A Primary Feature yeSpondyloarthritis
Kana iwe wakaona mazwi achivhara, enthesitis, kana kuti intesopathy mune yako x-ray kana mitsva yezvechiremba, izwi racho ringangodaro risina kujairika kwauri. Ngatitarisei zvinorehwa uyewo kuti zvinosanganiswa sei nemhando dzakasiyana dzemarthritis uye zvirwere zverheumatic.
- Kupindirana (zvizhinji: zvinopinda) zvinowanzoreva mishonga inobatanidza iyo maonde , ligaments, kana majokosi akabatanidzwa akabatanidza pfupa. Mhando mbiri dzomukati dziripo: fibrous entheses uye fibrocartilaginous entheses. Kunyange zvazvo iri iro tsanangudzo yekare, imwe nhaurwa, tsanangudzo yakawanda inoratidza kuti kutenderera kunopfuura kungoshamwaridzana chete kana kuisa nzvimbo-yakanyatsoshanda seyuniti iyo inosanganisira pedyo nematukisi (somuenzaniso, bone uye fibrocartilage yakabatana ne synovium). Chikwata chacho chinonzi "sangano rinopinza".
- Kunyanya kukanganisa chinhu chipi zvacho chisina kujairika chinokanganisa zvinyorwa (semuenzaniso, kuputika kwezvinyorwa). Kuvhiringidzika kunogona kunge kuripo nekuda kwechiremera chemuviri, zvakadai se psoriatic arthritis , kana chiitiko chakakonzerwa nekukuvadzwa kana kuwedzerwa, zvakadai se plantar fasciitis.
- Enthesitis inoreva kuvhiringidza kwezvinyorwa.
Zviratidzo
Enthesite inowanzobatanidzwa nekurwadziwa, kuoma, uye unyoro pakunzvimbo yekuisa, dzimwe nguva pasina kunyanya kukuru. Zvisinei, apo pane kuve nekubatanidzwa kwemashoko makuru emakumbo mashoma, kuzvimba kunogona kuve kwakakosha uye kwakakurumbira. Kana kutuka kusipo, enthesitis inogona kuva yakaoma kuziva kana kusungurudza panguva yekuongorora.
Enthesitis inowanikwa pazviitiko zvinotevera:
- Achilles tendon
- Patellar tendon
- Plantar fascia
- Elbow epicondyles
- Knees
- Vertebrae
- Iliac crest
Mamiriro Ezvinhu Anosangana neChitsitsiro
Enthesite inogona kuenzaniswa nemamiriro ekuvhiringidza kana inogona kunge yakagadziriswa nekukuvara.
Peripheral enthesitis inofanirwa nezvose zvinonzi spondyloarthropathies , kusanganisira unfferentiated spondyloarthritis, ankylosing spondylitis , psoriatic arthritis, uye reactive arthritis .
Reactive arthritis isiri yeArthritis inokonzerwa nehutachiona. Kuvhiringidzika kwechirwere chechirwere chinokonzerwa nehutachiona kazhinji kunokonzerwa nehutachiona mune imwe nzvimbo yakadzika yomuviri, zvakadai sehutori, urumbo kana mazamu.
Kazhinji masangano emabvi, tsoka, uye maziso emakumbo zvinokonzerwa nekuvhiringidzika kwechipiri kusvika pakugadzirisa arthritis. Kunyanya, zvirwere muvanhu vane arthritis inogadziriswa inowanzowanzova mumasango anonzi fascia, mapfupa emapfupa kana Achilles tendon. Reactive arthritis inowanzojairika uye inowanzoenda kuvanhu vakawanda mukati megore mushure mokutanga.
Ankylosing spondylitis chirwere chinoputika chinowanikwa kuvanhu. Kuvhiringidzika kwe ankylosing spondylitis kunokanganisa vertebrae uye inoita kuti vashandise. Chronic enthesitis yematononi nemiromo ye vertebrae ndiro danho rokutanga mukugadzirwa kwe vertebrae, iyo inonyanya kukosha ye ankylosing spondylitis. Vanhu vane ankylosing spondylitis vanogonawo kuwana enthesitis yezvikwata zvinodhura , kana kuti majoini embabvu. Vanenge 10 kubva muzana yevanhu vane ankylosing spondylitis vanoonawo inthesitis yeAchilles tendon uye plantar aponeurosis (zvikamu zvepamusoro, zvakadzika, zvakasvibirira semashizha). Izwi rokuti plantar aponeurosis rinoreva mazamu akabatanidzwa anogadzirisa anotsigira netsoka.
Mamwe mamiriro ezvinhu anosangana ne enthesitis anosanganisira Achilles tendinitis, rheumatoid arthritis , osteoarthritis , uye kuparadzanisa idiopathic skeletal hyperostosis (DISH).
Icho chinogona kunge chichigadzirisa chinopesopathy chinowedzera ne osteoarthritis. Kuchinja kunokonzera kuitika kunowanikwa nekuvhara-uye-kusveta osteoarthritis kunobatsirawo fibrocartilages.
Kufananidzira Kuziva
Kufananidza kunogona kubatsira kuongorora inthesitis, asi mifananidzo yemafungiro inoshandiswa inobva pakuti inonzi axial kana pembera skeleton inobatwa. MRI inoshandiswa kweaxial skeleton. Ultrasound inoshandiswa kune imwe nzvimbo skeleton. MRI inogonazve kuva yakanakisisa chero ipi zvayo inowanikwa iyo isingawanikwi.
Maererano neUp-To-Date, "Sonographic findings of enthesitis inosanganisira thickening kana intratendinous focal change ye tendon kuisa, edema yematoni inowedzera, calcific inowanikwa pamutambo wokuisa, kuputika, kusanganisa, itsva fufuro, kana periosteal change.
Mukuwedzera, pedo bursitis inoonekwa sechiratidzo chegungwa. Simba rakanaka Doppler US signal rinopindirana nekuwedzera kwevascularity inogona kuwanika mukushanda kwechithesitis. "
Kurapa
Kurapa kwe enthesitis kunobva pauri mamiriro ezvinhu. Somuenzaniso, kana inthesitis inokonzerwa nemamiriro ekuvhiringidza, kurapwa kunowanzotarisa mukurapa kupisa kweparyarthritis. Kurapa, mumamiriro ezvinhu akadaro, kunogona kusanganisira:
Nharaunda dzomunharaunda yegricticosteroid dzinogona kushandiswa kana mishonga yemuromo isingakwanisi. Izvo zvinonzi biomechanical zve enthesitis zvinoshandiswawo nekushandisa insoles nemakwenzi.
> Sources:
> Bruyn, George AW, MD. PhD. Musculoskeletal Ultrasonography - Clinical Applications. Kusvika pari zvino. Yakapedzisira yaongorora February 2017.
> Kehl, AS, MD. et al. Enthesitis. Arthritis & Rheumatology. 2016 Feb; 68 (2): 312-322.
> McGonagle D. naBenjamin, M. Entheses, Enthesitis, uye Enthesopathy. Arthritis Research Campaign. Nyaya dzeMusoro. Autumn 2009.