cartilage engxenyeni yesokhethi ye-hip joint esiza ukugcina uketshezi oluhlangene ngaphakathi ukuze kuqinisekiswe ukunyakaza kwe-hip okungenazintambo kanye nokuqondanisa ngesikhathi sokunyakaza. Izinyembezi ze-labral ze-hip ukulimala kwe-labrum. Izinga lomonakalo lingahluka. Ngezinye izikhathi, i-hip labrum ingaba nezinyembezi ezincane noma i-fray emaphethelweni, ngokuvamile okubangelwa ukuguga nokudabuka kancane kancane. Kwezinye izimo, ingxenye ye-labrum ingahlukana noma ihlukaniswe nethambo le-socket. Lezi zinhlobo zokulimala ngokuvamile zibangelwa ukuhlukumezeka. Kukhona ukuhlolwa kwezinyembezi ze-hip labral ezilondolozayo ukuze kutholakale uhlobo lokulimala. Ithimba le-Injury Medical Chiropractic kanye ne-Functional Medicine Clinic lingasiza. 

Izivivinyo ze-Hip Labral Tear: Ithimba le-EPs Chiropractic

Izimpawu

Izimpawu ziyefana kungakhathalekile ukuthi hlobo luni lwezinyembezi, kodwa lapho zizwakala khona kuya ngokuthi ukudabuka kungaphambili noma ngemuva. izimpawu ezivamile zibandakanya:

  • Ukuqina kwe-Hip
  • Ibanga elilinganiselwe lokunyakaza
  • Ukuzwa ngokuchofoza noma ukukhiya ekuhlanganyeleni kwe-hip lapho uhamba.
  • Ubuhlungu okhalweni, okhalweni, noma ezinqeni, ikakhulukazi lapho uhamba noma ugijima.
  • Ukungakhululeki ebusuku kanye nezimpawu zobuhlungu lapho ulele.
  • Ezinye izinyembezi azibangeli zimpawu futhi zingase zingabonakali iminyaka.

Ukuhlolwa kwezinyembezi ze-Hip Labral

Ukudabuka kwe-hip labral kungenzeka noma yikuphi eduze kwe-labrum. Angachazwa njengangaphambili noma ngemuva, kuye ngokuthi iyiphi ingxenye yejoyinti ethintekile:

  • Izinyembezi ze-hip labral zangaphambili: Uhlobo oluvame kakhulu lwe-hip labral izinyembezi. Lezi zinyembezi zenzeka ngaphambili kwe-hip joint.
  • I-posterior hip labral izinyembezi: Lolu hlobo luvela ngemuva kwe-hip joint.

Uvivinyo

Ukuhlolwa okuvame kakhulu kwe-hip labral izinyembezi kuhlanganisa:

  • I-Hip Impingement Test
  • Isivivinyo Sokuphakamisa Umlenze Oqondile
  • The U-FABER Ukuhlola - imele i-Flexion, Abduction, kanye Nokuzungezisa Kwangaphandle.
  • The ITHESI Ukuhlola – imele i-Hip Internal Rotation with Distraction.

Ukuhlolwa Kwe-Hip Impingement

Kunezinhlobo ezimbili zokuhlolwa kwe-hip impingement.

I-Anterior Hip Impingement

  • Lokhu kuhlolwa kuhilela isiguli esilele ngomhlane idolo laso ligobe ngamadigri angu-90 bese lizungeza ngaphakathi libheke emzimbeni.
  • Uma kukhona ubuhlungu, ukuhlolwa kuthathwa njengokuhle.

I-Posterior Hip Impingement

  • Lokhu kuhlolwa kuhilela isiguli esilele emhlane sinwetshiwe inqulu futhi idolo laso ligobile futhi ligobile ngamadigri angu-90.
  • Umlenze ube usujikeleziswa ngaphandle komzimba.
  • Uma kubangela ubuhlungu noma ukwesaba, kubhekwa njengento enhle.

Ukuhlolwa Kokuphakamisa Umlenze Oqondile

Lokhu kuhlolwa kusetshenziselwa izimo zezokwelapha ezihlukahlukene ezibandakanya ubuhlungu beqolo.

  • Ukuhlolwa kuqala ngokuthi isiguli sihlale noma silale phansi.
  • Ohlangothini olungathinteki, ububanzi bokunyakaza buyahlolwa.
  • Khona-ke inqulu iyagobeka kuyilapho idolo liqondile kuyo yomibili imilenze.
  • Isiguli singase sicelwe ukuthi siguqule intamo noma sinwebe unyawo ukuze lwelule izinzwa.

Ukuhlolwa kwe-FABER

Imele i-Flexion, Abduction, kanye ne-External Rotation.

  • Ukuhlolwa kuqala ngokuthi isiguli silale ngomhlane imilenze yaso iqonde.
  • Umlenze othintekile ubekwe endaweni yesibalo sesine.
  • Udokotela uzobe esefaka ingcindezi ekhuphukayo eya phansi edolweni eligobile.
  • Uma kukhona ubuhlungu be-hip noma i-groin, ukuhlolwa kuba positive.

Ukuhlolwa KWESITHATHU

Lokhu kumela - i I-Hip Internal Rotation nge Ukuphazamiseka

  • Ukuhlolwa kuqala ngokuthi isiguli silale ngomhlane.
  • Isiguli sibe sesiguqula idolo laso libe ngama-degree angu-90 futhi siliphendulela ngaphakathi cishe ngama-degree angu-10.
  • I-hip isuke ijikeleziswa ngaphakathi ngokucindezela okuya phansi endaweni ehlangene ye-hip.
  • Ukuqondisa kuyaphindwa ngejoyinti liphazamisekile/lihlukaniswe kancane.
  • Kubhekwa njengento enhle uma ubuhlungu bukhona lapho i-hip ijikeleza futhi iyancipha ubuhlungu lapho iphazamiseka futhi ijikeleza.

Ukwelashwa kwe-Chiropractic

Ukwelashwa kweChiropractic kuhilela ukulungiswa kwe-hip ukulungisa kabusha amathambo azungeze i-hip futhi akhuphuke ngomgogodla, ukwelashwa kwe-massage yezicubu ezithambile ukuze kuphumule imisipha ezungeze i-pelvis nethanga, ukuzivocavoca okuhlosiwe okuguquguqukayo ukubuyisela uhla lokunyakaza, ukuzivocavoca kokulawula ukunyakaza, nokuzivocavoca okuqinisayo ukulungisa ukungalingani kwemisipha.

Ukwelashwa Nokwelashwa

Okubhekwayo

Chamberlain, Rachel. "Ubuhlungu Be-Hip Kubantu Abadala: Ukuhlola kanye Nokuxilongwa Okuhlukile." Udokotela womndeni waseMelika vol. 103,2 (2021): 81-89.

Groh, MM, Herrera, J. Ukubuyekezwa okuphelele kwezinyembezi ze-hip labral. Curr Rev Musculoskelet Med 2, 105–117 (2009). doi.org/10.1007/s12178-009-9052-9

U-Karen M. Myrick, uCarl W. Nissen, Ukuhlolwa KWESITHATHU: Ukuxilongwa Kwezinyembezi Ze-Hip Labral Nge-Physical Examination Technique, The Journal for Nurse Practitioners, Volume 9, Issue 8, 2013, Amakhasi 501-505, ISSN 1555-4155, doi.org/10.1016/j.nurpra.2013.06.008. (www.sciencedirect.com/science/article/pii/S155541551300367X)

U-Roanna M. Burgess, u-Alison Rushton, uChris Wright, u-Cathryn Daborn, Ukuqinisekiswa nokunemba kokuhlolwa kokuxilongwa komtholampilo okusetshenziselwa ukuthola i-labral pathology ye-hip: Ukubuyekezwa okuhlelekile, I-Manual Therapy, Umqulu 16, Ukukhishwa 4, 2011, Amakhasi 318-326 , ISSN 1356-689X, doi.org/10.1016/j.math.2011.01.002 (www.sciencedirect.com/science/article/pii/S1356689X11000038)

Su, Tiao, et al. "Ukuxilongwa nokwelashwa kwezinyembezi ze-labral." Ijenali yezokwelapha yaseShayina vol. 132,2 (2019): 211-219. doi:10.1097/CM9.0000000000000020

Wilson, John J, kanye noMasaru Furukawa. "Ukuhlolwa kwesiguli esinobuhlungu be-hip." Udokotela womndeni waseMelika vol. 89,1 (2014): 27-34.

Ukuxilongwa Kokuhlolwa Kwegazi I-Ankylosing Spondylitis Back Clinic

Ukuxilongwa Kokuhlolwa Kwegazi I-Ankylosing Spondylitis Back Clinic

by | Ukuhlola Ukuhlola, Care Spine

Ukubona i-spondylitis e-ankylosing ngokuvamile kubandakanya ukuhlolwa okuningi. Lapho odokotela beyala ukuhlolwa kwegazi ukuze kutholakale i-ankylosing spondylitis, umuntu uba nezimpawu eziya ziba zimbi emhlane nasemalungeni. Ngokuvamile, ukuhlolwa kwegazi kusho ukuthi udokotela ufuna ubufakazi banoma yini enye engase ibangele izimpawu. Kodwa-ke, ukuhlolwa kwegazi ngokwako akukwazi ukuhlonza i-ankylosing spondylitis, kodwa uma kuhlanganiswe nesithombe nokuhlola, kunganikeza izinkomba ezibalulekile ezikhomba izimpendulo.Ukuxilongwa Kokuhlolwa Kwegazi I-Ankylosing Spondylitis

I-Ankylosing Spondylitis Blood Test Diagnosis

I-Ankylosing spondylitis yisifo samathambo ithinta ngokuyinhloko umgogodla nezinqulu. Kungaba nzima ukukuxilonga ngoba akukho ukuhlola okukodwa okunganikeza ulwazi oluphelele lokuxilongwa okuqinisekile. Kusetshenziswa inhlanganisela yokuhlolwa kokuxilonga, okuhlanganisa ukuhlolwa komzimba, ukuthwebula izithombe, nokuhlolwa kwegazi. Odokotela ababheki kuphela imiphumela ezokhomba ku-ankylosing spondylitis, kodwa bafuna noma yimiphi imiphumela engase ibhekisele kude nemiphumela ye-spondylitis engase inikeze incazelo ehlukile yezimpawu.

Ukuhlolwa Komzimba

Inqubo yokuxilonga izoqala ngomlando wezokwelapha womuntu ngamunye, umlando womndeni, nokuhlolwa komzimba. Ngesikhathi sokuhlolwa, udokotela uzobuza imibuzo ukusiza ukukhipha ezinye izimo:

  • Kunesikhathi esingakanani izimpawu ziba khona?
  • Ingabe izimpawu ziba ngcono ngokuphumula noma ngokuzivocavoca?
  • Ingabe izimpawu ziba zimbi kakhulu noma azishintshi?
  • Ingabe izimpawu ziba zimbi kakhulu ngesikhathi esithile sosuku?

Udokotela uzohlola ukulinganiselwa ekuhambeni kanye nasezindaweni zamathenda e-palpate. Abaningi izimo zingabangela izimpawu ezifanayo, ngakho udokotela uzohlola ukuze abone ukuthi ubuhlungu noma ukuntuleka kokuhamba kuyahambisana yini ne-ankylosing spondylitis. Uphawu lwesici se-ankylosing spondylitis ubuhlungu nokuqina kwamalunga e-sacroiliac. Amalunga e-sacroiliac atholakala emhlane ophansi, lapho kuhlangana khona isisekelo somgogodla ne-pelvis. Udokotela uzobheka ezinye izimo zomgogodla kanye nezimpawu:

  • Izimpawu zobuhlungu beqolo ezibangelwa - ukulimala, amaphethini wokuma, kanye / noma izindawo zokulala.
  • I-Lumbar spinal stenosis
  • rheumatoid arthritis
  • Isifo samathambo we-Psoriatic
  • Ukusabalalisa i-idiopathic skeletal hyperostosis

Umlando womndeni

  • Umlando womndeni ubamba iqhaza ekuxilongweni ngenxa ye isici sofuzo se-ankylosing spondylitis.
  • Isakhi sofuzo seHLA-B27 sihambisana ne-ankylosing spondylitis; uma umuntu enaso, omunye wabazali bakhe unaso.

Ukucabanga

  • Ama-X-ray ngokuvamile asebenza njengesinyathelo sokuqala sokuxilongwa.
  • Njengoba lesi sifo siqhubeka, amathambo amancane amasha akheka phakathi kwama-vertebrae, agcine ewahlanganisa.
  • Ama-X-ray asebenza kangcono ekwembeni ukuqhubekela phambili kwesifo kunokuxilongwa kokuqala.
  • I-MRI inikeza izithombe ezicacile ezinyathelweni zokuqala njengoba imininingwane emincane ibonakala.

Izivivinyo zegazi

Ukuhlolwa kwegazi kungasiza ekukhipheni ezinye izimo futhi kuhlole izimpawu zokuvuvukala, kunikeze ubufakazi obusekelayo kanye nemiphumela yokuhlolwa kwezithombe. Ngokuvamile kuthatha cishe usuku noma ezimbili kuphela ukuthola imiphumela. Udokotela anga-oda okunye kokuhlolwa kwegazi okulandelayo:

I-HLA-B27

Ukuhlolwa kwe-HLA-B27.

  • Ufuzo lwe-HLA-B27 lwembula ifulegi elibomvu ukuthi i-ankylosing spondylitis ingaba khona.
  • Abantu abanalolu fuzo basengozini enkulu kakhulu yokuba nalesi simo.
  • Kuhlanganiswe nezimpawu, amanye amalebhu, nokuhlolwa, kungasiza ukuqinisekisa ukuxilongwa.

ESR

Isilinganiso sedimentation se-Erythrocyte or Izibalo ze-ESRt.

  • Ukuhlolwa kwe-ESR kukala ukuvuvukala emzimbeni ngokubala izinga noma ukuthi amangqamuzana abomvu egazi ashesha kangakanani ukufika phansi kwesampula yegazi.
  • Uma zixazulule ngokushesha kunokujwayelekile, umphumela uba i-ESR ephakeme.
  • Lokho kusho ukuthi umzimba ubhekene nokuvuvukala.
  • Imiphumela ye-ESR ingase ibuye iphezulu, kodwa lena iyodwa ayihloli i-AS.

I-CRP

Amaprotheni asebenzayo - Ukuhlolwa kwe-CRP.

  • Ukuhlolwa kokuhlolwa kwe-CRP Amazinga e-CRP, iphrotheni ehambisana nokuvuvukala emzimbeni.
  • Amazinga e-CRP aphakeme abonisa ukuvuvukala noma ukutheleleka emzimbeni.
  • Kuyithuluzi eliwusizo lokulinganisa ukuqhubeka kwesifo ngemuva kokuxilongwa.
  • Kuvame ukuhambisana nezinguquko emgogodleni oboniswa ku-X-ray noma i-MRI.
  • Bangama-40-50% kuphela abantu abane-ankylosing spondylitis abathola i-CRP eyengeziwe.

esithi asifane nesika ANA

Ukuhlolwa kwe-ANA

  • Amasosha omzimba e-anuclear, noma i-ANA, ilandela amaprotheni kunucleus yengqamuzana, itshela umzimba amangqamuzana awo ayisitha.
  • Lokhu kuvuselela ukusabela komzimba okulwa nokuqeda.
  • Ucwaningo luthole ukuthi i-ANA itholakala ku-19% wabantu abaphethwe i-ankylosing spondylitis futhi iphezulu kwabesifazane kunabesilisa.
  • Kuhlanganiswe nokunye ukuhlola, ukuba khona kwe-ANA kunikeza omunye umkhondo wokuxilongwa.

Gut Health

  • The i-microbiome yamathumbu idlala indima ebalulekile ekuvuseni ukuthuthukiswa kwe-ankylosing spondylitis kanye nokwelashwa kwayo.
  • Ukuhlolwa kokuthola impilo yamathumbu kunganikeza udokotela isithombe esiphelele salokho okwenzeka ngaphakathi emzimbeni.
  • Ukuxilongwa kokuhlolwa kwegazi kwe-ankylosing spondylitis nezinye izimo ezivuvukalayo kuncike kakhulu ekuhlanganiseni ndawonye ukuhlolwa okuhlukile eceleni kokuhlolwa komtholampilo nokuthwebula izithombe.

Izimbangela, Izimpawu, Ukuxilongwa, kanye Nokwelashwa

Okubhekwayo

Cardoneanu, Anca, et al. "Izici ze-microbiome yamathumbu ku-ankylosing spondylitis." Umuthi wokuhlola kanye nokwelapha vol. 22,1 (2021): 676. doi:10.3892/etm.2021.10108

Prohaska, Et al. “Antinukleäre Antikörper bei Spondylitis ankylosans (Morbus Bechterew)” [Amasosha omzimba e-Antinuclear ku-ankylosing spondylitis (transl yombhali)]. Wiener klinische Wochenschrift vol. 92,24 (1980): 876-9.

Sheehan, Nicholas J. “The ramifications of HLA-B27.” Ijenali yeRoyal Society of Medicine vol. 97,1 (2004): 10-4. doi:10.1177/014107680409700102

Wenker KJ, Quint JM. I-Ankylosing Spondylitis. [Kubuyekezwe 2022 Ephreli 9]. Ku: StatPearls [I-inthanethi]. I-Treasure Island (FL): I-StatPearls Publishing; 2022 Jan-. Itholakala ku: www.ncbi.nlm.nih.gov/books/NBK470173/

Xu, Yong-Yue, et al. "Indima ye-gut microbiome ku-ankylosing spondylitis: ukuhlaziywa kwezifundo ezincwadini." Umuthi wokutholwa vol. 22,123 (2016): 361-370.

I-Scoliosis Diagnosis: I-Adams Forward Bend Test Back Clinic

I-Scoliosis Diagnosis: I-Adams Forward Bend Test Back Clinic

by | indlela yekuma, Ukuhlola Ukuhlola

The Adams phambili bend test kuyindlela yokuhlola elula engasiza ekuxilongweni kwe-scoliosis nokusiza ekuthuthukiseni uhlelo lokwelapha. Ukuhlolwa kuqanjwe nge- Udokotela oyiNgisi uWilliam Adams. Njengengxenye yokuhlolwa, udokotela noma isazi se-chiropractor sizobheka ukugoba okuphambene nomgogodla okungavamile.Ukuxilongwa kwe-Scoliosis: Ukuhlolwa kwe-Adams Forward Bend

Ukuxilongwa kwe-Scoliosis

  • Ukuhlolwa kwe-Adams phambili-bend kungasiza ekunqumeni ukuthi zikhona yini izinkomba ze-scoliosis.
  • Akusona isifo esisemthethweni, kodwa imiphumela ingasetshenziswa njengesiqalo.
  • Ukuhlolwa kwenziwa kanye neminyaka yesikole izingane phakathi kwe-10 ne-18 ukuthola ingane idiopathic scoliosis noma i-AIS.
  • Ukuhlolwa okuqondile kuyi-asymmetry ebonakalayo ezimbanjeni ngokugoba phambili.
  • Ingakwazi ukubona i-scoliosis kunoma iyiphi ingxenye yomgogodla, ikakhulukazi emkhatsini we-thoracic nangaphezulu.
  • Ukuhlolwa akukona okwezingane kuphela; i-scoliosis ingakhula kunoma yisiphi isikhathi, ngakho-ke iyasebenza nakubantu abadala.

Adams Forward Bend Test

Ukuhlolwa kuyashesha, kulula, futhi akunabuhlungu.

  • Umhloli uzohlola ukuze abone ukuthi akukho yini okungalingani lapho emi ngokuqondile.
  • Khona-ke isiguli sizocelwa ukuba sigobe phambili.
  • Isiguli sicelwa ukuba sime sihlanganise imilenze, sibheke kude nomhloli.
  • Bese iziguli zigobela phambili kusukela okhalweni, izingalo zilenga zibheke phansi.
  • Umhloli usebenzisa a i-scoliometer-njengezinga lokubona ama-asymmetries ngaphakathi komgogodla.
  • Ukuchezuka kubizwa ngokuthi I-Cobb angle.

Ukuhlolwa kwe-Adams kuzoveza izimpawu ze-scoliosis kanye/noma okunye ukukhubazeka okufana nalokhu:

  • Amahlombe angalingani
  • Izinqe ezingalingani
  • Ukuntuleka kokulinganisa phakathi kwama-vertebrae noma amahlombe ehlombe.
  • Ikhanda alihlangani no-a ubambo hump noma i-pelvis.

Ukutholwa Kwezinye Izinkinga Zomgogodla

Ukuhlolwa kungasetshenziswa futhi ukuthola izinkinga zokugoba komgogodla nezimo ezifana nalezi:

  • I-Kyphosis noma i-hunchback, lapho ingemuva elingenhla ligobe phambili.
  • Isifo sikaScheuermann iwuhlobo lwe-kyphosis lapho i-thoracic vertebrae ingakhula ngokungalingani ngesikhathi sokukhula futhi ibangele ukuthi ama-vertebrae athuthuke abe yisimo esifana ne-wedges.
  • Umgogodla wokuzalwa izimo ezibangela ijika elingavamile lomgogodla.

Ukuqinisekiswa kwe

Ukuhlolwa kwe-Adams ngokwako akwanele ukuqinisekisa i-scoliosis.

  • I-X-ray emile enezilinganiso ze-Cobb angle ezingaphezu kuka-10 degrees iyadingeka ukuze kuhlolwe i-scoliosis.
  • I-engeli ye-Cobb inquma ukuthi yimaphi ama-vertebrae atsheke kakhulu.
  • Uma i-engeli iphakeme, isimo sinzima kakhulu futhi kungenzeka ukuthi sizoveza izimpawu.
  • I-computed tomography noma i-CT kanye ne-magnetic resonance imaging noma izikena ze-MRI nazo zingasetshenziswa.

Phambili Bend Test

Okubhekwayo

Glavaš, Josipa et al. "Iqhaza lomuthi wesikole ekutholweni nasekuphathweni kwentsha idiopathic scoliosis." Wiener klinische Wochenschrift, 1–9. 4 Okthoba 2022, doi:10.1007/s00508-022-02092-1

Grossman, TW et al. "Ukuhlolwa kokuhlolwa kwe-Adams forward bend kanye ne-scoliometer endaweni yokuhlolwa kwesikole se-scoliosis." Ijenali yezingane zamathambo vol. 15,4 (1995): 535-8. doi:10.1097/01241398-199507000-00025

Letts, M et al. "I-ultrasonic digitization yekhompyutha esikalini sokugoba komgogodla." Umgogodla vol. 13,10 (1988): 1106-10. doi:10.1097/00007632-198810000-00009

Senkoylu, Alpaslan, et al. "Indlela elula yokuhlola ukuguquguquka okujikelezayo ku-adolescent idiopathic scoliosis: ukuhlolwa okuguquguqukayo okuguquguqukayo kuka-Adamu." Ukukhubazeka komgogodla vol. 9,2 (2021): 333-339. doi:10.1007/s43390-020-00221-2

Kungani Ngidinga i-X-ray noma i-MRI ye-Lower Back Pain El Paso, TX?

Kungani Ngidinga i-X-ray noma i-MRI ye-Lower Back Pain El Paso, TX?

by | Ukuhlolwa kwe-Chiropractic, Ukuhlola Ukuhlola

Ubuhlungu obuphansi emuva bungesinye sezifo ezivame kakhulu kubantu abavakashela udokotela noma umtholampilo wokunakekelwa okuphuthumayo. Lapho ubuhlungu beqolo buba namandla, bungakwenza ucabange ukuthi kukhona okungahambi kahle emhlane wakho. Udokotela angase anikeze i i-x-ray noma i-MRI scan ukuze ubeke okukukhathazayo kalula.

Ngenhlanhla, izimo eziningi zobuhlungu obuphansi emuva, ngisho nobuhlungu obukhulu, ziba ngcono phakathi nezinsuku noma amasonto ambalwa. Amacala amaningi alungiswa nge i-chiropractic, ukwelashwa ngokomzimba, ukwelapha ukushisa/iqhwa, nokuphumula. Futhi eziningi zalezi zimo azidingi noma yiluphi uhlobo lokucabanga komgogodla. Kodwa-ke, yingakho i-X-ray, i-MRI, ne-CT scans kudingekile ukuthola ukuthi kwenzekani.

  • Umsipha oqinile
  • Umsipha ochotshoziwe
  • Ukumiswa okubi

Lezi zimbangela ezijwayelekile zobuhlungu obuphansi emuva zingaba buhlungu futhi zinciphise imisebenzi.

 

11860 Vista Del Sol, Ste. 128 Kungani Ngidinga i-X-ray noma i-MRI ye-Lower Back Pain El Paso, TX?

 

Ubuhlungu Emuva Buhlala Isikhathi Eside Kunamaviki angu-2/3

Ubuhlungu be-Subacute buhlala phakathi kwamaviki angu-4 kuya kwangu-12, kuyilapho ubuhlungu obungapheli beqolo buhlala izinyanga ezintathu noma ngaphezulu. Lezi akuzona izinkomba zesimo esinzima somgogodla ophansi.

Ngaphansi kwe-1% yabantu abanobuhlungu obuphansi emuva bathola ukuthi banesimo esingase sidinge ukuhlinzwa komgogodla:

 

Ama-X-ray noma ama-MRIs Wokuhlonza Izinhlungu Eziphansi Emuva

Doctors bangase batuse i-x-ray noma i-MRI uma ubuhlungu obuphansi emuva buvela ekulimaleni okubuhlungu, njenge:

  • ukushelela
  • Fall
  • Ingozi yemoto

Ezinye izimbangela ezingase zibe nobuhlungu obuphansi emuva zingase zithole isithombe sezokwelapha ngokushesha noma kamuva.

Inqubo yokuxilonga iqala ngokuhlolwa kwezimpawu eziphansi emuva nokuthi zihlobana kanjani nalokho okutholwe ngesikhathi:

  • Ukuhlolwa ngokomzimba
  • Ukuhlolwa kwezinzwa
  • Umlando wezokwelapha

Udokotela usebenzisa le miphumela ukuze anqume ukuthi i-imaging yomgogodla iyadingeka yini, kanye nohlobo lokuhlolwa kwezithombe, i-x-ray, noma i-MRI kanye nesikhathi sokuqinisekisa ukuxilongwa.

I-Low Back X-Ray/MRI

I-X-ray imaging yomgogodla ithola kangcono izinkinga zesakhiwo samathambo kodwa hhayi kakhulu ngokulimala kwezicubu ezithambile. Uchungechunge lwe-X-ray lungenziwa ukuze kuhlonzwe ukuphuka kwe-vertebral compression fractures.

  • sangaphambilini
  • Iphosta yangaphandle
  • Ukubuka kwangemuva

I-MRI iwukuhlola okungenawo imisebe. Ama-MRI ayakha Ukubuka kwe-3-D kwe-anatomical yamathambo omgogodla nezicubu ezithambile. Udayi wokuqhathanisa njengo i-gadolinium isetshenziselwa ukuthuthukisa nokwenza ngcono ikhwalithi yezithombe. Umehluko ujovwa ngomugqa womthambo osesandleni noma engalweni yakho ngaphambi noma phakathi nokuhlolwa. An I-MRI ingahlola izimpawu zemizwa, njengobuhlungu obukhiphayo noma ubuhlungu obuvela ngemva kokuxilongwa komdlavuza.

Izimpawu, Ukuxilongwa Okukhona Kwezokwelapha, kanye Nezimo ezingase Zidinge Ukufanekisa Umgogodla

Izimpawu ze-Neurological

  • Ubuhlungu obuphansi emuva obuphumayo, abalandeli baphume, noma behle baye ezinqeni, emilenzeni nasezinyaweni
  • I-reflexes engavamile emzimbeni ophansi ingabonisa ukuphazamiseka kwezinzwa
  • Ukuba ndikindiki, ukuntweza, futhi mhlawumbe nokuba buthakathaka kuyakhula
  • Ukungakwazi ukuphakamisa unyawo lwakho, i-foot drop

Ukuxilonga okukhona kanye nezimo

  • Cancer
  • Diabetes
  • Fever
  • Kwamathambo
  • Ukuphuka komgogodla kwangaphambilini
  • Ukuhlinzekwa ngesivinini
  • Ukutheleleka kwakamuva
  • Ukusetshenziswa kwama-immunosuppressants
  • Imithi ye-Corticosteroid
  • Ukwehla kwesisindo

 

I-X-ray Radiation Exposure

Ukukhishwa kwemisebe emzimbeni wakho wonke kukalwa nge-millisievert (mSv), eyaziwa nangokuthi umthamo osebenzayo. Umthamo wemisebe uyinani elifanayo njalo uma uthola i-x-ray. Lapho wenza i-x-ray, i- imisebe engamuncwanga umzimba yakha isithombe.

Umthamo osebenzayo usiza udokotela ukukala ubungozi be imiphumela emibi engenzeka I-radiographic imaging:

  • Ama-CT scan nawo asebenzisa imisebe
  • Izicubu ezithile zomzimba nezitho ezingaphansi komhlane ziyazwela emisebeni, njengezitho zokuzala.

 

I-MRI Radiation-Free Kungani Ungavele Usebenzise Lesi Sivivinyo Ngaso Sonke Isikhathi

I-MRI ayikwazi ukusetshenziswa kuzo zonke iziguli ngenxa yobuchwepheshe bayo bezibuthe obunamandla. Abesifazane abakhulelwe noma abantu abanensimbi ngaphakathi emizimbeni yabo, njengesivuseleli somgogodla, i-pacemaker yenhliziyo, njll., abakwazi ukuskenwa nge-MRI.

Ukuhlolwa kwe-MRI nakho kuyabiza; odokotela abafuni ukunikeza ukuhlolwa okungadingekile okwandisa izindleko. Noma ngenxa yemininingwane emihle ehlinzekwa yi-MRIs, ngezinye izikhathi inkinga yomgogodla ingabukeka inzima kodwa akunjalo.

Isibonelo: I-MRI yomgogodla ophansi wembula a i-herniated disc esigulini esingenabuhlungu emuva / emlenzeni noma ezinye izimpawu.

Yingakho odokotela beletha konke abakutholile njengezimpawu, ukuhlolwa ngokomzimba, nomlando wezokwelapha ukuze baqinisekise ukuxilongwa nokudala uhlelo lokwelapha olungokwezifiso.

Imaging Test Takeaways

Uma ubuhlungu obuphansi emuva buthatha umonakalo, lalela lokho okutuswa udokotela. Bangase banga-oda i-x-ray ye-lumbar noma i-MRI ngokushesha kodwa bakhumbule izindaba ezishiwo ngenhla, njengezimpawu zemizwa kanye nezimo zezokwelapha ezikhona. Kodwa lezi zivivinyo zisiza ukuthola imbangela noma izimbangela zobuhlungu. Khumbula ukuthi lokhu ukusiza ukwenza iziguli zibe nempilo engcono futhi ezingenabuhlungu.

 

Indlela Yokuqeda Ubuhlungu Basemuva ngokwemvelo | (2020) Amaleveli Ezinyawo | El Paso, Tx

 

 

Izinsiza ze-NCBI

Ukuxilongwa kwesithombe iyisici esibalulekile ekuhloleni ukuhlukumezeka komgogodla. Ukuziphendukela kwemvelo okusheshayo kobuchwepheshe be-imaging kuye kwashintsha kakhulu ukuhlolwa nokwelashwa kokulimala komgogodla. Ukuxilongwa kwe-imaging kusetshenziswa i-CT ne-MRI, phakathi kokunye, kuyasiza kuzilungiselelo ezibucayi nezingamahlalakhona. Ukulimala komgogodla kanye nezicubu ezithambile kuhlolwa kangcono nge-imaging resonance magnetic, noma i-MRI., ngenkathi i-computed tomography scanning noma ama-CT scans ahlola kangcono ukuhlukumezeka komgogodla noma ukuphuka komgogodla.

 

 

Ukungajwayelekile Komgogodla Okuthathu Ukuthi I-Chiropractic Isiza El Paso, TX.

Ukungajwayelekile Komgogodla Okuthathu Ukuthi I-Chiropractic Isiza El Paso, TX.

by | Ukuhlola Ukuhlola, Care Spine

Ngezinye izikhathi kukhona okungavamile komgogodla futhi kubangela ukungahambi kahle kwama-curvatures emvelo noma amanye ama-curvatures angase enziwe ihaba. Lezi zigobe ezingezona ezemvelo zomgogodla zibonakala ngezimo ezintathu zezempilo ezibizwa i-lordosis, i-kyphosis, ne-scoliosis.

Ayihloselwe ukugoba ngokwemvelo, ukusonteka, noma ukugoba. Isimo semvelo somgogodla onempilo sithi siqondile futhi amajika amancane agijima ngaphambili ukuya emuva ukuze ukubuka okuseceleni kuziveze.

Uma ubuka umgogodla ngemuva, kufanele ubone okuhluke ngokuphelele � umgogodla ogijima uqonde phansi, phezulu uye phansi ngaphandle kwamajika asemaceleni. Lokhu akwenzeki njalo.

Umgogodla wakhiwe ama-vertebrae, amathambo amancane abekwe phezulu komunye nomunye anama-disc e-cushioning nomthelela phakathi kwelinye. Lawa mathambo asebenza njengamalunga, avumela umgogodla ukuba ugobe futhi usonte ngezindlela ezihlukahlukene.

Zigoba kancane, zitshekele ngaphakathi kancane endaweni encane yangemuva, ziphinde futhi kancane entanyeni. Ukudonsa kwamandla adonsela phansi, kuhlangene nokunyakaza komzimba, kungabeka ingcindezi enkulu emgogodleni futhi lamajika amancane asiza ukumunca omunye umthelela.

Izimo ezihlukene zezinhlobo ezahlukene zama-spinal curvatures

ukungahambi kahle komgogodla ukuthi i-chiropractic ingasiza el paso tx.

Ngayinye yalezi zinkinga ezintathu zokugoba komgogodla zithinta indawo ethile yomgogodla ngendlela eqondile.

  • I-Hyper noma i-Hypo Lordosis � Lokhu kugobeka komgogodla kuthinta ingemuva elingezansi, okwenza umgogodla ugobele ngaphakathi noma ngaphandle kakhulu.
  • Hyper noma Hypo Kyphosis � Lokhu kuphazamiseka kwe-spinal curvature kuthinta ingemuva elingenhla, libangele umgogodla ugobe, okuholela ekutheni leyo ndawo izungeleze noma ibe isicaba ngendlela engavamile.
  • I-Scoliosis � Lokhu kuphazamiseka kokugoba komgogodla kungathinta wonke umgogodla, kuwenze ugobele emaceleni, kwakhe umumo ongu-C noma u-S.

Ziyini izimpawu?

ukungahambi kahle komgogodla ukuthi i-chiropractic ingasiza el paso tx.

Uhlobo ngalunye lwe-curvature lubonisa isethi yalo yezimpawu. Ngenkathi ezinye izimpawu zingase zidlulele, eziningi zihlukile kukuphazamiseka okuthile kwe-curvature.

  • Lordosis
    • Ukubukeka �swayback� lapho izinqe ziphumela ngaphandle noma zigqame kakhulu.
    • Ukungakhululeki emhlane, ngokuvamile endaweni ye-lumbar
    • Uma ulele endaweni eqinile ngemuva, indawo engemuva ephansi ayithinti indawo, ngisho nalapho uzama ukudonsa i-pelvis futhi uqondise umhlane ophansi.
    • Ubunzima ngokunyakaza okuthile
    • Ukuhlungu obusemhlane
  • I-Kyphosis
    • Ijika noma i-hump ukuya phezulu ngemuva
    • Ubuhlungu obungenhla emuva kanye nokukhathala ngemva kokuhlala noma ukuma isikhathi eside (Scheuermann's kyphosis)
    • Ukukhathala komlenze noma emuva
    • Ikhanda ligobela kude kunokuba liqonde
  • I-Scoliosis
    • Izinqulu noma ukhalo azilingani
    • Ihlombe elilodwa liphakeme kunomunye
    • Umuntu uncike ohlangothini olulodwa

Ziyini izimbangela?

Izinkinga eziningi zezempilo ezihlukene zingabangela ukuthi umgogodla ungahambelani kahle noma wenze i-spinal curvature. Ngamunye we izimo zomgogodla okukhulunywa ngakho kuthintwa izimo nezimo ezahlukene.

  • Lordosis
    • Kwamathambo
    • I-Achondroplasia
    • I-Discitis
    • Ukukhuluphala
    • I-Spondylolisthesis
    • I-Kyphosis
  • I-Kyphosis
    • Isifo Sokuqaqamba Kwamalunga
    • Izimila phezu noma emgogodleni
    • I-Congenital kyphosis (ukukhula okungavamile kwe-vertebrae ngenkathi umuntu esesibelethweni)
    • I-Spine bifida
    • Isifo sikaScheuermann
    • Sula izifo
    • Kwamathambo
    • Ukuhlehla okujwayelekile noma ukungami kahle

I-Scoliosis kuseyimpicabadala kodokotela. Abaqiniseki ukuthi yini ngempela ebangela uhlobo oluvame kakhulu lwe-scoliosis oluvame ukubonakala ezinganeni nasebancane. Ezinye zezimbangela abazikhombile zihlanganisa:

I-chiropractic ingasiza el paso tx.
  • Ufuzo, unomkhuba wokugijima emindenini
  • Ukutheleleka
  • Ukukhubazeka kokuzalwa
  • Ukulimala

Ukuphazamiseka kokugoba komgogodla kanye ne-Chiropractic

Ukuguqulwa komgogodla kwezinkinga ze-spinal curvature kuboniswe ukuthi zisebenza kakhulu. I-Chiropractic isiza ukubuyisela ibhalansi yemvelo yomgogodla ngisho noma isiguli sinenye yalezi zinhlobo zezimo.

Bangu ukuhlolwa etholakalayo kubo bobabili izingane kanye nabantu abadala ukukhomba noma yikuphi ukugoba komgogodla ezinyathelweni zabo zakuqala nge-chiropractor yakho. Ukutholwa kusenesikhathi kwalezi ziphazamiso kubalulekile ukuze uzibone ngaphambi kokuba zibe zimbi kakhulu.

Umgogodla Owenziwe Ngokwakho & *UKWELASHWA KWE-SCIATICA* | El Paso, TX (2019)

Izinzuzo ze-4 Zokuhlolwa Kwe-Scoliosis Kusuka Ku-Chiropractor

Izinzuzo ze-4 Zokuhlolwa Kwe-Scoliosis Kusuka Ku-Chiropractor

by | Ukuhlola Ukuhlola

Kulinganiselwa ukuthi i-scoliosis ithinta noma yikuphi kusuka kumaphesenti angu-2 kuya kwangu-3 wezingane nabantu abadala e-United States. Lokho kubalelwa ezigidini eziyisithupha kuya kweziyisishiyagalolunye. Nakuba ibonakala ikhula ngokuvamile phakathi kwezigaba ezithile zeminyaka yabafana namantombazane, ingase ikhule besebancane. Njalo ngonyaka, cishe izingane ze-30,000 zifakwe i-scoliosis back brace kuyilapho abantu be-38,000 benokuhlinzwa komgogodla ukuze kulungiswe inkinga. Ukuhlolwa kwe-Scoliosis kungaba nezinzuzo ezinkulu ngokukhomba zombili izici eziyingozi ze-scoliosis nokuvumela ukwelashwa kusenesikhathi.

Uma ubona i-scoliosis kusenesikhathi, kulula ukuyelapha.

I-Scoliosis ngokuvamile iqala ebuntwaneni. Emantombazaneni, ngokuvamile kwenzeka phakathi kweminyaka engu-7 ne-14 ubudala. Abafana bakhula kamuva, phakathi kweminyaka eyi-6 ne-16 ubudala.

Ukuthola ukuhlolwa kwe-scoliosis unyaka ngamunye phakathi nalezi zigaba zeminyaka ebucayi kuvumela odokotela ukuthi babone isimo kusenesikhathi futhi baqale ukuselapha ngaphambi kokuba sibe sibi kakhulu. I-Advanced scoliosis ingadinga ukwelashwa okubanzi, i-bracing, ngisho nokuhlinzwa.

I-Chiropractic iboniswe ukusiza i-scoliosis, njengokwelula, ukuzivocavoca okukhethekile, nokwelapha ngokomzimba. Kukhona ukulungiswa komgogodla okwenziwa yi-chiropractors okuqondile ekwelapheni kwe-scoliosis.

Lapho kukhulunywa ngesimo kusenesikhathi, i-engeli ye-Cobb ingamiswa ekuqhubekeleni phambili futhi yehliswe ukuze umgogodla ube nejika elingokwemvelo. Ukwelashwa okungahlinzeki kuvame ukuphumelela kakhulu ezinyathelweni zangaphambili ze-scoliosis, ngakho-ke ukutholakala kusenesikhathi nokuxilongwa kusenesikhathi kubalulekile.

i-scoliosis screening chiropractor, el paso, tx.

Ukuhlonza amacala ayingozi kakhulu kusenesikhathi kungalungisa izinkinga zamanje futhi kuvimbele ezizayo.

Ama-Chiropractors angakwazi ukubona izici ezithile zengozi ye-scoliosis ezinganeni ngaphambi kokuba isimo sikhule. Ukuhlolwa kwe-scoliosis kubavumela ukuthi babone ukungezwani endaweni umgogodla wengane � uphawu olujwayelekile lokuthi bazoba ne-scoliosis.

Uma abazali beqaphela ukuthi ingane yabo isesigabeni esiyingozi kakhulu sokuthuthukisa i-scoliosis, bangathatha izinyathelo ezisebenzayo ngokuqapha ekhaya izimpawu ze-scoliosis kanye nokuhambisana nenkambo yokuhlolwa okunconywayo. Bazokwazi ukubheka izimpawu futhi bangabhekana nazo ngokushesha ukuze ukwelashwa kuqalwe ngokushesha ngangokunokwenzeka.

Siza abacwaningi nodokotela ukuthi baphumelele kakhulu ekwelapheni i-scoliosis.

Izigaba zokuqala kanye nokuthuthukiswa kwe-scoliosis kusafihliwe kubacwaningi nodokotela. Nakuba kube nentuthuko enkulu ekuqondeni kangcono lesi simo, kusekuningi okusamele kufundwe.

Kube nocwaningo oluningi olusize odokotela ekuhlonzeni izingane ezisengozini enkulu kanye nokuxilonga kusenesikhathi, njengokuthiI-angle ye-ankle nonyawo ixhunywe ku-scoliosis. Kodwa-ke, ukuhlonza, ukuxilonga, nokwelashwa kubalulekile ekugcineni ukuhamba kwedatha ukuze kwenziwe ucwaningo olwengeziwe kanye nocwaningo olwengeziwe.

Ukuhlolwa okwengeziwe okujwayelekile kusho ukuhlonza izimo eziningi ze-scoliosis ezigabeni zokuqala. Lokhu kungaba nomthelela onezinhlangothi ezimbili ocwaningweni. Izohlinzeka ngedatha eyengeziwe okufanele ibuyekezwe futhi ifundwe, futhi izokwandisa isithakazelo esimweni njengoba amacala amaningi esiteji sokuqala se-scoliosis etholakala. Lokhu kuzogqugquzela ucwaningo.

Gwema �umdlalo wokulinda� wokubona ukuthi i-scoliosis izothuthuka yini.

Noma yimuphi umzali okuye kwadingeka alinde imiphumela yokuhlolwa noma ukuze abone ukuthi isimo sizoba sibi nakakhulu yini ukwazi kahle ukukhathazeka ngokudlala lowo mdlalo wokulinda. Umndeni uvame ukuba ngumuntu wokuqala ukuthola i-scoliosis enganeni.

Nakuba bengase basole inkinga, noma bazi ukuthi inkinga ikhona, bangase bathathe �ukulinda babone’ indlela yokuthola ukwelashwa. Uma ijika liba libi bangase bagcine befuna ukwelashwa, kodwa ukubelesela njalo kokungazi ukuthi ijika lizoba libi nakakhulu yini � kanye nokukhathazeka elikuvezayo � kungase kuthinte hhayi kuphela ukuthula kwengqondo kubazali�kodwa nengane.

Ukuhlolwa kwe-Scoliosis kunikeza ukuthula kwengqondo futhi kuqaphe ukukhula kwengane ukuze uma i-scoliosis yayo iqhubeka noma iba inkinga ingaxazululwa ngendlela esheshayo, ephumelelayo ngangokunokwenzeka.

Ukuvuselelwa Kwemasaji

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Ukuxilongwa Nokuphathwa Kwe-Rheumatoid Arthritis

Ukuxilongwa Nokuphathwa Kwe-Rheumatoid Arthritis

by | Isifo Sokuqaqamba Kwamalunga, I-Arthropathies, I-Chiropractic, Ukuhlolwa kwe-Chiropractic, Ubuhlungu obungapheliyo, Izimo zenziwe, Impilo, Ukufanekisa Nokuxilonga, Izifundo zocwaningo, Ukuhlola Ukuhlola, Ukwelashwa, Ubuhle

Cishe abantu abayizigidi ezingu-1.5 e-United States banesifo samathambo. rheumatoid arthritis, noma i-RA, yisifo esingelapheki, esizimele esibonakala ngobuhlungu nokuvuvukala kwamalunga. Nge-RA, amasosha omzimba, avikela inhlalakahle yethu ngokuhlasela izinto zangaphandle njengama-bacteria namagciwane, ahlasela amalunga ngephutha. I-Rheumatoid arthritis ivame ukuphatha amalunga ezandla, izinyawo, izihlakala, izindololwane, amadolo namaqakala. Ochwepheshe abaningi bezempilo batusa ukuhlonzwa kusenesikhathi kanye nokwelashwa kwe-RA.  

abstract

  I-arthritis ye-Rheumatoid yisifo samathambo esivame ukutholakala kakhulu. Abesifazane, ababhemayo, nalabo abanomlando womndeni walesi sifo bavame ukuthinteka. Imibandela yokuxilongwa ihlanganisa ukuba okungenani nelunga elilodwa elinokuvuvukala okuqondile okungachazwanga esinye isifo. Amathuba okuxilongwa kwe-arthritis ye-rheumatoid ayanda ngenani lamalunga amancane ahilelekile. Esigulini esinesifo samathambo esivuvukalayo, ukuba khona kwesici se-rheumatoid noma i-anti-citrullinated protein antibody, noma izinga eliphezulu le-C-reactive protein noma izinga le-erythrocyte sedimentation liphakamisa ukuxilongwa kwe-arthritis ye-rheumatoid. Ukuhlolwa kwaselabhorethri kokuqala kufanele futhi kufake inani legazi eliphelele elinomehluko kanye nokuhlolwa kokusebenza kwezinso nesibindi. Iziguli ezithatha ama-biologic agents kufanele zihlolwe i-hepatitis B, i-hepatitis C, nesifo sofuba. Ukuxilongwa kwangaphambi kwesikhathi kwe-arthritis ye-rheumatoid kuvumela ukwelashwa kwangaphambili ngama-antirheumatic agents okuguqula izifo. Inhlanganisela yemithi ivame ukusetshenziselwa ukulawula lesi sifo. I-Methotrexate imvamisa umuthi womugqa wokuqala we-rheumatoid arthritis. Ama-biologic agents, afana ne-tumor necrosis factor inhibitors, ngokuvamile athathwa njengama-ejenti omugqa wesibili noma angangezwa ukuze athole ukwelashwa okukabili. Imigomo yokwelashwa ihlanganisa ukunciphisa ubuhlungu obuhlangene nokuvuvukala, ukuvimbela ukulimala kwe-radiographic nokukhubazeka okubonakalayo, nokuqhubeka komsebenzi kanye nemisebenzi yomuntu siqu. Ukushintshwa okuhlangene kuboniswa ezigulini ezinokulimala okukhulu kwamalunga azo izimpawu zazo zingalawulwa kahle ukuphathwa kwezokwelapha. (Am Fam Physician. 2011;84(11):1245-1252. Copyright � 2011 American Academy of Family Physicians.) I-arthritis ye-Rheumatoid (RA) yisifo samathambo esivame kakhulu esivuvukalayo, esinobukhulu bokuphila kuze kufike kumaphesenti angu-1 emhlabeni wonke. Ukuqala kwe-1 kungenzeka kunoma yikuphi ubudala, kodwa ukuphakama phakathi kweminyaka engu-30 no-50. 2 Ukukhubazeka kuvamile futhi kubalulekile. Eqenjini elikhulu lase-US, amaphesenti angama-35 eziguli ezine-RA abenokukhubazeka emsebenzini ngemva kweminyaka eyi-10  

I-Etiology kanye ne-Pathophysiology

  Njengezifo eziningi ze-autoimmune, i-etiology ye-RA i-multifactorial. Ukuthinteka kwezakhi zofuzo kubonakala ekuhlanganiseni komndeni kanye nezifundo zamawele e-monozygotic, ngamaphesenti angu-50 wengozi ye-RA ebangelwa izici zofuzo. Izifundo ze-4 Genome-wide association ziye zathola amasignesha engeziwe ofuzo okwandisa ingozi ye-RA nezinye izifo ezizimele, kuhlanganise ne-STAT45 gene kanye ne-CD1 locus.6,7 Ukubhema kuyimbangela enkulu yemvelo ye-RA, ikakhulukazi kulabo abane-genetic predisposition.4 Nakuba izifo ingase ivule impendulo ye-autoimmune, ayikho i-pathogen ethile eye yafakazelwa ukuthi ibangele i-RA.40 RA ibonakala ngezindlela zokuvuvukala eziholela ekwandeni kwamaseli e-synovial emalungeni. Ukwakheka kwe-pannus okulandelayo kungase kuholele ekubhujisweni koqwanga kanye nokuguguleka kwamathambo. Ukukhiqizwa ngokweqile kwama-cytokines ane-pro-inflammatory, kuhlanganise ne-tumor necrosis factor (TNF) ne-interleukin-5, kuqhuba inqubo ebhubhisayo.8  

Izingozi Zezingozi

  Iminyaka yobudala, umlando womndeni wesifo, kanye nobulili besifazane kuhlotshaniswa nengozi eyengeziwe ye-RA, nakuba ukuhlukana kobulili kungabonakali kakhulu ezigulini ezindala.1 Kokubili ukubhema ugwayi wamanje nangaphambilini kwandisa ingozi ye-RA (ingozi ehlobene [RR]) = 1.4, kuze kufike ku-2.2 kubantu ababhemayo abaneminyaka engaphezu kwengu-40).11 Ukukhulelwa ngokuvamile kubangela ukukhululwa kwe-RA, cishe ngenxa yokubekezelelana kwe-immunologic.12 Ukulingana kungase kube nomthelela ohlala njalo; I-RA mancane amathuba okuthi itholwe kwabesifazane abaqhanyelwe kunakwabesifazane abangenalutho (RR = 0.61).13,14 Ukuncelisa ibele kunciphisa ingozi ye-RA (RR = 0.5 kwabesifazane abancelisa okungenani izinyanga ezingu-24), kanti ukuya esikhathini ngaphambi kwesikhathi�(RR = 1.3 kulabo abaqala ukuya esikhathini lapho beneminyaka engu-10 ubudala noma ngaphansi) kanye nezikhathi zokuya esikhathini ezingavamile kakhulu (RR = 1.5) zandisa ingozi.14 Ukusetshenziswa kwamaphilisi okuvimbela inzalo ngomlomo noma i-vitamin E ayithinti ingozi ye-RA.15   isithombe-16.png

Sifo

   

Isethulo Esijwayelekile

  Iziguli ezine-RA ngokuvamile ziba nobuhlungu nokuqina emalungeni amaningi. Izihlakala, amalunga e-interphalangeal asondelene, namajoyinti e-metacarpophalangeal avame ukubandakanyeka. Ukuqina kwasekuseni okuhlala isikhathi esingaphezu kwehora elilodwa kubonisa i-etiology yokuvuvukala. Ukuvuvukala kwe-Boggy ngenxa ye-synovitis kungase kubonakale (Umfanekiso 1), noma ukuqina kwe-synovial okucashile kungase kubonakale ekuhlolweni okuhlangene. Iziguli zingase futhi zibe ne-arthralgia engavamile ngaphambi kokuqala kokuvuvuka kwamalunga okubonakala ngokomtholampilo. Izimpawu zesistimu zokukhathala, ukuncipha kwesisindo, nomkhuhlane wezinga eliphansi kungase kwenzeke ngesifo esisebenzayo.  

Imfuneko Yokuthola

  Ku-2010, i-American College of Rheumatology kanye ne-European League Against Rheumatism babambisana ukuze benze izindlela ezintsha zokuhlukanisa i-RA (Ithebula 1) .16 Izindlela ezintsha ziwumzamo wokuxilonga i-RA ngaphambi kwesikhathi ezigulini okungenzeka zingahlangabezani nesigaba se-1987 American College of Rheumatology. imibandela. Imibandela yango-2010 ayibandakanyi ukuba khona kwamaqhuqhuva e-rheumatoid noma izinguquko zokuguguleka kwe-radiographic, kokubili okungenzeka mancane kakhulu nge-RA yakuqala. I-symmetric arthritis ayidingeki futhi kumibandela yango-2010, okuvumela ukwethulwa kwangaphambi kwesikhathi kwe-asymmetric. Ukwengeza, abacwaningi baseDashi baye bahlakulela futhi baqinisekisa umthetho wokubikezela emtholampilo we-RA (Ithebula 2) .17,18 Inhloso yalo mthetho ukusiza ukukhomba iziguli ezine-arthritis engahlukanisiwe okungenzeka ukuthi iqhubekele ku-RA, kanye nokuqondisa ukulandela- phezulu kanye nokudluliselwa.  

Izivivinyo zokuxilonga

  Izifo ezizimele ezifana ne-RA zivame ukubonakala ngokuba khona kwama-autoanti- body. I-Rheumatoid factor ayiqondile ku-RA futhi ingase ibe khona ezigulini ezinezinye izifo, njenge-hepatitis C, nakubantu abadala abanempilo. I-anti-citrullinated protein antibody icace kakhulu ku-RA futhi ingase ibe neqhaza ku-pathogenesis yesifo.6 Cishe amaphesenti angama-50 kuya kwangu-80 abantu abane-RA ane-rheumatoid factor, anti-citrullinated protein antibody, noma kokubili.10 Iziguli ezine-RA zingase zibe nazo. umphumela wokuhlolwa kwe-anuclear antibody, futhi ukuhlolwa kubaluleke kakhulu ezinhlotsheni zentsha zalesi sifo. Amazinga e-protein ayi-19 e-C-reactive kanye nezinga le-erythrocyte sedimentation livame ukukhuphuka nge-RA esebenzayo, futhi lawa ma-reactants esigaba esibucayi ayingxenye entsha. I-RA classification criteria.16 Amazinga amaprotheni e-C-reactive kanye ne-erythrocyte sedimentation rate ingase isetshenziselwe ukulandela umsebenzi wesifo nokusabela emithini. Isisekelo sokubala kwegazi eliphelele elinomehluko kanye nokuhlolwa kokusebenza kwezinso nesibindi kuyasiza ngoba imiphumela ingase ibe nomthelela ezinkethweni zokwelapha (isb., isiguli esinenkinga yokungasebenzi kahle kwezinso noma i-thrombocytopenia ephawulekayo cishe ngeke sinikezwe umuthi ovimbela ukuvuvukala [NSAID]). I-anemia encane yesifo esingelapheki ivela kumaphesenti angu-33 kuya kwangu-60 azo zonke iziguli ezine-RA, i-20 nakuba ukulahlekelwa kwegazi emathunjini kufanele futhi kucatshangelwe ezigulini ezithatha i-corticosteroids noma ama-NSAID. I-Methotrexate iphikisana neziguli ezinesifo se-hepatic, njenge-hepatitis C, kanye neziguli ezinokukhubazeka okuphawulekayo kwezinso.21 Ukwelashwa kwe-Biologic, njenge-TNF inhibitor, kudinga ukuhlolwa kwe-tuberculin okungalungile noma ukwelashwa kwesifo sofuba esicashile. Ukuvuselelwa kwe-Hepatitis B kungenzeka futhi ngokusetshenziswa kwe-TNF inhibitor.22 I-Radiography yezandla nezinyawo kufanele yenziwe ukuze kuhlolwe izinguquko ze-periarticular erosive, ezingase zibonise uhlobo oluncane lwe-RA olunolaka.10  

Ukuxilongwa Okuhlukile

  Imiphumela yesikhumba iphakamisa i-systemic lupus erythematosus, i-systemic sclerosis, noma i-psoriatic arthritis. I-Polymyalgia rheumatica kufanele icatshangelwe esigulini esikhulile esinezimpawu ngokuyinhloko ehlombe nasesinqeni, futhi isiguli kufanele sibuzwe imibuzo ehlobene ne-arteritis yesikhashana ehambisanayo. I-Chest radiography iyasiza ukuhlola i-sarcoidosis njenge-etiology ye-arthritis. Iziguli ezinezimpawu ezivuvukalayo zeqolo, umlando wesifo samathumbu avuvukalayo, noma isifo samehlo esivuvukalayo singase sibe ne-spondyloarthropathy. Abantu abanezimpawu ezingaphansi kwamasonto ayisithupha bangase babe nenqubo yegciwane, njenge-parvovirus. Iziqephu eziphindaphindayo ezizikhawulayo zokuvuvukala kwamalunga okubukhali ziphakamisa i-crystal arthropathy, futhi i-arthrocentesis kufanele yenziwe ukuze kuhlolwe amakristalu e-monosodium urate monohydrate noma i-calcium pyrophosphate dihydrate. Ukuba khona kwamaphoyinti amaningi we-myofascial trigger kanye nezimpawu ze-somatic kungase kuphakamise i-fibromyalgia, engahlala kanye ne-RA. Ukuze usize ukuqondisa ukuxilongwa nokunquma isu lokwelapha, iziguli ezine-arthritis ezivuthayo kufanele zihanjiswe ngokushesha ku-rheumatology subspecialist.16,17  
UDkt Jimenez White Coat
I-Rheumatoid arthritis, noma i-RA, uhlobo oluvame kakhulu lwe-arthritis. I-RA yisifo esizimele, esibangelwa lapho amasosha omzimba, isimiso sokuzivikela somzimba womuntu, sihlasela amangqamuzana awo nezicubu, ikakhulukazi amalunga. I-Rheumatoid arthritis ivame ukubonakala ngezimpawu zobuhlungu nokuvuvukala, ngokuvamile ezithinta amalunga amancane ezandla, izihlakala nezinyawo. Ngokusho kochwepheshe abaningi bezokunakekelwa kwempilo, ukuhlonzwa kusenesikhathi kanye nokwelashwa kwe-RA kubalulekile ukuze kuvinjelwe ukulimala kwamalunga nokunciphisa izimpawu ezibuhlungu. UDkt. Alex Jimenez DC, CCST Insight
 

Ukwelashwa

  Ngemva kokuba i-RA ixilongwa futhi kwenziwa ukuhlolwa kokuqala, ukwelashwa kufanele kuqale. Imihlahlandlela yakamuva ikhulume nabaphathi be-RA, i-21,22 kodwa ukukhetha kwesiguli nakho kunendima ebalulekile. Kukhona ukucatshangelwa okukhethekile kwabesifazane abaneminyaka yobudala ngoba imithi eminingi inemiphumela eyingozi ekukhulelweni. Imigomo yokwelapha ihlanganisa ukunciphisa ubuhlungu obuhlangene nokuvuvukala, ukuvimbela ukukhubazeka (okufana nokuchezuka kwe-ulnar) nokulimala kwe-radiographic (njengokuguguleka), ukugcina izinga lokuphila (okomuntu siqu kanye nomsebenzi), nokulawula ukubonakaliswa okungaphezulu kwe-articular. Imithi elwa nokuvuvukala eguqula izifo (DMARDs) iyinsika yokwelashwa kwe-RA.  

Ama-DMARD

  Ama-DMARD angaba yi-biologic noma i-nonbiologic (Ithebula 3) .23 Ama-Biologic agents ahlanganisa amasosha omzimba e-monoclonal kanye nama-recombinant receptors ukuze avimbele ama-cytokines akhuthaza i-cascade yokuvuvukala ebhekene nezimpawu ze-RA. I-Methotrexate inconywa njengendlela yokwelapha yokuqala ezigulini ezine-RA esebenzayo, ngaphandle uma iphikisana noma ingabekezeleleki.21 I-Leflunomide (Arava) ingasetshenziswa njengenye indlela ye-methotrexate, nakuba imiphumela emibi yamathumbu ivame kakhulu. I-Sulfasalazine (Azulfidine) noma i-hydroxychloroquine (i-Plaquenil) ebangela ukuvuvukala njenge-monotherapy ezigulini ezinomsebenzi ophansi wesifo noma ezingenazo izici zokubikezela ezimbi (isb., i-seronegative, i-RA engacelisisi).21,22 Ukwelapha okuhlanganisiwe nama-DMARD amabili noma ngaphezulu kusebenza kangcono kakhulu. ngaphandle kwe-monotherapy; kodwa-ke, imiphumela emibi ingase ibe mkhulu.24 Uma i-RA ingalawulwa kahle nge-DMARD engeyona ye-biologic, i-DMARD ye-biologic kufanele iqalwe.I-21,22 TNF inhibitors iyindlela yokwelapha ye-biologic yokuqala futhi iyona efundwa kakhulu kulawa ma-agent. Uma ama-TNF inhibitors engasebenzi, izindlela zokwelapha ezengeziwe ze-biologic zingacatshangelwa. Ukusetshenziswa kanyekanye kokwelapha okungaphezu kokukodwa kwe-biologic (isb, i-adalimumab [Humira] ne-abatacept [Orencia]) akunconywa ngenxa yezinga elingamukeleki lemiphumela emibi.21  

Ama-NSAID kanye nama-Corticosteroids

  Ukwelashwa ngezidakamizwa kwe-RA kungase kuhlanganise ama-NSAID kanye ne-oral, intramuscular, noma intra-articular corticosteroids yokulawula ubuhlungu nokuvuvukala. Ngokufanelekile, ama-NSAID nama-corticosteroids asetshenziselwa ukuphatha isikhathi esifushane kuphela. Ama-DMARD yindlela yokwelapha ekhethwayo.21,22  

Izindlela Zokwelapha Ezihambisanayo

  Ukungenelela kokudla, okuhlanganisa ukudla kwemifino kanye nokudla kwaseMedithera, kufundwe ekwelapheni i-RA ngaphandle kobufakazi obugculisayo benzuzo. nge-RA.25,26 Ngaphezu kwalokho, i-thermotherapy kanye ne-ultrasound yokwelapha ye-RA ayizange ifundwe ngokwanele.27,28 Ukubuyekezwa kwe-Cochrane yemithi yokwelapha ye-RA iphethe ngokuthi i-gamma-linolenic acid (kusukela ku-primrose kusihlwa noma amafutha e-currant emnyama) kanye ne-Tripterygium i-wilfordii (i-thunder god vine) inezinzuzo ezingase zibe khona.29,30 Kubalulekile ukwazisa iziguli ukuthi imiphumela emibi emibi iye yabikwa ngokusetshenziswa kwemithi yokwelapha.31  

Ukuzivocavoca Nokwelapha Ngomzimba

  Imiphumela yezilingo ezilawulwa ngokungahleliwe isekela ukuvivinya umzimba ukuze kuthuthukiswe izinga lokuphila namandla emisipha ezigulini ezine-RA.32,33 Izinhlelo zokuqeqesha umzimba azizange ziboniswe zinemiphumela eyingozi emsebenzini we-RA wesifo, amaphuzu obuhlungu, noma umonakalo ohlangene we-radiographic. I-34 i-Tai chi iboniswe ukuthuthukisa ukunyakaza kwama-ankle kubantu abane-RA, nakuba ukuhlolwa okungahleliwe kunqunyelwe.35 Izilingo ezilawulwa ngokungahleliwe ze-Iyengar yoga kubantu abasha abane-RA ziyaqhubeka.36  

Isikhathi Sokwelashwa

  Ukukhululwa kutholakala kumaphesenti angu-10 kuya kwangu-50 eziguli ezine-RA, kuye ngokuthi ukuxolelwa kuchazwa kanjani kanye namandla okwelapha.10 Ukukhululwa kungenzeka kakhulu kwabesilisa, abangabhemi, abantu abangaphansi kweminyaka engu-40, nakulabo abanesifo esisheshe sifike ( iziguli ezindala kuneminyaka engu-65), ezinesikhathi esifushane sesifo, esinomsebenzi wesifo esibi kakhulu, ngaphandle kwama-reactants e-acute phase ephakeme, futhi ngaphandle kwesici esihle se-rheumatoid noma okutholakala kwe-anti-citrullinated protein antibody.37 Ngemva kokulawulwa kwesifo, imithamo yemithi ingase yehliswe ngokuqapha. ngenani elincane elidingekayo. Iziguli zizodinga ukuqapha njalo ukuze kuqinisekiswe izimpawu ezizinzile, futhi ukwanda ngokushesha kwemithi kunconywa ngokuqubuka kwezifo.22  

Ukujoyina Okuhlangene

  Ukushintshwa kwamalunga kuboniswa uma kukhona ukulimala okukhulu kwamalunga kanye nokulawulwa okungagculisi kwezimpawu ngokuphathwa kwezokwelapha. Imiphumela yesikhathi eside iwukusekelwa, okunamaphesenti angu-4 kuya kwangu-13 kuphela okushintshaniswa okukhulu okudinga ukubuyekezwa phakathi neminyaka eyi-10 I-hip nedolo yizona ezivame ukushintshwa.  

Ukuqapha Kwesikhathi Eside

  Nakuba i-RA ithathwa njengesifo samalunga, iphinde ibe yisifo sesistimu esikwazi ukubandakanya izinhlelo zezitho eziningi. Ukubonakaliswa okungeziwe kwe-RA kufakwe kuThebula 4.1,2,10 Iziguli ezine-RA zinengozi ephindwe kabili eyanda ye-lymphoma, okucatshangwa ukuthi ibangelwa inqubo yokuvuvukala engaphansi, hhayi umphumela wokwelashwa.39 Iziguli ezine-lymphoma I-RA nayo isengozini eyengeziwe yokuba nesifo se-coronary artery, futhi odokotela kufanele basebenze neziguli ukuze baguqule izici eziyingozi, njengokubhema, umfutho wegazi ophakeme, kanye ne-cholesterol ephezulu.40,41 I-Class III noma i-IV congestive heart failure (CHF) ukuphikisana nokusetshenziswa kwe-TNF inhibitors, okungase kube nzima kakhulu imiphumela ye-CHF. I-Biologic DMARD, i-methotrexate, ne-leflunomide akufanele iqalwe ezigulini ezine-herpes zoster esebenzayo, ukutheleleka okuphawulekayo kwefungal, noma ukutheleleka kwebhaktheriya okudinga ama-antibiotics.21 Izinkinga ze-RA kanye nokwelashwa kwayo zibhalwe kuThebula 21  

Isibikezelo

  Iziguli ezine-RA ziphila iminyaka emithathu kuya kwengu-12 ngaphansi komphakathi jikelele.40 Ukufa okukhulayo kulezi ziguli kubangelwa ikakhulukazi isifo senhliziyo esisheshayo, ikakhulukazi kulabo abanomsebenzi wezifo eziphezulu kanye nokuvuvukala okungapheli. Imithi yokwelapha emisha uma kuqhathaniswa ingase ihlehlise ukuqhubeka kwesifo sokuqina kwemithambo yegazi futhi andise ukuphila kwalabo abane-RA.41 Imithombo yedatha: Ukusesha kwe-PubMed kwaqedwa kokuthi Imibuzo Yomtholampilo kusetshenziswa amagama ayinhloko i-arthritis ye-rheumatoid, ukubonakaliswa okungaphezulu kwe-articular, nama-antirheumatic agents aguqula izifo. Ukusesha kwakuhlanganisa ukuhlaziywa kwe-meta, ukuhlolwa okulawulwa ngokungahleliwe, ukuhlolwa kwemitholampilo, nokubuyekezwa. Kwaseshwa futhi i-Agency for Healthcare Research kanye nemibiko yobufakazi bekhwalithi, Ubufakazi Bemitholampilo, isizindalwazi se-Cochrane, Ubufakazi Obubalulekile, kanye ne-UpToDate. Idethi yokusesha: Septhemba 20, 2010. Ukudalulwa kombhali: Awekho amanxusa ezezimali okufanele adalulwe. Ekuphetheni, i-rheumatoid arthritis yisifo esingapheli, esizimele esibangela izimpawu ezibuhlungu, njengobuhlungu nokungahambi kahle, ukuvuvukala nokuvuvukala kwamalunga, phakathi kwabanye. Umonakalo ohlangene obonakala ngokuthi i-RA uyalingana, okusho ukuthi ngokuvamile uthinta izinhlangothi zombili zomzimba. Ukuxilongwa kusenesikhathi kubalulekile ekwelapheni i-RA. Ububanzi bolwazi lwethu bukhawulelwe ezindabeni ze-chiropractic kanye nezempilo yomgogodla. Ukuze uxoxe ngesihloko, sicela ukhululeke ukubuza uDkt. Jimenez noma usithinte kokuthi 915-850-0900 . Ikhethwe nguDkt Alex Jimenez Inkinobho Yokushaya Manje Okuhlaza H .png  

Ingxoxo Yesihloko Eyengeziwe: Ukukhulula Ubuhlungu Bedolo Ngaphandle Kokuhlinzwa

  Ubuhlungu bedolo kuwuphawu olwaziwayo olungase lwenzeke ngenxa yokulimala kwamadolo kanye/noma izimo, kuhlanganisaukulimala kwezemidlalo. Idolo lingelinye lamalungu ayinkimbinkimbi kakhulu emzimbeni womuntu njengoba lenziwe ngokuphambana kwamathambo amane, imigqa emine, imisipha ehlukahlukene, i-menisci emibili, ne-cartilage. Ngokusho kwe-American Academy of Family Physicians, izimbangela ezivame kakhulu zobuhlungu bamadolo zihlanganisa i-patellar subluxation, i-patellar tendinitis noma i-jumper's knee, nesifo sika-Osgood-Schlatter. Nakuba ubuhlungu bamadolo buvame ukwenzeka kubantu abangaphezu kweminyaka engu-60 ubudala, ubuhlungu bamadolo bungenzeka nasezinganeni nasebancane. Ubuhlungu bamadolo bungaphathwa ekhaya ngokulandela izindlela ze-RICE, noma kunjalo, ukulimala kanzima kwamadolo kungase kudinge ukunakekelwa kwezokwelapha ngokushesha, kuhlanganise nokunakekelwa kwe-chiropractic.  
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Akukho lutho
Okubhekwayo

1. I-Etiology kanye ne-pathogenesis ye-rheumatoid arthritis. Ku: Firestein GS, Kelley WN, ed. Kelley's Textbook of Rheumatology. 8th ed. Philadelphia, Pa.: Saunders/Elsevier; 2009:1035-1086.
2. Bathon J, Tehlirian C. Rheumatoid arthritis Clinic kanye
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