Kupararira kweIdiopathic Skeletal Hyperostosis, inowanzonzi DISH, chirwere chinozivikanwa ne calcification (kuiswa kwe calcium) uye ossification (kuumbwa kwefupa) muzvinyama zvinyoro, zvinonyanya kupinda uye mishonga. Chokutanga chakaziviswa uye chakatsanangurwa naForestier naRotes-Querol muna 1950, chirwere chacho chainzi "senile ankylosing hyperostosis." Iyo yakave yakatumidzwawo sechirwere cheForestier.
MuchiDISH, iyo axial skeleton inowanzobatanidzwa, kunyanya mutsara wemagetsi . Asi, apo vatsvakurudzi vakaona kuti chirwere chacho chakanga chisingarevi kumusana uye kuti chinogona kukanganisa nhengo dzomumativi, vakazvitumidza zvakare kuti Diffuse Idiopathic Skeletal Hyperostosis.
Zviratidzo uye Zviratidzo zveDISH
Nenzira, DISH inosanganisira kugadzirwa kweasteophytes iri kurutivi rworudyi rwemitsipa inonzi thoracic (ne intervertebral disk space isina kuchinjwa) uye kusvibiswa kweanterior longitudinal ligament. Kuchengetedza uye kushandiswa kwemashure ekureba kwenguva refu kunogonawo kuitika muDISH, pamwe nenzvimbo dzinopindirana, kusanganisira piratatlar ligaments, fascia yemiti, Achilles tendon, olecranon (chikamu chechirna kupfurikidza nejoko rehota), nezvimwewo.
Kuongorora DISH
A definitive diagnosis yeDISH yakabva pane zvitsvaga zvese, kusanganisira:
- Kuvapo kwemaosteophyte akaoma, ari kufamba nechepamusoro kwemitsipa yemagetsi, achibatanidza zvishoma zvina zvinokonzera vertebrae -or-ossification ye anterior longitudinal ligament
- Preserved intervertebral disk urefu munharaunda inobatanidzwa
- Kushayikwa kwepophyseal joint ankylosis, sacroiliac joint joint , sclerosis, kana intra-articular fusion. Nhengo yepophyseal ipo iyo apo mapfupa maviri kana akawanda anopindira mumutsana.
Chiitiko chinogona kuonekwa cheDISH chinobva pakuenderera mberi kwekubata, ossification, kana zvose zve anterolateral nzvimbo yezvinyorwa zviviri zvinokonzera vertebral, uye zvakagadziriswa zvakagadziriswa zvechitsinho, olecranon, uye patella.
Uyewo, peripheral enthesopathies inogona kunge inoratidza yekutanga DISH iyo inogona kuve yakatanga kuva DISH yakazara yakajeka inoratidzika pachena.
Kuwanda uye Matanho Akabatana neDISH
DISH inowanzoonekwa kune varume kupfuura vakadzi. Kuwanda kweDISH kunowirirana uye kunobva pazera, rudzi, uye nzvimbo. Maererano neKelley's Textbook yeRheumatology , zvidzidzo zvezvipatara zvakaratidza kupararira kweDISH kune varume vakwegura kune makore makumi mashanu ekusvika 25% nevakadzikadzi vanopfuura 50 pa15%. VaJudha vanopfuura makore makumi mana vaigara muJerusarema vaiva nehuwandu hwekuwanda, asi kupararira kwakadzika kwakawanikwa pakati pevaya muKorea (kwete kunyange 9% yevanhu vakwegura). Dild DISH yakawanikwa muzvisikwa zvevanhu zvinotangira makore 4000. Mumazamu evanhu kubva kumazana matanhatu kusvika kuma8, kupararira kwaive kwakakwirira kune varume kuenzaniswa nevakadzi, vachitarisa kusvika 3.7%.
Chikonzero cheDISH uye Mamiriro Akafanana
Chikonzero cheDISH hachizivikanwi, asi pane zvimwe zviitiko zvinoita sezviri kuenderana nehutano. Vanhu vane DISH kazhinji vane osteoarthritis zvakare. DISH yakabatanidzwawo ne:
- Metabolic syndrome
- Chirwere cheshuga mellitus (kwete-insulin inotenderera)
- Kuwedzera muviri
- High waist circumference chiyero
- Hypertension
- Hyperinsulinemia
- Dyslipidemia
- Yakakura mazinga ekukura kwehomoni
- Yakakura insulini-yakafanana kukura
- Hyperuricemia
- Kushandiswa kwe-retinoids (vitamini A zvinhu)
A genetic predisposition
Zviratidzo Zvinosanganiswa neDISH
Pane zviratidzo uye zviratidzo zvinowanzobatanidzwa neDISH. Zvisinei, vazhinji vevarwere veDISH vanoona kuoma kwemangwanani, kurwadziwa kweiyo dorsolumbar, uye vakaderedza huwandu hwekufamba. Ikoko kunogona kuva nekurwadziwa kwakanyanya kwezvikuru uye zviduku zvinoputika pamwe chete neperiipheral entheses (chitsitsinho, Achilles tendon, fudzi, patella, olecranon). Pain in the axial skeleton inogona kuonekwa kune dzose nhatu nhatu dzomukona, uye majosi anowedzera mari uye sternoclavicular.
Kurapa kweDISH
Kurapa kweDISH kunotungamirira kugadzirisa marwadzo nekuoma, kunonoka kuenderera mberi kwechirwere ichi, kuunza zvinetso zvemasikisi pasi pesimba, nekudzivirira zvinetso. Chiedza chekuvhenekera, kupisa, marwadzo ekurwadza, uye zvinonzi antisteroidal anti-inflammatory drugs (NSAIDs) zvinowanzoshandiswa kugadzirisa migumisiro yeDISH.
Sources:
Kelley's Textbook yeRheumatology. Ninth edition. Chitsauko 102. Zvirwere Zvirwere Zvirwere. Reuven Mader.
A primer paRheumatic Diseases. Yegumi nemitatu edition. Pasina Kubatana Arthropathies Kazhinji. Peji 480. Peter A. Merkel. MD