Isici esiyinhloko se-Spondyloarthritis
Uma ubonile amagama efaka phakathi, i-enthesitis, noma i-enthesopathy ku-x ray yakho noma imibiko yezokwelapha, lesi sihloko kungenzeka ukuthi sasingajwayelekile kuwe. Ake sibheke incazelo futhi ukuthi ihlobene kanjani nezinhlobo ezahlukene ze-arthritis nezifo ze-rheumatic.
- Ukungena (ubuningi: ukungena) ngokuvamile kubhekisela kumcubu ohlangene lapho amathonti , imigqa, noma ama-capsules ahlangene axhumene nethambo. Kunezinhlobo ezimbili zokufakelwa okukhona: izifayili ezinamafutha kanye nama-fibrocartilaginous entheses. Ngenkathi lokho kuyi-classic definition, incazelo entsha, ebanzi iphakamisa ukuthi i-enthesis ingaphezu kokunamathiselwe okulula noma ukufakwa kwe-site-enthesis njengeyunithi ehlanganisa izicubu eziseduze (isibonelo, amathambo ne-fibrocartilage exhunywe ku-synovium). Iyunithi ibizwa ngokuthi "i-organ organ complex".
- Ukungena kwe-intesopathy yisiphi isimo esingavamile esithinta ukungena (isb. Ukuvuvukala kokungena). Ukungenwa kwe-intesopathy kungase kube ngenxa yesimo sokuvuvukala, njenge- psoriatic arthritis , noma isimo esihlobene nokulimala noma ukulayisha ngokweqile, njenge-fastaitis plantar.
- I-enthesitis ibhekisela ukuvuvukala kokungena.
Izimpawu
I-enthesitis ivame ukuhlotshaniswa nobuhlungu, ubulukhuni, kanye nesisa endaweni yokufaka indawo, ngezinye izikhathi ngaphandle kokuvuvukala okukhulu. Noma kunjalo, lapho kukhona ukubandakanya ukufakwa okukhulu kwamalungu angaphansi, ukuvuvukala kungaba okuphawulekayo futhi okuvelele. Uma ukuvuvukala kungekho, i-enthesitis ingaba nzima ukubona noma ukusola ngesikhathi sokuhlolwa komzimba.
I-enthesitis ivame kakhulu kumasayithi alandelayo:
- I-tendon ye-Achilles
- I-tendellar tendon
- Plantar fascia
- Ama-Epicondyles we-Elbow
- Amaqhubu
- I-Vertebrae
- Iliac crest
Izimo Ezihlobene Ne-Enthesitis
I-enthesitis ingaxhunyaniswa nemibandela yokuvuvukala noma ingase isetshenziswe ngokulimala ngokulimala.
I-peripheral enthesitis iyisici sezo zonke izifo ze- spondyloarthropathies , kuhlanganise ne-spondyloarthritis engafanelekile, i- anondlosing spondylitis , i-psoriatic arthritis, kanye nesifo samathambo esisebenzayo .
I-arthritis esebenzayo iyindlela ye-arthritis ephumela ekutheleleni. Ukuvuvukala kwe-arthritis esebenzayo ngokuvamile kubangelwa ukutheleleka endaweni engxenyeni engaphandle yomzimba, njenge-urinary tract, amathumbu noma izitho zangasese.
Ngokujwayelekile amalunga emadolo, izinyawo, nama-ankle yizibhebhe zokuvuvukala kwesinye isifo samathambo asebenzayo. Ngokuqondile, i-enthesitis kubantu abane-arthritis esebenzayo ngokuvamile ivela ku-fascia plantar, amathambo ama-pelvic noma i-Achilles tendon. I-arthritis esebenzayo ingavamile futhi ngokuvamile ihamba kubantu abaningi engakapheli unyaka ngemva kokuqala.
I-ankylosing spondylitis yisimo sokuvuvukala esivame kakhulu emadodeni. Ukuvuvukala kwe-spondylitis e-ankylosing kuthinta ama-vertebrae futhi kubangele ukuthi bafake. Ukwelashwa okungapheli kwamathenda kanye nemigqa ye-vertebrae yisinyathelo sokuqala ekuhlanganisweni kokugcina kwama-vertebrae, okuyisici esiyinhloko se-anondlosing spondylitis. Abantu abane-ankylosing spondylitis nabo bangathola i-enthesitis yamalungu e- costochondral , noma amajoyini wezintambo. Amaphesenti angaba ngu-10 abantu abane-spondylitis e-ankylosing nabo bathola i-enthesitis ye-tendon yama-Achille kanye ne-aponeurosis ye-plantar (izingxenye zezintambo ezinjengezicabha, ezibanzi, ezinjenge-sheet). Igama le-plantar aponeurosis lisho izicubu ezixubile ezixhumene nazo ezisekela umqubu wonyawo.
Ezinye izimo ezihlobene ne-enthesitis zihlanganisa i-Achilles tendinitis, i- arthritis ye-rheumatoid , i- osteoarthritis , futhi isakaza i-idiopathic skeletal hyperostosis (DISH).
Kungaba yi-enthesopathy eguquguqukayo eyenziwa nge-osteoarthritis. Izinguquko ezishintshashintshayo ezenzeka nge-osteoarthritis yokugqoka nokuphumula nazo zithinta ama-fibrocartilages.
Ukucabangela Ukuxilongwa
Ukucabanga kungasiza ekuxilongeni i-enthesitis, kodwa indlela yokucabanga ye-imaging esetshenziswayo incike ekutheni i-skeleton ye-axial noma ye-peripheral iyathinteka yini. I-MRI isetshenziselwa i-axial skeleton. I-Ultrasound ikhethwa ngamasipha omzimba. I-MRI izophinde ikhetheke kunoma yikuphi ukufaka okungenakufinyeleleka.
Ngokusho kwe-Up-to-Date, "Ukutholakala kwe-Sonographic of enthesitis kuhlanganisa ukuguqulwa noma ukuguqulwa okukhulu kwe-tendon kokufakwa kwethenda, i-edema ye-tendon ukufakwa, i-calcific efakwe ku-tendon ukufakwa, ukuqhuma, ukuguqulwa kwamathambo, ukubunjwa kwamathambo amasha, noma izinguquko ze-periosteal.
Ngaphezu kwalokho, i- bursitis eseduze ibhekwa njengophawu lwe-enthesitis. Amandla amandla e-Doppler US signal afana nokukhula kwe-vascularity angatholakala ku-enthesitis esebenzayo. "
Ukwelapha
Ukwelashwa kwe-enthesitis kusekelwe esimweni esingaphansi. Isibonelo, uma i-enthesitis ingenxa yesimiso sokuvuvukala, ukwelashwa ngokuvamile kugxile ekwelapheni i-polyarthritis evuthayo. Ukwelashwa, ezimweni ezinjalo, kungafaka:
Amapayipi omzimba we-corticosteroid angasetshenziswa uma imithi yomlomo ingeneli. Izici ze-biomechanical ze-enthesitis nazo zibhekwa ngokusebenzisa ama-insoles nama-cushions.
> Imithombo:
> Bruyn, uGeorge AW, MD. PhD. I-ultrasonography yama-Musculoskeletal - Izicelo zoKliniki. Kusesikhathini. Kugcine ukubuyekezwa ngo-February 2017.
> Kehl, AS, MD. et al. Ukwelashwa. I-arthritis ne-Rheumatology. 2016 Feb; 68 (2): 312-322.
> McGonagle D. noBenjamini, M. Entheses, Enthesitis, no-Enthesopathy. Umkhankaso Wokuhlola I-Arthritis. Ukubuyekeza okuphezulu. I-autumn ka-2009.