Psoriatic arthritis ndeyeboka remamiriro ezvinhu, anozivikanwa sepondyloarthropathies . Kunyanya, psoriatic arthritis inozivikanwa sechirwere chechirwere chinonzi arthritis chinosanganiswa neganda chimi psoriasis uye kazhinji hachina kunaka kwerhumatoid factor . Zvinofadza kuti kusvikira kuma1950, zviratidzo zvekuvhiringidza arthritis zvakaitika ne psoriasis zvaifungidzirwa kuva rheumatoid arthritis iyo yakaitika pamwe ne psoriasis.
Zvishoma nezvishoma, mamiriro maviri aya aionekwa semakiriniki akasiyana. Muna 1964, psoriatic arthritis yakarongerwa sechirwere chinokonzerwa nechirwere neAmerican Association of Rheumatism.
Nzira yakajairika yeganda kubatanidzwa nevarwere vane psoriatic arthritis is plaque psoriasis (inozivikanwawo seyi psoriasis vulgaris), kunyange mamwe maitiro anogona kuitika. Muzviitiko zvakawanda, arthritis inowedzera kune vanhu vakagadzira psoriasis. Zvisinei, vamwe varwere vangave vasingazivi kuti vane psoriasis (somuenzaniso, psoriasis inogona kuonekwa zvisingaonekwi mucheka), kana psoriasis inogona kukura mushure mekushaya arthritis munenge 15 muzana ye psoriatic arthritis matambudziko.
Maitiro ezviratidzo nezvimwe zviitiko
Psoriatic arthritis varwere vane zviratidzo uye zviratidzo zvekubatana kwekubatana, enthesitis , kana kuvhuvhuta kwepamuviri. Pane 5 makiriniki maitiro e psoriatic arthritis:
- Asymmetric oligoarthritis (inobata zvishoma zvishoma zvishanu zviduku kana zvikuru; majoka akabatanidzwa ari kune rumwe rutivi rwemuviri, kwete zvose)
- Symmetric polyarthritis (inobata zvikamu zvishanu kana kupfuura; majoka akabatanidzwa ari kumativi ose omumuviri, somuenzaniso, mabvi maviri ose)
- Predominant (DIP) distal interphalangeal joint involvement (inoguma kuguma kwezvenwe neminwe)
- Predominant spondyloarthritis (inokanganisa mazamu emupona)
- Arthritis mutilans (inoshandura uye inoparadza masangano anokanganisa)
Muenzaniso wekubatanidzwa pamwe chete mumapuroriyamu arthritis haisi yakagadzirirwa zvakadaro; inogona kusiyana uye kuchinja. Iyo chirwere cheparyarticular ndiyo inonyanya kuonekwa, inosvika makumi matanhatu kubva muzana yevarwere vane psoriatic arthritis. Iorigoarticular pattern inobata anenge 13 muzana ye psoriatic arthritis varwere. DIP yePredominant inowanikwa mune zvishoma kudarika 5 muzana yevarwere. Predominant spondyloarthritis inofungidzirwa isingazivikanwi, kunyange zvazvo mamwe maginha ekubatanidza angaita mu 40-70 muzana ye psoriatic arthritis matambudziko. Chimiro chinoparadza (mutilans) chinonzi chisingabviri, kunyange chinogona kukura nekufamba kwenguva, kunyanya kana zvisina kukodzera kurapwa.
Zvimwe zviitiko zveporiorian arthritis iyo inobatsira pakuongorora chirwere ichi inosanganisira dactylitis uye enthesitis. Dactylitis inoratidzirwa nekuputika kwakagadzirwa neminwe kana zvigunwe. Enthesite inotsanangurwa sekuputika panzvimbo yetendon kana ligament kuisa mufupa. Kazhinji kazhinji, iyo inobatanidza kushandiswa kwemasayiti ndeye Achilles tendon uye inomera fascia. Zvimwe kuisa nzvimbo dzingave dzakabatanidzwa zvinosanganisira quadriceps kana patellar tendons, creed yaacac, rotator cuff, uye epicondyles yeheta. Njodzi, unyoro, uye kuzvimba zvinogona kuitika, asi kubatanidzwa kwezvivako izvi zvinogona kuitika pasina zviratidzo.
Zvimwe zvikamu zve psoriatic arthritis zvinogona kusanganisira tenosynovitis (kuvhiringidza kwetendon sheath), zvinetso zvemakumbo (semuenzaniso, zvigunwe zvakagadzirirwa), uye zvinetso zveziso (semuenzaniso, uveitis kana iritis).
Kunze kwe psoriasis uye nail dystrophy, zviratidzo zvinowedzera-articular zviratidzo hazvizivikanwi ne psoriatic arthritis kana zvichienzaniswa nerheumatoid arthritis. Pakave nemazano anovhiringidza zvirwere, pamwe nekuparadzanisa chikamu chema edema kana lymphedema, inogona kuitika kakawanda pakati pevarwere ve psoriatic arthritis, asi inoramba isina chokwadi. Amyloid , iyo ichitaridzika isingawanzoitiki, yakatsanangurwa ne psoriatic arthritis.
Kusiyanisa Psoriatic Arthritis kubva kuRheumatoid Arthritis uye Zvimwe Zvimwe
Nyanzvi dzezvirwere dzinotarisa mapurogiramu ekubatanidzana pamwe chete paanosiyanisa psoriatic arthritis kubva ku rheumatoid arthritis, pamwe nezvimwe zvinhu. Dactylitis, DIP kubatanidzwa, uye enthesitis inotaura nezvemapuraneti arthritis. Sacroiliitis kana kurwadziwa kwepfungwa kunokonzera kuputika kunoonekwa pa-x-ray kana kuti MRI inotaurawo nezvehutoriyori yehutano. Kupindirana kwepasepa hakuiti kunowanzoonekwa nehutachi hutachiona. Kusiyana naizvozvo, kuvapo kwerheumatoid kunogunun'una kana zvimwe zvimwe zviratidzo zvinoratidzira zvinoratidza rheumatoid arthritis panzvimbo ye psoriatic arthritis.
Psoriatic arthritis inofanirawo kusiyaniswa kubva kune dzimwe spondyloarthropathies, yakadai seyakagadzirisa arthritis kana ankylosing spondylitis . Dactylitis inogonawo kuva chirwere chetachiona chechirwere chetachiona. Mune psoriatic arthritis, sacroiliitis inowanzove yakanyanya kufanana (imwe yechipfuuri yakaipisisa kupfuura imwe) yakaenzaniswa ne sacroiliitis ye ankylosing spondylitis, iyo inowanzoenzaniswa. Uyezve, psoriatic arthritis inofanira kusiyaniswa kubva pamakristini-anokonzerwa nemaitiro eArthritis. Sirium urate mazinga angave akakwirira mumapuroriki arthritis. Synovial fluid analysis inobatsira kusiyanisa mbiri.
Icho hachina hutano chaihwo hwema laboratory ye psoriatic arthritis. Kunyange zvazvo chirwere cherumatoid chisina kunaka chakagara chichionekwa sechimiro che psoriatic arthritis, mazinga akaderera ehurumatoid chinogona kuitika ne psoriatic arthritis. Maitiro anonzi anti-CCP , anotanga kufungidzirwa kuti anonyanya kurwisa rheumatoid arthritis, anogona kuwanika inenge 5 muzana ye psoriatic arthritis varwere. Sedimentation rate , CRP , uye serum amyloid A ingave yakakwirira mu psoriatic arthritis, asi inopfuura kudarika mu rheumatoid arthritis varwere.
Sources:
Kelley's Textbook yeRheumatology. Ninth edition. Elsevier. Chitsauko 77 - Psoriatic Arthritis. Oliver Fitzgerald. Akawana 03/04/16.
Information Patient: Psoriatic Arthritis (Beyond the Basics) UpToDate. Gladman naRitchlin. Yashandurwa 4/9/15.