Ukubukeka nokubaluleka kwama-nodules we-rheumatoid
Uma une-arthritis ye-rheumatoid, ungase uzibuze ukuthi i-rheumatoid nodules ayinakugwemeka yini. Ama-nodules ama-rheumatoid abonakala kubantu abangamaphesenti angama-35 abanesifo samathambo esiwumzimba . Njengengxenye yenqubo yesifo, ama-nodules aqinile, angenasethenda, angenawo ithenda, ahlakulela amaphuzu okucindezela, amalunga, ngisho nasezimbilini zangaphakathi. Funda kabanzi ngokubaluleka kwabo nokuthi ngabe kukhona ukwelashwa okuphumelelayo.
Sibutsetelo kanye nokubaluleka
Ama-nodules we-rheumatoid abhekwa njenge-manifestaneous (isikhumba) esivame kakhulu (isikhumba) esibonakalayo se-arthritis ye-rheumatoid. Ekubonisweni kokuqala, lapho abantu beqala ukuhlolwa ngesifo samathambo ngodokotela, cishe amaphesenti angu-7 awo atholakalayo anezintambo ezinamahlombe ezincane ezingaphansi kwegazi.
Ama-nodules we-rheumatoid avame ukuhlotshaniswa nokukhubazeka okuhlangene kanye nokubonakaliswa okunamandla okukhulu kwe-arthritis ye-rheumatoid, engabandakanya ukubandakanya kwamapayipi noma amehlo . Ama-nodules angase ahluke ngosayizi phakathi nenqubo yesifo. Bangase bahlotshwe nezinkinga, kufaka phakathi ukuhamba okuhlangene okulinganiselwe, izinzwa ze-neuropathy, ukwakheka kwe-fistula, nokutheleleka.
Cishe amaphesenti angu-75 abantu abane-Felty's syndrome (uhlobo olunzima lwe-arthritis ye-rheumatoid) anama-nodules we-rheumatoid. Iziguli ze-rheumatoid arthritis ezinama-nodules zinamathuba amaningi okuthuthukisa i- vasculitis . Ngokuvamile, kucatshangwa ukuthi labo abanezinyosi zesifo se-rheumatoid banenkinga enkulu yesifo esinesifo samathambo kanye nomonakalo ohlangene ngokuqhubekayo.
Izimpawu Nezibonakaliso
Ama-nodules we-rheumatoid angaba yizicabha ezingenangqondo. Ngokuvamile zikala phakathi kwamamitha amabili no-5 cm. Ama-nodules, angabonakala njengesisindo esisodwa noma njengamaqoqo ama-nodules, avame ukuthuthukisa lapho i-arthritis yesifo se-rheumatoid isebenza. Ama-nodules angaphansi komzimba ngokuvamile ashukunyiswa futhi abe nomuzwa we-rubbery.
Ezinye zihambisana ne-periosteum (ithambo) bese uzizwa uqinile noma unzima ukuthinta.
Izingosi ezijwayelekile zezinyosi ze-rheumatoid zihlanganisa i-elbow, emuva kwe-forearm, ama- metacarpophalangeal joints (knuckles) , ithononi ye-Achilles, kanye ne-tendens extensor.
Ama-nodules ama-rheumatoid ayitholakali kutholakala phezu kwe-sacrum, i-occiput (emuva kwekhanda), izintambo zamagama, i-parenchyma ye-pulmonary, i-pleura, i-pericardium, i-myocardium, noma i-leptomeninges yesistimu ye-central central-kodwa kungenzeka. Kungenzeka futhi ukuthi ama-nodules we-rheumatoid athuthukiswe ngaphakathi kwezitho zangaphakathi.
Izixuku ezingenayo i-arthritis kuphela. Izixuku ezingenalutho zingase zenzeke nge- gout (okuthiwa i- gout tophi ), i- rheumatic fever , i-xanthomatosis, ne- sarcoidosis , phakathi kwezinye izimo. Esinye isici esihlukanisayo phakathi kwama-nodules we-rheumatoid kanye ne-gout tophi ukuthi ama-nodules we-rheumatoid awanaso isiqhwaga noma avela esikhumbeni esiphezulu. Kukhona ukuhlanganiswa okudumile phakathi kwama-nodules we-rheumatoid kanye nezinga eliphakeme le- rheumatoid ekuhlolweni kwegazi.
Ukwelapha
Imishanguzo ye-steroid ye-intranodular inganciphisa ubukhulu be-nodule. Ukwelapha nge- DMARD noma ama- block block we-TNF kungenzeka noma awuqede ama-nodules we-rheumatoid njengoba i-rheumatoid arthritis ilawulwa. Ngokuthakazelisayo, abanye abantu abaphathwa ngethothotrexate isipiliyoni bebuhlungu kakhulu, ngisho noma ezinye izici zesifo zibonakala zilawulwa kahle.
Ukususwa okuhlinzekwayo kuyindlela yokukhetha, kodwa ama-nodules avame ukuphindaphinda ezinyangeni ezimbalwa, ikakhulukazi lapho bekhona endaweni yokucindezeleka okuphindaphindiwe. Ngokuvamile, ngenxa yalesi sizathu, ukuhlinzwa kudikibala.
> Imithombo:
> Cush JJ, Weinblatt ME, i-Kavanaugh A. I- Rheumatoid Arthritis: Ukuxilongwa Nokunakekelwa . West Islip, NY: Ukuxhumana kobuchwepheshe; 2014.
> Davis JM. Ama-Nodules we-Rheumatoid. Kusesikhathini.
> Firestein GS, uKelley WN. I-Kelleys Textbook ye-Rheumatology . Philadelphia, PA: Elsevier / Saunders; 2013.