Ayikho ivivinyo elilodwa, ngakho kudingeka ukuhlolwa okuhle kwezokwelapha
Ukuxilongwa kwe- ankylosing spondylitis kudinga ukuthi umculi omuhle asebenze engxenyeni kadokotela wakho, njengoba kungekho ukuhlolwa okujwayelekile kwegolide. Kunalokho udokotela kufanele acabangele izimpawu zomuntu, ukuhlola ngokomzimba, nokuhlolwa kwezokwelapha njengama-x-ray kanye nokusebenza kwegazi ukwenza ukuxilongwa-kufane nokuhlanganisa izingcezu ze-puzzle.
Umlando Wezokwelapha
Umuntu ophethe i-AS ngokuvamile ubona kuqala udokotela wabo oyinhloko noma udokotela womndeni ngokukhalaza ngobuhlungu, ngokuvamile emhlane noma phezulu.
Ukuxazulula imbangela yalolu buhlungu, udokotela angabuza imibuzo elandelayo:
- Ingabe uncane kuneminyaka engama-40?
- Ingabe ubuhlungu buqhubeka izinyanga ezintathu noma ngaphezulu?
- Ingabe ubuhlungu buya ngcono ngokuzivocavoca?
- Ingabe ubuhlungu bubuhlungu kakhulu ngokuphumula, ikakhulukazi okubonakalayo ebusuku?
- Ingabe ubuhlungu buyathuthuka kakhulu emva kokuthatha i-NSAID? (isibonelo, ibuprofen)
Ukuphendula u-yebo eningi yale mibuzo kuyokwenza udokotela wakho acabangele ukuxilongwa kwe-arthritis evuvukalayo (njenge-ankylosing spondylitis), ngokumelene nobuhlungu obujwayelekile bokubuyisela emuva (isibonelo, uhlobo lwe-muscle noma isifo se-disc degenerative ).
Udokotela wakho uzophinde abuze ngezibonakaliso zomzimba wonke ezifana nokukhathala noma ukushayeka, ngoba lokhu kungase kusekele ukuxilongwa kwesipulylithe i-ankylosing. Lokhu kungenxa yokuthi izimpawu zomzimba wonke zingabonakalisa ukuthi kukhona okungavamile okwenzekayo ngesistimu yakho yomzimba. E-anklyosing spondylitis, amasosha omzimba wakho ahlasela amalunga enempilo (ikakhulukazi amalunga omgogodla ne- sacroiliac ).
Umlando womndeni we-anondlosing spondylitis, noma umlando womuntu siqu wezifo zomzimba, isifo sofuba esivuvukalayo , u- uveitis (ukuvuvukala kwengxenye yemibala yakho), noma i- psoriasis kukhona izinkomba ezengeziwe zokuxilonga.
Uma udokotela wakho wokunakekelwa oyinhloko noma udokotela womndeni esolisa i-spondylitis engenayo i-ankylosing noma enye inqubo ye-immune-mediated process, uzokudlulisela kudokotela we-rheumatologist-udokotela obhekene nezifo ezihlangene nezizimele.
Ukuhlolwa Kwemvelo
Ngesikhathi uhlolwa ngokucophelela nge-ankylosing spondylitis, udokotela wakho uzohlola umgogodla wakho, i-hip, namajoyina we-sacroiliac ngokucindezela kuzo ukuhlola isisa. Ngokuhambisa amajoyina akho, udokotela wakho angakwazi ukuhlola ukuhamba nokuguquguquka. Udokotela wakho futhi uzohlola izingxenyana ezincane zezandla nezinyawo zakho, kanye namanye amalunga afana nezimbambo zakho, amadolo, namahlombe, ukucacisa ukuthi kukhona ukuvuvukala, ukufudumala noma uketshezi okwamanje.
Ukuhlola izithende zakho ze- enthesitis , ukulalela amaphaphu akho, nokwenza isheke lesikhumba nesikhumba (ukufuna i-psoriasis) nazo izingxenye ezivamile zokuhlolwa komzimba uma umuntu ecatshangwa ukuthi une-spondylitis e-ankylosing.
Ungamangazi uma ngabe udokotela wakho ekutshela udokotela wezilanga (i-ophthalmologist) uma unesifo sobuso noma ubomvu kanye / noma umbono obonakalayo, njenge-uveitis yi-complication evamile ye-anklyosing spondylitis.
Ukuhlolwa kwezilingo
I-X-ray futhi ngezinye izikhathi imaging yamaconilium (i-MRI) yama-sacroiliac (futhi ngezinye izikhathi umgogodla) ngokuvamile isetshenziselwa ukuqinisekisa ukuxilongwa kwe-anondlosing spondylitis. Inkinga ngokuhlolwa kwe-imaging ukuthi ukuvuvukala kungathatha iminyaka ukukhombisa, nakuba i-MRI ingayithola ngaphambi kwe-x-ray.
Ukuhlola ukuhlola kusetshenziselwa ukuqapha ukuqhuma kwesifo somuntu, ngemuva kokuthi kutholakala ukuthi kune-spondylitis e-ankylosing.
I-HLA-B27 Imizamo Yegazi
Ukuhlolwa kwegazi okuyinhloko ukuxilongwa kwe-anklyosing spondylitis yi- HLA-B27 test . I-HLA-B27 uhlobo lweprotheyini olutholakala kumangqamuzana egazi elimhlophe (amasosha akho okulwa nokutheleleka). Uma sikhona, kungabangela amangqamuzana akho amhlophe egazi ukuba ahlasele amaseli enempilo emzimbeni wakho, njengalawo angaphakathi komgogodla wakho, intamo noma amehlo.
Ungamangala lapho ufunda ukuthi amaprotheni i-HLA-B27 akhona cishe ngamaphesenti angu-95 aseCaucasus nge-anklyosing spondylitis. Lokho okushiwo, kulabo abathandekayo ngegciwane le-HLA-B27, cishe amaphesenti angu-5 kuphela anesipulylitis e-ankylosing.
E-Afrika-Amamerika ase-AS, i-HLA-B27 igega ayifani ngokujwayelekile-ngakho akuyona into yokuhlolwa kokuhlola.
Ngakho uma unezimpawu ezibonisa ukuthi i-AS, udokotela wakho angakuvivinya ngeprojekthi ye-HLA-B27 ukuze usize ukuqinisekisa ukuxilongwa, ikakhulukazi uma kukhona ukungaqiniseki okuqhubekayo (mhlawumbe kunamanye izingxenye ezididekayo zokuhlolwa kwakho ngokomzimba noma umlando). Kodwa futhi, ukuba khona kwe-HLA-B27 akuyona i-slam dunk "yebo une-AS" ukuhlolwa-zonke izingcezu kufanele zihlangane ndawonye. Uhlolo oluhle olungenazo izimpawu noma izimpawu zesifo esizimele ngokuzenzakalelayo akusho okuningi. Ngakolunye uhlangothi, abanye abantu (kuhlanganise nabantu baseCaucasus, nakuba kungavamile) babe ne-AS, kepha abahlolwayo abahlukumezi isakhi.
Kuzo zonke, ukuchazwa kwezivivinyo ze-HLA-B27 kuyinkimbinkimbi, ngakho-ke kudinga ukuhlaziywa ngokucophelela udokotela onolwazi.
Ezinye izivivinyo zegazi
Ukuhlolwa okunye kwegazi ezimbili udokotela wakho angayala uma ephikisana ne-anondlosing spondylitis ihlanganisa:
Omunye noma kokubili lawa makaki angaphakanyiswa uma kukhona ukuvuvukala okusebenzayo emzimbeni.
Lokhu kuthiwa, i-CRP ne-ESR ayihlolisisi igazi, okusho ukuthi ingaphakanyiswa ezimweni eziningi zempilo ngaphandle kwe-anklyosing spondylitis. Lokhu kufaka:
- Esinye isifo se-autoimmune (isibonelo isifo se-rheumatoid arthritis noma i- lupus )
- Ukwelashwa (isibonelo, isibhamu)
- I-Cancer
Ngaphezu kwalokho, i-ESR ne-CRP ingaba yinto evamile, futhi umuntu angakwazi ukuthola i-ankylosing spondylitis (ikakhulukazi uma isifo sabo singafaki ngesikhathi sokudweba kwegazi).
Izwi elivela
Kubalulekile ukuthi ungatholakali phansi imininingwane lapha. Isithombe esikhulu ukuthi ukuxilongwa nge-ankylosing spondylitis kudinga ukuhlaziywa okucabangelayo kwezici eziningi udokotela wakho, i-crux elele emlandweni omuhle wezokwelapha nokuhlolwa ngokomzimba. Ukuhlolwa kwegazi kanye nama-x-ray kungase kuqiniswe ukuxilongwa.
Qinisekisa ukubuza udokotela wakho nganoma yimiphi imibuzo ephathelene nokuxilongwa kwakho noma imiphumela yokuhlolwa yomuntu siqu. Ukuthatha indima ebalulekile empilweni yakho kungakusiza kuphela.
> Imithombo:
> American Association for Clinical Chemistry. I-HLA-B27: Ukuhlolwa.
> I-National Institute of Arthritis kanye neMisculoskeletal kanye Nezifo Zesikhumba. Imibuzo Nezimpendulo Nge-Spondylitis E-Ankylosing.
> Rudwaleit M et al. Ukuhlolwa kwe-SpondyloArthritis I-International Society Classification Criteria for Peripheral Spondyloarthritis kanye ne-Spondyloarthritis ngokujwayelekile. I-Ann Rheum Dis . 2011 Jan; 70 (1): 25-31.
> I-Spondylitis Association of America. Sibutsetelo se-Ankylosing Spondylitis.