Ziyaziwa Njani?
I-arthritis ye-rheumatoid iyinkimbinkimbi. Abantu abaningi abane-arthritis ye-rheumatoid bayokutshela ukuthi kudlule isikhathi esithile ngaphambi kokuba banikwe ukuxilongwa okucacile. Ngisho noma udokotela wabo ecabanga ukuthi i-arthritis ye-rheumatoid ekuqaleni, akukho uvivinyo olulodwa noma ubufakazi obufakazela ukuxilongwa. Ukuthola okuvela kokuhlolwa komzimba kwesiguli, umlando wezokwelapha, izivivinyo zebholabhu, nezifundo zokucabanga kufanele zonke zicatshangelwe.
Akukhona nje kuphela ukuthi kunezici ezimbalwa eziphathelene nezifo ezihambisana nesifo samathambo, iziguli ezikhona ngezibonakaliso ezihlukahlukene zalesi sifo. Eziguli eziningi ze-rheumatoid arthritis, ukuqala kwezimpawu kwenzeka kancane kancane futhi kuqiniswe kahle ngaphambi kokuba kubonakale ngisho nokuqashelwa. Isici se- polyarthritis sihilela ngokuvamile amalunga amancane ezandla nezinyawo ngaphambi kokuthuthela emajoyini amakhulu. Kodwa zikhona ezinye izindlela ze-arthritis ye-rheumatoid ezenza ngokwazo ezingavamile: i-palindromic (izibopho ezimfushane zobuhlungu obuphindaphindiwe nokuqina, okuthinta isakhi esisodwa noma ngaphezulu, kamuva ziphikelela); I-polymyalgic (ngokuvamile isiguli esikhulile esinesikhalazo esiyinhloko sokuqina, ngokuvamile amahlombe noma izintambo); amasistimu (ukubonakaliswa okungewona okubonakalayo, njengemfiva, i- malaise , ukulahlekelwa kwesisindo); i- monoarthritis eqhubekayo (i-arthritis engxenyeni enkulu eyodwa ephikelela).
I-arthritis yokuqala ye-rheumatoid ingase ihluke kulokho esikucabangela njengokuthi i-arthritis ejwayelekile ye-rheumatoid.
Iziguli eziningi zinezimpawu ezijwayelekile zokuvuvukala lapho ziqala ukubonana nodokotela mayelana nezimpawu zabo zokuqala. Abaningi bane-x-ray evamile. Yini engase idideke ngisho nakakhulu kumculi we-diagnostic, ngakho-ke isiguli, ukuthi kunezimo eziningi eziningana ezibonakala nge-polyarthritis enezici ezivame ukuhambisana ne-arthritis ye-rheumatoid.
Ngenxa yokuthi lezo zimo zilinganisa i-arthritis ye-rheumatoid, kufanele zicatshangelwe, bese zingabanjwanga, ngaphambi kokuthi kutholakale ukuthi isifo samathambo singasungulwa ngokuqiniseka. Nazi ezinye zezimo ezilinganisa i-arthritis ye-rheumatoid:
I-Post-Viral Arthritis
Izifo ezithathelwanayo nezifo ezingapheli zingabangela i-polyarthritis ebukeka sengathi i-rheumatoid arthritis emitholampilo. Izifo ezithathelwanayo zegciwane, njenge-parvovirus B19, ngokuvamile zingahlukaniswa nomlando wokuchayeka, ukuqhuma, nokuthi izimpawu zigcina isikhathi esithile. Kubalulekile ukuthi isifo sokuxilonga sikhiphe ukutheleleka kwesifo sofuba noma isifo sengculaza somuntu, ikakhulukazi uma ukwelashwa kucatshangwa nge-immunosuppressants.
I-spondyloarthritis yama-Seronegative
I-arthritis ye-Psoriatic ingaba nzima ukuhlukanisa isifo samathambo, ikakhulukazi uma kungekho ukuqhuma okukhona. Ukubandakanywa kwamajoyini e-sacroiliac noma ama-distal interphalangeal joints ezandleni zinganciphisa ukuxilongwa kwi-psoriatic arthritis. Elinye le- spondyloarthropathies ye- seronegative (i- arthritis esebenzayo , i- ankylosing spondylitis , i-arthropathy ehambisana nesifo sofuba) ingabuye ilandele isifo samathambo. "Ukubandakanyeka kokuhlanganyela okulinganiselwe, ukungabikho kwezifo ezincane ezihlangene, ukubonakala okunjengama-sausage-like of digits, nokubandakanyeka kwe-lumbosacral umgogodla konke okuthandwa yi-arthropathies ye-seronegative", ngokusho kweCleveland Clinic.
Lupus
I-systemic lupus erythematosus ingahlotshaniswa nokubandakanyeka okuhlangene okulingisa i-arthritis ye-rheumatoid, kodwa i-lupus ihluke ngokungajwayelekile ukuthi iyisifo esiyingozi. Nge-lupus, ukukhubazeka kungahlakulela okufana nalabo ahlobene nesifo samathambo - umahluko ngoba kungenxa ye-tendon ne-ligament laxity ne-lupus, hhayi ukubhujiswa okuhlangene.
Scleroderma
Ukubalwa kwegazi okuphelele, iphaneli yamakhemikhali ephelele, kanye nezifundo ze-serologic (isib. I-antinuclear, antiticentromere, ne-antitopoisomerase antibodies) zivame ukulalelwa lapho isiguli sikhishwa ukuba nesifo se- scleroderma . Izilinganiso ze-Creatine kinase, isilinganiso se-erythrocyte sedimentation, kanye nezilinganiso ze-protein ezisebenzayo zingasiza futhi njengoba kutholakala ukuxilongwa.
"Imiphumela ephakanyisiwe ibonisa ukuthi i-myositis, i-vasculitis, i-malignancy, noma i-systemic sclerosis ehambisana nesifo esisodwa," kusho i-AAFP.
I-Vasculitis
I-Polymyalgia rheumatica (PMR) kanye ne- giant cell arteritis (GCA) ingaba ne-polyarthritis ehambisanayo. Ngokuvamile, umlando wezokwelapha okuningiliziwe kulezi ziguli ungasiza ukuhlukanisa i-PMR noma i-GCA (isb., Ikhanda, kanye nobuhlungu behlombe ne-hip). Kwezinye izimo, ukuxilongwa kungase kuxhomeke ekuboneni lesi sifo ngokuhamba kwesikhathi. Ngamanye amazwi, izinkinga ezinkulu zingathuthuka ngokuhamba kwesikhathi ezikhomba i-vasculitide. I- vasculitis yesistimu nayo ingabonakala nge-polyarthritis. I-granulomatosis ka-Wegener ingaba yisifo se-rheumatoid esihle.
I-osteoarthritis
Ukungabikho kwezibonakaliso nezimpawu zokuvuvukala kwesistimu, ukuqala lapho umuntu esekhulile, futhi isibonelo sokubandakanyeka ngokuhlanganyela (ngokuvamile asymmetric) kaningi okwanele ukuhlukanisa i- osteoarthritis e-arthritis ye-rheumatoid. "I- osteoarthritis enobungozi ingaba nokubukeka kokuvuvukala ekuhlolweni, kodwa ijwayele ukubandakanya amalunga e-PIP ngokuyinhloko, ayihlotshaniswa nesifo esingaba yi-synovitis, ayiyona i-RF (i-rheumatoid factor factor), futhi ibukeka ngendlela ehlukile ye-radiographic", kubika iCleveland Clinic.
Gout
I-gout ejwayelekile ngokuvamile ihlotshaniswa nokuvuvukala kwe-monoarticular noma i-oligoarticular ne-arthritis, okuhlala izinsuku ezintathu kuya kwezingu-10. Kodwa, ukuhlaselwa kwe-gout kungase kube kaningi, kuhlale isikhathi eside, futhi kungase kungabi nokuxazululwa, okuholela ekutheni i-arthropathy engavamile. I-gouty arthropathy ingabangela ukukhulelwa nokubhujiswa okuhlangene. Ihlukaniswe nesikhwama se-rheumatoid arthritis ngokungabi khona kwendawo ehlangene yokunciphisa nokungabi khona kwe-periarticular osteopenia , ngokwe-Cleveland Clinic.
I-Pseudogout
I-CPPD i-crystal deposition disease ixhunyaniswe nemibono eminingi yemitholampilo. Kungaba yinkimbinkimbi, i-gout-like (i-pseudogout), i-rheumatoid arthritis-like, noma i-osteoarthritis-like. I-pseudogout ihlukaniswa ngokuhlaselwa okunamandla kwe-synovitis okulingisa ukuvuza. Ukuhlaziywa kwamanzi kagesi kusetshenziselwa ukuhlonza ukuhlukana.
I-Sjogren's Syndrome
I-Sjogren's syndrome yisifo esizimele, isifo sokuvuvukala. Kungenzeka njengesimo esiyisisekelo ngaphandle kwesinye isifo se-rheumatic noma njengesimo sesibili kanye nesinye isimo se-rheumatic. Isifo se-Primary Sjogren sika singalingisa i-arthritis ye-rheumatoid. Cishe amaphesenti angama-60 kuya ku-70 weziguli eziyisisekelo zikaSjogren zinezici ezihambisana nesifo se-rheumatoid. Kukhona futhi ubuhlungu, ukuqina, nokuvuvukala okuncane kwamalungu. Ukuhlolwa okukhethekile kungasiza ukuhlukanisa phakathi kweSjogren's syndrome ne-arthritis ye-rheumatoid.
I-Sarcoidosis
I-Sarcoidosis ingabonakala nge-synovitis ezinhlanganisweni eziningana futhi ingase ibe nesifo se-rheumatoid esihle. Kodwa, ezinye izici zisiza ukuhlukanisa phakathi kwesifo samathambo. Kwezinye izimo, kungadingeka ukuthi i-biopsy yezicubu ikwazi ukutholakala.
I-Fibromyalgia
I-Fibromyalgia ingabonakaliswa yi-arthralgias ehambelanayo kanye nokuqina kokuphumula, kodwa ukungabi khona kwe-synovitis, ukuntuleka kobuhlungu ekuhambeni, nokuhlola okuvamile kwe-laboratory kanye nokuzicabangela kufisa ukuxilongwa kwe-fibromyalgia, ukuyihlukanisa ne-rheumatoid arthritis, ngokusho kwe-Cleveland Clinic.
Okubalulekile
Kunezimo ezilinganisa i-arthritis ye-rhumum, ikakhulukazi ekuqaleni kwaleso sifo. Isici esiyinhloko esivamile siyi-polyarthritis. Umlando wezokwelapha wesiguli, ukubonwa kwezibonakaliso kanye nokubonakaliswa kwezifo ngokuhamba kwesikhathi, futhi usizo olwengeziwe lokuhlola ukuhlonza ukuhlukanisa izimo ku-arthritis ye-rheumatoid.
Imithombo:
I-Gout ne-Pseudogout. I-Feyrouz Al-Ashkar. Umtholampilo waseCleveland.
http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/rheumatology/gout-and-pseudogout/
I-rheumatoid Arthritis. UWilliam S. Wilke. Umtholampilo waseCleveland.
http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/rheumatology/rheumatoid-arthritis/
I-Systemic Sclerosis / i-Scleroderma: Isifo Se-Multisystem Ephathwayo. UMonique Hinchcliff, MD kanye noJohn Varga, uMdokotela waseMelika waseMelika. Ngo-Okthoba 15, 2008.
http://www.aafp.org/afp/2008/1015/p961.html
Ukuxilongwa kwe-Arthritis Yokuqala Ye-Rheumatoid: Lokho Okungewona Ochwepheshe Okudingeka Ukwazi. E Suresh, MD MRCP. Journal of the Royal Society of Medicine. September 2004.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1079582/