I-arthritis ye-Psoriatic iyingxenye yezimiso , ezaziwa ngokuthi i- spondyloarthropathies . Ngokuyinhloko, i-psoriatic arthritis ibhekwa njengendlela yokuvuvukala kwesifo samathambo esihlotshaniswa nesimo sesikhumba psoriasis futhi ngokuvamile ayinayo isifo se-rheumatoid . Ngokuthakazelisayo, kwaze kwaba ngawo-1950, izimpawu zesifo samathambo esivuthayo esenzeka nge-psoriasis babhekwa njenge- arthritis ye-rheumatoid eyenzeka ngokuzenzakalelayo ne-psoriasis.
Kancane kancane, lezi zimo ezimbili zazibhekwa njengemikhakha emtholampilo. Ngo-1964, i-psoriatic arthritis yayihlukaniswa njengesifo esithile esiyingxenye ye-American Association of Rheumatism.
Iphethini evamile kakhulu yokubandakanya isikhumba kwiziguli ezine-arthritis ye-psoriatic yi-plaque psoriasis (eyaziwa ngokuthi i-psoriasis vulgaris), nakuba amanye amaphethini angenzeka. Ezimweni eziningi, i-arthritis iqala kubantu abaye basebenzisa i-psoriasis. Kodwa-ke, ezinye iziguli kungenzeka ukuthi azikwazi ukuthi zine-psoriasis (isibonelo, i-psoriasis ingakwazi ukubonakala engqondweni), noma i-psoriasis ingathuthuka ngemva kwesifo se-arthritis cishe ngamaphesenti angu-15 e-psoriatic arthritis.
Amaphethini Ampawu Nezici Ezivamile
Iziguli ze-Psoriatic arthritis zinezibonakaliso nezimpawu zokuvuvukala okuhlangene, i- enthesitis , noma ukuvuvukala komgogodla. Kunamaphethini angu-5 emitholampilo we-arthritis ye-psoriatic:
- I-oligoarthritis engenasimethri (ithinta amalunga amancane angaphansi kwangu-5 noma amancane; ukuhlanganiswa okuthintekile kuhlangothini olulodwa lomzimba, hhayi kokubili)
- I-Symmetric polyarthritis (ithinta amalunga amahlanu noma ngaphezulu; ukuhlanganiswa okuthintekile kuhlangothi zombili zomzimba, isibonelo, kokubili amadolo)
- Ukubandakanyeka kokuhlanganiswa okubambene kwe-Predominant (DIP) okuphazamisayo (kuthinta ukuhlanganiswa kokugcina kweminwe nezinzwane)
- I-spondyloarthritis eyinhloko (ithinta amalunga omgogodla)
- I-arthritis mutilans (ihlukumeza futhi ibhubhise amalunga afintekile)
Isibonelo sokubandakanya okuhlangene ku-arthritis ye-psoriatic asikwenziwe noma kunjalo; ingahluka futhi iguquke. Iphethini ye-polyarticular iyona evame kakhulu, echaphazela amaphesenti angaphezu kuka-60 weziguli ezine-arthritis ye-psoriatic. I-oligoarticular pattern ithinta ama-13 amaphesenti ama-psoriatic arthritis. I-DIP eyinhloko ivela ngaphansi kwama-5 amaphesenti weziguli. I-spondyloarthritis eyinhloko ibhekwa njengento engavamile, nakuba ukubandakanyeka komgogodla kungase kuvele kumaphesenti angu-40-70 wezinkinga ze-psoriatic arthritis. Ifomu elibhubhisa (mutilans) libhekwa lingavamile, nakuba lingase likhule ngokuhamba kwesikhathi, ikakhulukazi uma lingaphathwa kahle.
Izici ezijwayelekile ze-arthritis ye-psoriatic ezisiza ekuhloleni lesi sifo zihlanganisa i-dactylitis ne-enthesitis. I-Dactylitis iboniswa ukuvuvukala okwenziwe umvimba weminwe noma iminwe. I-enthesitis ichazwa njengokuvuvukala endaweni yesithoni noma i-ligament ukungena emathanjeni. Ngokuvamile, izingosi ezibandakanyekayo ziyi-tendon ye-Achille kanye ne-fasta plantar. Ezinye izingosi zokufakelwa ezingase zihileleke kufaka phakathi ama-quadriceps noma ama-patellar tendon, i-aliac crest, i-rotator cuff, kanye ne-epicondyles ye-elbow. Ubuhlungu, ububele, nokuvuvukala kungenzeka, kepha ukubandakanyeka kwalezi zindawo ezithintekayo kungenzeka ngaphandle kwempawu.
Ezinye izici ze-arthritis ye-psoriatic zingabandakanya i-tenosynovitis (ukuvuvukala kwe-tendon sheath), izinkinga ze-nail (isib. Izipikili ezikhonjiwe), nezinkinga zamehlo (isib. Uveve noma i-iritis).
Ngaphandle kwe-psoriasis ne-nail dystrophy, ukubonakaliswa kwesifo se-extra-articular akufani kakhulu ne-psoriatic arthritis uma kuqhathaniswa nesifo se-rheumatoid arthritis. Kube nokusikisela ukuthi izifo zesifo sofuba, kanye nesiguli se-edema noma i-lymphedema, singase senzeke kakhulu phakathi kweziguli ze-psoriatic arthritis, kodwa ahlale engaqiniseki. I-Amyloid , ngenkathi ibhekwa njengeyinqaba, ichazwe nge-psoriatic arthritis.
Ukuhlukanisa i-Psoriatic Arthritis kusuka ku-Rheumatoid Arthritis nezinye izimo
Izifo zokuxilonga zibuka amaphethini wokubandakanyeka okuhlangene lapho zihlukanisa i-psoriatic arthritis kusuka ku-arthritis ye-rheumatoid, kanye nezinye izici. I-Dactylitis, ukubandakanyeka kwe-DIP, ne-enthesitis kukhomba i-psoriatic arthritis. I-Sacroiliitis noma ubuhlungu bokubuhlungu obuhlobene nokuvuvukala obubukwe ku-x-ray noma i-MRI iphinde ikhombe ku-arthritis ye-psoriatic. Ukubandakanyeka komgogodla kungabhekwa njengento evamile nge-arthritis ye-rheumatoid. Ngakolunye uhlangothi, ukutholakala kwesifo sofuba noma ezinye izibonakaliso zesistimu kubonisa ukuthi i-arthritis ye-rheumatoid kune-arthritis ye-psoriatic.
I-arthritis ye-Psoriatic kufanele ihlukaniswe nakweminye i-spondyloarthropathies, njenge- arthritis esebenzayo noma i- spondylitis e-ankylosing . I-Dactylitis ingaba isici somtholampilo se-arthritis esebenzayo. Nge-arthritis ye-psoriatic, i-sacroiliitis ijwayele ukuba yi-asymmetric (olunye uhlangothi olubi kunalunye) uma kuqhathaniswa ne-sacroiliitis ye-ankylosing spondylitis, evame ukulinganisa. Futhi, i-arthritis ye-psoriatic kufanele ihlukaniswe nezinhlobo ze-arthritis ezihlobene ne-crystal. Amazinga e-urate urate angakhuphuka e-arthritis ye-psoriatic. Ukuhlaziywa kwamanzi kagesi kusiza ukuhlukanisa lezi ezimbili.
Awekho ukuhlolwa okuqondile kwelabhoratri ye-psoriatic arthritis. Ngenkathi isifo se-rheumatoid esibi selokhu sibhekwa njengesici se-psoriatic arthritis, amazinga aphansi wesifo sofuba angase avele nge-arthritis ye-psoriatic. Ama-antibodies eyaziwa ngokuthi anti-CCP , okuqale acatshangwa ukuthi aqondene nesifo samathambo e-rheumatoid, angatholakala ema-5 amaphesenti ama-psoriatic arthritis. Izinga lokudabuka , i- CRP , ne-serum amyloid A ingakhuphuka e-arthritis ye-psoriatic, kodwa engaphansi kwesiguli se-rheumatoid arthritis.
Imithombo:
I-Kelley's Bookbook of Rheumatology. Umagazini wesishiyagalolunye. Elsevier. Isahluko 77 - I-Arthritis Psoriatic. Oliver Fitzgerald. Kufinyelele ngo-03/04/16.
Ukwaziswa kwesineke: I-Psoriatic Arthritis (Ngaphandle Kwezinto Eziyisisekelo) UpToDate. UGladman noRitchlin. Kubuyekezwe 4/9/15.