Nangona i-gout ibonakala ibonakala ngokubonakalayo ngokusekelwe kwimibala yodwa, ugqirha uya kuthanda ukwenza iimvavanyo ukuqinisekisa ukuxilongwa nokulawula ezinye izizathu. Njengesifo esibonakaliswe yidizithi ye-uric acid crystals kumalungu, ugqirha unokufuna ukukhangela ubungqina balo ngokukhupha umxube ohlangeneyo kunye nenaliti ukuba uhlole ngaphantsi kwe-microscope.
Kwezinye iimeko, ukuxilongwa kunokukwazi ukuthelekisa iimpawu kunye neembalo zeetri kunye / okanye iimvavanyo zokucinga.
Uvavanyo lweMzimba
Kwiimeko ezininzi ezininzi, ukuxilongwa kwe-gout kungenziwa ngokusekelwe ekuhlaziyweni kweempawu zakho kunye nembali yonyango. Ukongezelela ukuhlolwa komzimba, ugqirha wakho uya kufuna ukuchazwa kokuhlaselwa (kubandakanye indlela eqalise ngayo kwaye ihlala ixesha elingakanani) kwaye uphonononge nayiphi na ingozi ebangela ukuba ibe negalelo ekuhlaselweni.
Ezinye iimpawu zokuxela ziyakwanela ukwenza ukuxilongwa, njengoku:
- Ukuhlaselwa kwe-mono-arthritic (ithetha kuphela umdibaniso omnye uchaphazelekayo)
- Intlungu ebuhlungu kwisiqalo sokuqala se- metatarsal-phalangeal yezinzwane ezinkulu
- Ukuvutha komzimba kunye nokubomvu okudlulileyo kunomhla
- Ukuba nohlaselo oluphindwe kwesinye kwimbutho efanayo
Ngoxa le nto ingakho konke ugqirha wakho kufuneka adinge isicwangciso sonyango , ubungqina obongezelelweyo bungafuneka ukuba d uku kuhlaselwa kwakho kokuqala okanye ukuba iimpawu eziphindaphindiweyo ziba nzima.
IiLabs kunye novavanyo
Umgangatho wegolide wokwenza i-diagnostic gout yiyokukhupha i-synovial fluid kwi-joint kunye nokufuna ubungqina besikristali (ubizwa ngokuba yi-monosodium urate crystals) phantsi kwe-microscope. I-Synovial fluid yinto enobumba obunzima, obumbala obunokubambisana kunye nokucoca i-space phakathi kwamalungu.
Inkqubo, eyaziwa ngokuba yi- synovial analysis analysis , iqala nge-injection ye-anesthetic yasekuhlaleni ukuze idibanise idibene. Emva kwemizuzu embalwa, ugqirha uya kufaka inaliti kwindawo edibeneyo ukuze akhiphe isampula yomnyuzi oya kuthi uthunyelwe kwibhule yokuhlalutya.
Ukongezelela ekufuneni i-monosodium urate crystals, i-lab iya kukhangela amanqanaba aphezulu e- uric kunye nobungqina bokuba i- tophus , iimbumba ezinzima ze-uric acid ezifunyenwe kwisifo esilandelayo.
Phakathi kwezinye iimvavanyo zebhabhi eziyalelwe:
- Uvavanyo lwegazi lwe-uric lungenziwa ukwenzela ukujonga amanqanaba ase-acid ngaphezulu kwe-6.8 milligrams nganye nge-deciliter (nangona abantu abanezinga eliphantsi banakho ukuba ne-gout).
- Urea kunye novavanyo lwegazi lwe- creatinine lunokwenziwa kwakhona ukuze ubone ukuba isifo sakho sezintso siphumelele ngenxa yempembelelo ye- hyperuricemia .
- I- urinalysis ingasetyenziselwa ukujonga amanqanaba e-uric acid kumchamo wakho kwaye uhlole ingozi yakho yamatye entso.
Uvavanyo lweemvavanyo
Ukuncedisa ukuxilongwa, ugqirha unokuyalela iimvavanyo zokuhlola ukujonga iimpawu zesigxina sokuvuvukala okanye ukujonga i- subchondral bone cysts ebonisa i-arthritis. Ukukhethwa kweendlela zokuhlola kufaka i-X-ray, i- tomography (CT) , i-imagery magnetic resonance (MRI) , kunye ne-ultrasound.
Uvavanyo ngalunye lunemivuzo kunye nemida:
- I-ray-ray ingabonakalisa ukuguguleka kwethambo kunye ne-cartilage kodwa iyanceda kuphela emva komnyaka wesifo esingalawulekiyo.
- I-CT kunye ne-MRI i-scrification inokukunceda ukufumanisa ukutshabalala, ukuguguleka kwethambo kunye nomonakalo we-cartilage kodwa, ngokutsho kwesifundo esashicilelwe kwi-European Radiology, sinokungakwazi ukufumana izifo zakuqala.
- I-ultrasounds zinenzuzo njengoko ziphathekayo, zifumaneka ngokukhawuleza, kwaye ayifuni i-ionizing radiation. Banokufumanisa ubungqina bokuqala be-crystal deposits, ukuqokelela kwamanzi kunye nokuphakanyiswa kwendawo edibeneyo. Ngaphazamisekanga, abakwazi ukujonga iinjongo ezinzulu zomxube.
Ngokwenza oko, i-ultrasounds isetyenziswa ngokuqhelekileyo ukuba sele uqale ukufumana iimpawu okanye ukuhlaselwa okuphindaphindiweyo. Ezinye iimvavanyo ze-imaging zingahle zenziwe ngokusekelwe kwimbali yeempawu zakho okanye ubunzima beemeko zakho.
Ukuxilongwa okuhlukeneyo
Nangona iimpawu zesifo sengqondo zingabonakala zicacile ngokubonakala kwedwa, kukho ezinye iimeko ezimbini oogqirha abaza kujonga ezi zinto ziphawulekayo: i- pseudogout and septic arthritis .
Ukwahlula, ugqirha uya kukhangela izinto ezine: uhlalutyo lwamanzi olumanzi (ukuhlola ubungqina be-crystallization), inani legazi elimhlophe (ukujonga ukusulelwa kwintsholongwane), isiqhelo segram ye-synovial fluid (ukujonga ibhaktheriya), kunye nendawo yentlungu yakho.
Gout
I-Gout iya kuba neempawu ezithile zomzimba kunye nokuxilonga ezahlula kwezinye izifo, oku:
- Uhlalutyo lwamanzi olushushu lwe-Synovial: iikristst ezifakwe ngeesalane
- Inani leeseli legazi le-White: ngaphantsi kwama-50,000
- Inkcubeko yeGraam: engalunganga (ithetha ukuba akukho sulelo)
- Indawo: ngokuyinhloko inzwane enkulu, i-midfoot, idolo, kunye nemigangatho ephantsi (ngokubandakanyeka kwesandla, umlenze, isandla, okanye iminwe kwisifo esilandelayo)
Inkcazo
I-Pseudogout imeko apho i-calcium crystals (engekho i-monosodium urate crystals) ikhula kwindawo edibeneyo. Esi sifo sinokuhlukaniswa ukusuka kwintlobo ngeendlela ezilandelayo:
- Uhlalutyo lwamanzi olushushu lwe-Synovial: i-crymboal-formed crystals
- Inani leeseli legazi le-White: ngaphantsi kwama-50,000
- I-Gram stain stain culture: negative
- Indawo: ngokuqhelekileyo idolo, isandla, okanye inzwane enkulu
Septic Arthritis
I-Septic yamathambo, eyaziwa ngokuba yi-arthritis echaphazelekayo, kwaye idla ngokubangela ukusuleleka kwintsholongwane kwaye ingaba yingozi uma ingashiywanga. Ihluke kwi-gout kule ndlela elandelayo:
- Uhlalutyo lwamanzi olumanzi: akukho kristal
- Inani lamaseli e-White: ngaphezu kwama-50,000
- Isiqhamo sesityalo se-grain (positive confirming infection)
- Indawo: ngokuyinhloko idolo
> Imithombo:
> Rettenbacher, T .; Ennemoser, S .; Weirich, H. et al. "Ukufaneka kweengcamango zesifo sengqondo: ukuthelekiswa kwe-US ngokuchasene ne-X-ray evamile. " I- Eur Radiol. 2008; 18 (3): 621-30. INGXELO: 10.1007 / s00330-007-0802-z.
> Tuhina, N; Jansen, T .; UDalbeth, uL. et al. "Iinqununu zokuBaluleka kweGout 2015 I-American College yeRheumatology / iYurophu yoLuntu ekuchasene neRheumatism Colaborative Initiativ e." Arthritis Rheumatol. 2015; 67 (1): 2557-68. INGXELO: 10.1002 / ubugcisa.39254.