Ipropati yePrayimari ye-Spondyloarthritis
Ukuba ubonile amagama engena, i-enthesitis, okanye i-enthesopathy kwi-x ray yakho okanye iingxelo zonyango, isigama esingaqhelekanga kuwe. Makhe sijonge intsingiselo kunye nendlela ehambelana ngayo neentlobo ezahlukeneyo ze-arthritis nezifo ze-rheumatic.
- I-enthesis (ubuninzi: i-entheses) ibhekisela kwizicubu ezinxibelelwano apho i- tendon , ligaments, okanye i-capsules ezidibeneyo zidibanisa namathambo. Kukho iintlobo ezimbini zokungena: i-fibrous entheses kunye ne-fibrocartilaginous entheses. Nangona le nto ingcaciso yeklasiki, inkcazo entsha, inkcazo ebanzi ibonisa ukuba i-enthesis ingaphezu kokuqhotyoshelweyo okulula okanye ukufaka indawo ye-site-enthesis njengeyunithi equka izicubu ezikufutshane (umzekelo, ithambo kunye ne-fibrocartilage exhunywe kwi synovium). Iyunithi ibhekiselwa kuyo ngokuthi "isakhiwo esiyinkimbinkimbi yesakhiwo".
- I-intesopathy yiphina imeko engaqhelekanga echaphazela ukungena (umzekelo, ukuvuvukala kokungena). I-intesopathy ingaba ngenxa yeso simo sokuvuvukala, njenge- psoriatic arthritis , okanye imeko enxulumene nokulimala okanye ukugqithisa, ngokufana ne-plantar fasciitis.
- I-enthesitis ibhekisela ekuvukeleni kwamangenelo.
Iimpawu
I-enthesitis ihlobaniswa nosizi, ukuqina, kunye nesisa kwiwebhusayithi yokufakela, ngamanye amaxesha ngaphandle kokuvuvukala okukhulu. Nangona kunjalo, apho kukho ukubandakanya ukufakwa okukhulu kweengalo ezisezantsi, ukuvuvukala kunokubaluleka kwaye kuvelele. Ukuba ukuvuvukala kungekho, i-enthesitis ingaba nzima ukuyiqonda okanye ukukrokra ngexesha loviwo lomzimba.
I-inthesitis iyaqhelekileyo kwiziko ezilandelayo:
- I-tendon ye-Achilles
- Ithenda ye patellar
- Plantar fascia
- I-Elbow epicondyles
- Amathanga
- Vertebrae
- I-Iliac
Iimeko ezidibene ne-enthitis
I-enthesitis ingadibaniswa neemeko ezivuthayo okanye inokuthi yenziwe ngokuchanekileyo ngengozi.
I-peripheral enthesitis iyimpawu yazo zonke i- spondyloarthropathies , kubandakanywa ne-spondyloarthritis engaxhamliyo, i- spondylitis engabonakaliyo, i-psoriatic arthritis, kunye ne -arthritis esebenzayo .
I-arthritis esebenzayo yindlela yesifo se-arthritis esiphumela kwisifo. Ukuvuvukala kwe-arthritis esebenzayo kudla ngokubangela ukusuleleka kwinqanaba lomzimba elikude, njengendlela yokucoca, amathumbu okanye izitho zangasese.
Ngokuqhelekileyo amalunga emadolo, iinyawo, kunye neengqungquthela zijoliswe ekuvukeleni kwesibini kwisifo se-arthritis. Ngokukodwa, i-enthesitis kubantu abane-arthritis esebenzayo ngokuqhelekileyo ivela kwi-fascia plantar, amathambo e-pelvic okanye i-Achilles tendon. I-arthritis esebenzayo ayiqhelekanga kwaye ngokuqhelekileyo iyahamba kubantu abaninzi phakathi konyaka emva kokuqala.
I-ankylosing spondylitis yimeko evuthayo ebonakalayo emadodeni. Ukuvuvukala kwe-spondylitis e-ankylosing kuthinta i-vertebrae kwaye kubangele ukuba bafake. I-enthesitis engapheliyo yamathambo kunye nemigqa ye-vertebrae yinyathelo lokuqala kwi-fusion ye-vertebrae, eyona nto iphambili ye-spondylitis engavumelaniyo. Abantu abane-spondylitis e-ankylosing nabo banokufumana i-enthesitis yamalungu e- costochondral , okanye amanxeba eembambo. Amaphesenti angama-10 abantu abane-spondylitis e-ankylosing nabo bafumana i-enthesitis ye-tendon ye-Achilles kunye ne-aponeurosis ye-plantar (iindawo eziphathekayo, ezibanzi, ezinjenge-sheet). Ixesha elithi plantar aponeurosis libhekisela kwiimpawu ezixubileyo ezixhasa isantya seenyawo.
Ezinye iimeko ezinxulumene ne-enthesitis zibandakanya i-Achilles tendinitis, i- rheumatoid arthritis , i- osteoarthritis , kunye nokwahlula i-idiopathic skeletal hyperostosis (DISH).
Kungenzeka ibe yinto ephuculisayo ye-osteoarthritis. Utshintsho olwenziwe kakubi olwenzekayo nge-wear-and-tear-tear-osteoarthritis luchaphazela ne-fibrocartilages.
Ukucingela ukuxilongwa
Ukucingwa kunokunceda ukuxilonga i-enthesitis, kodwa indlela yokucinga yokusetyenziswa esekelwe kuxhomekeke ekubeni ingaba isifo se-axial okanye se-peripheral sichaphazelekayo. I-MRI isetyenziselwa i-axial skeleton. I-ultrasound ikhethwayo kwi-skeleton ye-périphheral. I-MRI iya kuphinda ibe yinto ekhethekileyo kuyo nayiphi na ingeniso engenakufikeleleka.
Ngokwe-Up-to-Date, "Ukufunyanwa kweenombolo ze-enthesitis kubandakanya ukutshintsha okanye ukutshintsha okugxininisiweyo kwintsimbi yokufaka, i-edema ye-tendon insertion, i-calcific ifakwe kwi-tendon yokungeniswa, i-spurs, i-erosions, i-bone form entsha, okanye iinguqu ze-periosteal.
Ukongezelela, i- bursitis esondeleyo ithathwa njengophawu lwe-enthesitis. Amandla afanelekileyo Isibonakaliso se-Doppler yase-US esifana nokunyuka kwe-vascularity singatholakala kwi-enthesitis esebenzayo. "
Unyango
Utyando lwe-enthesitis lusekelwe kwiimeko eziphantsi. Ngokomzekelo, ukuba i-enthesitis ingenxa yeso simo sokuvuvukala, unyango luvame ukugxila ekuphatheni i-polyarthritis evuthayo. Unyango, kwiimeko ezinjalo, zingabandakanya:
Amagciwane e-corticosteroid asekuhlaleni angasetyenziswa xa amayeza omlomo ayanele. Iinkalo ze-biomechanical ze-enthesitis nazo zijongiswa ngokusebenzisa i-insoles kunye ne-cushions.
> Imithombo:
> Bruyn, George AW, MD. PhD. I-Ultrasonography ye-Musculoskeletal - Izicelo zeKliniki. Isemgangathweno. Kugqitywe ukuhlaziywa ngoFebhuwari 2017
> Kehl, AS, MD. okqhubekayo. Enthesitis. Arthritis & Rheumatology. 2016 Feb; 68 (2): 312-322.
> McGonagle D. kunye noBenjamin, M. U-Entheses, i-Enthesitis, kunye ne-Enthesopathy. I-Arthritis Research Campaign. Uphononongo lwezihloko. Kwindla ka-2009.