Nakuba i-gout ingase ibonakale ibe yinto ebonakalayo ngokusekelwe ekubukeni yedwa, udokotela uzovame ukufuna ukuhlola ukuhlolwa nokulawula ezinye izimbangela. Njengesifo esibonakala nge-deposit of uric acid crystals emajoyini, udokotela angase afune ukubheka ubufakazi balokhu ngokukhipha umthamo ohlangene ngenaliti ukuze ahlole ngaphansi kwe-microscope.
Kwezinye izimo, ukuxilongwa kungaba ngokuqhathanisa izimpawu nge uchungechunge lwelabhu kanye / noma ukuhlola izithombe.
Ukuhlolwa Kwemvelo
Ezimweni eziningi, ukuxilongwa kwe-gout kungenziwa ngokusekelwe kokubuyekezwa kwezimpawu zakho nomlando wezokwelapha. Ukwengeza ukuhlolwa ngokomzimba, udokotela wakho uzofuna ukuchazwa kokuhlaselwa (kufaka phakathi ukuthi uqale kanjani nokuthi uhlala isikhathi eside kangakanani) futhi uhlole noma yiziphi izici eziyingozi ezingase zibe negalelo ekuhlaselweni.
Ezinye izimpawu zokutshela kungenzeka zanele ukwenza ukuxilongwa, njengokuthi:
- Ukuhlaselwa kwe-mono-arthritic (okusho ukuhlanganiswa okukodwa kuphela kuthintwa)
- Ubuhlungu obukhulu emhlanganisweni wokuqala we- metatarsal-phalangeal wezinzwane ezinkulu
- Ukuvuvukala okuhlangene nokubomvu okwedlulele ngaphezu kosuku olulodwa
- Ukuba nokuhlaselwa okungaphezu kokukodwa kokujoyina okufanayo
Ngenkathi lokhu kungaba yilokho udokotela wakho adinga ukwakha uhlelo lwezokwelapha , ubufakazi obengeziwe bungadingeka d uma lokhu kuhlaselwa kwakho kokuqala noma uma izimpawu eziphindaphindiwe seziba nzima.
Ama-Labs nezivivinyo
Isimo segolide sokwenza ukuxilongwa kwe-gout ngokukhipha uketshezi lwe-synovial kusuka ekuhlanganyeleni nokufuna ubufakazi bekristali (ubizwa ngokuthi i-monosodium urate crystals) ngaphansi kwe-microscope. I-Synovial fluid iyinhlangano enobuthi, enombala okhanyayo oqondisa ukujoyina kanye nokugcoba isikhala phakathi kwamajoyina.
Inqubo, eyaziwa ngokuthi ukuhlaziywa kwe-synovial fluid , iqala ngomjovo we-anesthetic wendawo ukuze unqamule ukujoyina. Ngemuva kwemizuzu embalwa, udokotela uzofaka inaliti endaweni ehlangene ukuze akhiphe isampula ketshezi ezobe ithunyelwa kubhubhu yokuhlaziywa.
Ngaphezu kokusesha amakristalu e-monosodium urate, ibhubhu izohlola amazinga aphakeme e- uric acid kanye nobufakazi be- tophus , izinsimbi ezinzima ze-uric acid ezitholakalayo esifundeni esilandelayo.
Phakathi kwezinye izivivinyo zamalebhu ezingase zibekwe:
- Uhlolo lwegazi lwe-uric acid lungenziwa ukuze uhlole amazinga e-asidi ngaphezu kwama-6.8 milligrams nge-deciliter (nakuba abantu abanamazinga aphansi nabo bangaba nomuthi).
- Ukuhlolwa kwegazi kwe-Urea ne- creatinine kungenziwa futhi ukuze ubone ukuthi umsebenzi wakho wezinso uphelelwe amandla ngenxa ye- hyperuricemia (i-uric acid ngokweqile).
- Ukuvuthwa kwegazi kungasetshenziselwa ukuhlola amazinga e-uric acid kumchamo wakho bese uhlola ingozi yezinso zezinso.
Ukuhlolwa kwezilingo
Ukuze usize ngokuxilongwa, udokotela angase acele ukuhlolwa kwe-imaging ukuhlola izici zesibalo sokuvuvukala noma ukuhlola ama-cysts bone we- subchondral obonisa isifo samathambo. Ukukhethwa kokuhlolwa kokuhlola kufaka phakathi i-X ray, i- computed tomography (CT) , i- imagery magnetic resonance (MRI) , ne-ultrasound.
Isivivinyo ngasinye sinenzuzo kanye nokulinganiselwa kwayo:
- I-X-ray ingabonisa ukuguguleka kwamathambo ne-cartilage kodwa kuyi-ngempela kuphela ewusizo emva konyaka wesifo esingalawuleki.
- I-CT kanye ne-MRI ukuhlola kungasiza ekuboneni ukuvuvukala, ukuguguleka kwamathambo, nokulimala kwe-cartilage kodwa, ngokusho kocwaningo olushicilelwe e-European Radiology, lungase lungakwazi ukuthola izifo zakuqala.
- Ama-ultrasound azuzisa njengoba ayathwala, atholakala kalula, futhi akadingi ama-radiation ionizing. Bangabona futhi ubufakazi bokuqala bokuthi i-crystal idiphozi, ukuqoqwa kwamanzi, nokwandisa isikhala esihlangene. Ngaphansi kwehla, abakwazi ukubona ngeso lengqondo izakhiwo ezijulile zesibambisene.
Ngokwenza njalo, ama-ultrasound asetshenziswe uma usanda kuqala ukuzwa izimpawu noma ukuhlaselwa okuphindaphindiwe. Okunye ukuhlolwa kwe-imaging kungalawulwa ngokusekelwe emlandweni wezimpawu zakho noma ubunzima besimo sakho.
Ukuhlonza okuhlukile
Ngenkathi izimpawu ze-gout zingabonakala zicacile ngokubukeka yedwa, kunezinye izimo ezimbili odokotela abazozibuka eziphethe izici ezifanayo ngokuphawulekayo: i- pseudogout and septic arthritis .
Ukuhlukanisa, udokotela uzobheka izinto ezine: ukuhlaziywa kwe-synovial fluid (ukuhlola ubufakazi be-crystallization), isibalo segazi esimhlophe (ukuhlola ukutheleleka), isiko segrimu ye-synovial fluid (ukuhlola amabhaktheriya), futhi indawo yobuhlungu bakho obuhlangene.
Gout
I-Gout izoba nezici ezithile zomzimba nezokuxilonga ezihlukanisa nezinye izifo, okungukuthi:
- Ukuhlaziywa kwamanzi kagesi: ama-crystals enjengezinaliti
- Ukubala kwegazi elimhlophe: ngaphansi kuka-50,000
- Isiko se-gram: okungalungile (okusho ukuthi akukho ukutheleleka)
- Indawo: ikakhulukazi izinzwane ezinkulu, i-midfoot, idolo, nemikhawulo engezansi (ngokubandakanyeka kwesandla, isibalo, isandla, noma iminwe esesigabeni esilandelayo)
I-Pseudogout
I-pseudogout yisimo lapho amakristalu e-calcium (hhayi ama-crystals e-monosodium urate) akhula endaweni ehlangene. Lesi sifo singahlukaniswa kusuka ku-gout ngezindlela ezilandelayo:
- Ukuhlaziywa kwamanzi abizwayo: ama-crystals enama-rhomboid
- Ukubala kwegazi elimhlophe: ngaphansi kuka-50,000
- I-Gram stain culture: negative
- Indawo: ngokuvamile ngamadolo, isibindi, noma izinzwane ezinkulu
I-arthritis ye-Septic
I-arthritis ye-Septic, eyaziwa nangokuthi i-arthritis esithathelwanayo, futhi ngokuvamile ibangelwa ukutheleleka kwebhaktheriya futhi ingaba yingozi uma ishiywe ingalashwa. Ihluke ku-gout kulezi zindlela ezilandelayo:
- Ukuhlaziywa kwe-synovial fluid: akukho amakristalu
- Ukubala kwegazi elimhlophe: ngaphezulu kuka-50,000
- Isiko lesitshalo se-grain: elihle (okuqinisekisa ukutheleleka kwebhaktheriya)
- Indawo: ngokuyinhloko amadolo
> Imithombo:
> Rettenbacher, T .; I-Ennemoser, i-S.; Weirich, H. et al. "Ukufaniswa kwe-gout yokuxilonga: ukuqhathaniswa kwe-X ngokumelene ne-X- radi evamile. " I- Eur Radiol. 2008; 18 (3): 621-30. I-DOI: 10.1007 / s00330-007-0802-z.
> Tuhina, N .; Jansen, T .; UDalbeth, uL. et al. "I-Gout Classification Criteria I-American College of Rheumatology / i-European League Yokulwa Ne-Rheumatism Collaborative Initiativ e." I-Arthritis Rheumatol. 2015; 67 (1): 2557-68. I-DOI: 10.1002 / ubuciko.39254.