Ƙungiyar Hoto na Clinical Back & Diagnostics Team. Dokta Alex Jimenez yana aiki tare da manyan ƙwararrun masu bincike da ƙwararrun hoto. A cikin ƙungiyarmu, ƙwararrun hoto suna ba da sakamako mai sauri, ladabi da inganci. Tare da haɗin gwiwar ofisoshinmu, muna ba da ingancin sabis na majinyatan mu da kuma cancanta. Hoto na Mashin Lafiya (DOI) cibiyar Radiology ce ta zamani a El Paso, TX. Ita ce kawai cibiyar irinta a cikin El Paso, mallakar wani Masanin Radiyo ne kuma ke sarrafa shi.
Wannan yana nufin lokacin da kuka zo DOI don jarrabawar rediyo, kowane dalla-dalla, daga ƙirar ɗakuna, zaɓin kayan aiki, ƙwararrun fasahar da aka zaɓa da hannu, da software da ke gudanar da ofis, Masanin Radiyo ne ya zaɓa ko tsara shi a hankali. kuma ba ta wani akawu ba. Kasuwar mu ita ce cibiyar inganci. Dabi'un mu masu alaƙa da kulawar haƙuri sune: Mun yi imani da kula da marasa lafiya yadda za mu bi da danginmu kuma za mu yi iya ƙoƙarinmu don tabbatar da cewa kun sami gogewa mai kyau a asibitin mu.
Kashin baya shine lokacin da sarari wani wuri tare ko a cikin kashin baya ya fara raguwa, yana rufe ikon motsi na al'ada / jin dadi da kuma wurare dabam dabam na jijiya. Yana iya rinjayar wurare daban-daban, ciki har da mahaifa/wuyansa, lumbar / ƙananan baya, kuma, ƙasa da ƙasa, yankunan thoracic / babba ko tsakiyar baya haifar da tingling, numbness, cramping, zafi, raunin tsoka, ko haɗuwa a baya, ƙafa / s, cinya, da gindi. Akwai iya zama daban-daban dalilai haddasa stenosis; daidai ganewar asali shine mataki na farko, kuma inda ciwon kashin baya MRI ya zo a cikin.
Spinal Stenosis MRI
Stenosis na iya zama ƙalubalanci don ganewar asali kamar yadda ya fi alama / rikitarwa fiye da yanayin, sau da yawa yakan haifar da fayafai na herniated, ƙasusuwa na kasusuwa, yanayin yanayin haihuwa, bayan tiyata, ko bayan kamuwa da cuta. Hoton rawanin maganadisu/MRI gwaji ne na gama gari da ake amfani da shi wajen ganewar asali.
ganewar asali
Kwararren mai kula da lafiya, kamar chiropractor, likitan kwantar da hankali, ƙwararren kashin baya, ko likita, zai fara da fahimtar alamun bayyanar cututtuka da tarihin likita.
Za a gudanar da jarrabawar jiki don ƙarin koyo game da wurin, tsawon lokaci, matsayi, ko ayyukan da ke raguwa ko kuma cutar da alamun.
Ƙarin gwaje-gwaje sun haɗa da ƙarfin tsoka, samun bincike, da gwajin ma'auni don taimakawa wajen fahimtar inda ciwon ke fitowa.
Don tabbatar da ganewar asali, za a buƙaci hoto don ganin abin da ke faruwa.
Ana amfani da MRI na'urar daukar hoto ta kwamfuta don samar da hotunan da ke nuna kashi da laushi masu laushi, kamar tsokoki, jijiyoyi, da tendons, da kuma idan sun matsa ko fushi.
Masanin kiwon lafiya da MRI mai fasaha zai wuce ka'idodin aminci kafin hoton.
Saboda injin yana amfani da maganadisu masu ƙarfi, ba za a iya samun ƙarfe a jiki ko a cikin jiki, kamar dashen da aka dasa su ko na'urorin da suka haɗa da:
Za a iya amfani da gwajin hoto daban-daban idan mutum ba zai iya samun MRI kamar a CT dubawa.
MRI na iya tafiya daga mintuna da yawa zuwa sa'a ɗaya ko ya fi tsayi, dangane da yawan matsayi da ake bukata don ware yankin da aka ji rauni da kuma samun hoto mai haske. Gwajin ba shi da zafi, amma wani lokacin ana tambayar mutane don kiyaye takamaiman matsayi wanda zai iya zama mara daɗi. Mai fasaha / s zai tambayi idan akwai rashin jin daɗi kuma ya ba da kowane taimako don sauƙaƙa ƙwarewar da zai yiwu.
Jiyya
Ba duk lokuta na stenosis ke haifar da bayyanar cututtuka ba, amma akwai zaɓuɓɓukan magani waɗanda ƙwararrun kiwon lafiya zasu iya ba da shawarar.
Kulawa mai ra'ayin mazan jiya shine shawarwarin farko wanda ya hada da chiropractic, decompression, traction, da gyaran jiki.
Jiyya yana ƙara ƙarfin tsoka, inganta kewayon motsi, inganta matsayi da daidaituwa, rage rashin jin daɗi, kuma ya haɗa da dabarun hanawa da sarrafa alamun.
Magungunan magani na iya zama wani ɓangare na babban shirin jiyya.
Tiyata na iya zama zaɓi a cikin mafi tsanani lokuta inda kulawar mazan jiya ba ta aiki.
Spinal Stenosis
References
Database of Abstracts of Reviews of Effects (DARE): Nazari masu inganci [Internet]. York (Birtaniya): Cibiyar Bincike da Watsawa (Birtaniya); 1995-. Sakamakon ganewar ƙwayar cuta na lumbar: sabuntawa na yau da kullum game da daidaiton gwaje-gwajen bincike. 2013. Akwai daga: www.ncbi.nlm.nih.gov/books/NBK142906/
Ghadimi M, Sapra A. Magnetic Resonance Hoto Contraindications. [An sabunta 2022 Mayu 8]. A cikin: StatPearls [Internet]. Tsibirin Treasure (FL): Bugawa na StatPearls; 2022 Jan-. Akwai daga: www.ncbi.nlm.nih.gov/books/NBK551669/
Gofur EM, Singh P. Anatomy, Back, Vertebral Canal Blood Supply. [An sabunta 2021 Jul 26]. A cikin: StatPearls [Internet]. Tsibirin Treasure (FL): Bugawa na StatPearls; 2022 Jan-. Akwai daga: www.ncbi.nlm.nih.gov/books/NBK541083/
Lurie, Jon, da Christy Tomkins-Lane. "Gudanar da ciwon lumbar spinal stenosis." BMJ (binciken asibiti ed.) vol. 352 h6234. 4 ga Janairu, 2016, doi:10.1136/bmj.h6234
Stuber, Kent, et al. "Maganin chiropractic na lumbar kashin baya: bita na wallafe-wallafe." Jaridar maganin chiropractic vol. 8,2 (2009): 77-85. doi:10.1016/j.jcm.2009.02.001
Chiropractors da ƙwararrun kashin baya suna amfani da hotunan kashin baya ta hanyar radiyon X, MRIs, ko CT don gano abin da ke haifar da matsalolin baya da ciwo. Hoto na kowa. Ko chiropractic ko tiyata na kashin baya, suna taimakawa sosai gano abubuwan da suka shafi baya kuma suna ba da damar mutum ya ga abin da ke faruwa. Nau'in shari'o'in sun haɗa da ciwon baya cewa:
Likitoci suna amfani da waɗannan hotunan lokacin bincikar yanayin kashin baya. Anan akwai ƙarin haske game da hoton kashin baya.
Harkokin X
X-ray don ciwon baya na iya zama da taimako sosai. An X-ray yana dogara ne akan radiation kuma ana amfani dashi don bincika yanayin tsarin kashi. Hoton X-ray yana da kyau ga nama na kashi ko kyallen da aka yi wa ossified ko calcified. Suna aiki mafi kyau tare da kyallen takarda, musamman ƙasusuwa. Nama mai laushi kamar tsokoki, ligaments, ko fayafai na intravertebral ba su samuwa kuma.
Mutanen da ke yin X-ray na baya za a duba su ta injin da ke haifar da katako. Mai karɓa yana ɗaukar katako bayan ya wuce ta jiki kuma ya haifar da hoto. Yana ɗaukar kusan mintuna biyar don kammalawa amma zai iya daɗe ya danganta da adadin hotunan likitan. Hasken X-ray yana taimakawa don dalilai na inshora kuma yana kawar da yanayin ƙasusuwa kamar raunin da ya faru da / ko ƙashi. Ana yin odar X-ray don wasu dalilai na musamman kuma galibi wani bangare ne na binciken gano cutar gaba daya. Wannan ya haɗa da MRI da/ko CT scan.
CT Scan
CT yana nufin lissafin tomography. Silsilar X-ray ne da aka ƙirƙira su cikin hotuna ta amfani da kwamfuta. Amfanin CT scan zuwa daidaitattun haskoki na X shine cewa yana ba da ra'ayoyi / kusurwoyi daban-daban na jiki kuma yana iya kasancewa cikin 3D. An fi amfani da CT scans a lokuta masu rauni ko mutanen da aka yi wa tiyata. Suna ɗaukar kusan mintuna biyar. Don haskoki na X-ray, daidaikun mutane suna tsaye ko kwance a ƙarƙashin na'urar X-ray yayin da take duba jikin. CT scan yana sa mutum ya kwanta a cikin na'ura mai kallon donut mai da'irar da ke dubawa yayin juyawa yayin hoton. Ana ba da shawarar ɗaiɗaikun su sa kayan sawa na yau da kullun, sutura masu daɗi. Wani lokaci ana amfani da rini, ko bambanci na jijiya, don samun kyallen jikin jijiyoyin jini su fita waje, samar da mafi bayyanan hotuna.
MRI
MRI takaice don Magnetic rawa imaging. MRIs suna amfani da maganadisu don samar da hotuna. Ana amfani da hoton MRI sau da yawa a cikin mutanen da aka yi wa tiyata. Suna ɗaukar tsayi, yawanci kusan mintuna 30 zuwa 45. Ba a yarda da abubuwa na ƙarfe a cikin MRI ba. Ana tambayar marasa lafiya su cire abubuwa kamar bel, kayan ado, da sauransu. Rini na bambanci na iya zama wani ɓangare na MRI. Injin kamar rami ne. Wannan na iya zama kalubale ga mutanen da ke da claustrophobia. Tuntuɓi likita kuma gano yadda za a sami kwanciyar hankali yayin aikin.
Sauran Siffofin Hoto na Spinal
Sauran nau'ikan hoto sun haɗa da:
CT kewayawa
CT kewayawa yana nuna ainihin CT scans yayin aikin.
Fluoroscopy
Fluoroscopy ya ƙunshi katako na X-ray wanda ke wucewa kai tsaye ta jiki wanda ke nuna hotuna masu rai, masu motsi.
Duk waɗannan nau'ikan hotunan kashin baya ana amfani dasu yayin tiyata. Ga wasu lokuta, intraoperative hoto ana amfani da shi. Irin wannan hoton yana amfani da injina na fasaha na zamani don taimakawa likitocin fiɗa su kewaya ta wurare masu tsauri yayin aikin. Wannan yana ƙara daidaiton likitan fiɗa kuma yana rage girman ƙaddamarwa.
Duban dan tayi
Ana iya amfani da duban dan tayi don yanayin kashin baya. Wannan gwajin hoto ne wanda ke amfani da igiyoyin sauti don samar da hotuna. Koyaya, gwaje-gwajen hoto waɗanda aka yi amfani da su a cikin hoto na kashin baya sune na farko X-ray da MRIs.
Hoto Alƙawari
Yi magana da likitan ku ko chiropractor kafin lokaci don fahimtar abin da za ku yi tsammani yayin aiwatar da hoto. Za su sanar da ku yadda ake shiryawa da kowane umarni na musamman kafin alƙawari. Tare da tarihin likita da jarrabawar jiki, hotunan kashin baya wani muhimmin bangare ne na tsarin bincike don gano abin da ke haifar da ciwo da kuma inganta tsarin kulawa mafi kyau.
Jiki Shafi
Illolin Kofi da Hawan Jini na ɗan lokaci
Caffeine a cikin kofi wani abu ne mai kara kuzari ko abin da ke motsa tsarin jiki. Lokacin amfani da maganin kafeyin, mutane suna samun karuwa a cikin farin ciki, musamman a cikin tsarin zuciya da jijiyoyin jini. Wannan tashin hankali yana haifar da bugun zuciya da hawan jini ya tashi sannan ya ragu baya zuwa matakin tushe ga mutane masu lafiya. Kofi kadan yana ƙara hawan jini na ɗan gajeren lokaci. Matsakaicin shan kofi yana da lafiya ga mutanen da ba su da yanayin cututtukan zuciya da suka gabata.
Wannan taƙaitaccen bita ne na wasu mahimman gunaguni na yara da aka fuskanta a aikin asibiti.
Mugun rauni gami da ciwon kai mai tsanani
Cutar da ba hatsari ba a cikin yara (yaron da aka yi masa duka)
Ƙorafi na Musculoskeletal (Juvenile Idiopathic Arthritis, scoliosis,
Na yau da kullun na neoplasms na yara (CNS da sauransu)
kamuwa da cuta
Cutar cututtuka
Mugun rauni na Yara:
Raunin FOOSH (misali, fadowa daga sandar biri)
Supracondylar Fx, gwiwar hannu. Koyaushe d/t rauni na bazata. <10-yo
Extra-articular Fx
Gartland rarrabuwa maki a ɗan gudun hijira da dabara raunin da aka bi da tare da sauki immobilization vs. na baya gwiwar hannu dislocation bi da operatively
Haɗarin haɓakar ischemic idan an jinkirta kulawa (Volkmann contracture)
Jarabawar rediyo yana da mahimmanci: alamar jirgin ruwa da alamar kushin mai na baya tare da layin humeral na baya sun kasa shiga tsakiyar/2/3 na Capitellum.
Fx na yara bai cika ba:
Mafi yawa a cikin <10 yo Greenstick, Torus, Plastick aka nakasa Bowing
Yawanci ana warkewa da kyau, ana kula da su ta hanyar rashin motsi
Nakasar filastik idan> 20-digiri na buƙatar rage rufaffiyar
Karyewar kwanyar Ping pong na iya tasowa bayan rauni, tilasta haihuwa da rikitarwa na raunin haihuwa. Mai yiwuwa ya buƙaci a tantance ta wurin likitan yara neurosurgeo.n
Salter-Harris nau'ikan raunin farantin girma na physeal
Nau'in 1- zamewa. misali, Slipped Capital Femoral Epiphysis. Yawanci ba a lura da karaya ba
Nau'in 2-M / C tare da tsinkaye mai kyau
Nau'in 3- intra-articular, don haka yana ɗaukar haɗarin da wuri osteoarthritis kuma yana iya buƙatar kulawar aiki d/t kasancewar rashin kwanciyar hankali
Nau'in 4- Fx ta duk yankuna game da physis. Hasashen mara kyau da rage gaɓoɓi
Nau'i na 5- sau da yawa babu shaida na ainihin karayar kashi. Rashin hasashe mai rauni d/t murkushe rauni da lalacewar jijiyoyin jini tare da rage gaɓoɓi
Ƙimar hoto yana da mahimmanci
Rauni mara Hatsari (NAI) a cikin Yara
Akwai nau'ikan cin zarafin yara daban-daban. Cin zarafi na jiki na iya kasancewa daga raunin fata zuwa daban-daban na MSK / raunin tsarin da ke shafar ƙasusuwa da kyallen takarda. Hoto yana da mahimmanci kuma yana iya gano takamaiman alamun faɗakar da ma'aikatan kiwon lafiya da sanar da sabis na kare yara da hukumomin tilasta doka game da cin zarafi na jiki.
A cikin jariri: Ciwon jariri na girgiza yana iya nunawa tare da alamun CNS d/t yaga jijiyoyin da ba su balaga ba da hematoma na subdural wanda zai iya zama m. Zubar da jini na hanji sau da yawa alama. Babban CT yana da mahimmanci.
Tutocin Radiyo na MSK:
1) Babban kashi Fx a cikin ƙaramin yaro mara lafiya (0-12 mo)
2) Haƙarƙari na baya Fx: a zahiri bai taɓa faruwa d/t hadurran ba. Mafi yuwuwar hanyoyin: kamawa da matse yaro ko buga kai tsaye.
3) Karaya da yawa tare da adadin waraka na zamani daban-daban, watau, kiran kashi wanda ke nuni da maimaita raunin jiki.
4) Metaphyseal kusurwa Fx aka Bucket rike Fx, sau da yawa pathognomonic ga NAI a cikin yara. Yana faruwa lokacin da aka riƙe ƙarshen abin da ya shafa kuma an murƙushe shi da ƙarfi.
5) Karya dogayen kasusuwa ga karamin yaro wani misali ne na NAI.
Wasu mahimman bayanai na NAI. Tarihin da bai dace ba wanda masu kulawa/masu kulawa suka bayar. Babu wata shaida da ke nuna rashin daidaituwar ƙashi na haihuwa ko na rayuwa kamar Osteogenesis Imperfecta ko Rickets/osteomalacia da dai sauransu.
NB Lokacin da masu kula da yara suka faɗi tarihin da ke ba da rahoton faɗuwa da hatsarori a cikin gida, Yana da mahimmanci a san cewa a fili yawancin hatsarori da faɗuwa a cikin gida ba safai ba ne ko kuma da wuya su haifar da babban karyewar kashi.
Juvenile Idiopathic Arthritis (JIA)-la'akari da M/C na kullum cuta na yara. Clinical Dx: ciwon haɗin gwiwa / kumburi na 6-makonni ko fiye a cikin yaro <16-yo Akwai nau'i daban-daban: Dx na farko yana da mahimmanci don hana jinkirta rikitarwa
Mafi sanannun nau'ikan JIA:
1) Cutar cutar pauciarticular (40%) - m / c nau'in JIA. 'Yan mata suna cikin haɗari mafi girma. Yana gabatarwa a matsayin arthritis a cikin <4 gidajen abinci: gwiwoyi, idon sawu, wuyan hannu. Elbow. Wannan nau'in yana nuna babban haɗin gwiwa tare da shigar da ido kamar iridocyclitis (25%) wanda zai iya haifar da makanta. Labs: RF-ve, ANA tabbatacce.
2) Cututtukan polyarticular (25%): RF-ve. 'Yan mata suna cikin haɗari mafi girma. Yana shafar ƙanana da manyan haɗin gwiwa sau da yawa yana shafar kashin mahaifa
3) Tsarin tsarin JIA (20%): sau da yawa yana gabatar da bayyanar cututtuka mai tsanani kamar zazzaɓi, arthralgias, myalgias, lymphadeno [hanyoyi, hepatosplenomegaly, polyserositis (pericardial/pleural effusion). Muhimmiyar Dx yana fasalta ƙwaƙƙwaran ƙazamin ruwan hoda mai ƙanƙara a kan iyakar da gangar jikin. Siffar tsarin tana da ƙarancin shigar ido. Haɗuwa yawanci takalma babu yazara idan aka kwatanta da sauran nau'ikan. Don haka lalata haɗin gwiwa ba a saba gani ba
Hoton in JIA
Zubar da haɗin gwiwa kashi overgrowth squaring na patella guringuntsi/ zaizayar ƙashi superimposed DJD
Yatsu da dogayen ƙasusuwa da wuri rufewar jiki/rage gaɓoɓi
Rad DDx gwiwa / idon kafa: Hemophilic arthropathy Rx: DMARD.
Matsaloli na iya haifar da lalata haɗin gwiwa, haɓaka haɓakawa / rage gaɓoɓin hannu, makanta, rikice-rikice na tsarin, nakasa.
Mafi Yawan Ciwon Ciwon Yara na Kashi Neoplasms
Osteosarcoma (OSA) & Ewing's sarcoma (ES) su ne 1 st da 2nd M / C ƙananan ƙananan ƙananan ƙananan ƙananan ƙananan ƙananan ƙananan yara (kololuwa a 10-20 yo) A asibiti: ciwon kashi, canji a cikin aiki, farkon metastasis musamman na huhu na iya faruwa. Rashin hasashe
Ewing zai iya kasancewa tare da ciwon kashi, zazzabi da haɓakar ESR/CRP kamuwa da cuta. Dx na farko tare da hoto da tsarawa suna da mahimmanci.
Hoton OSA & ES: x-ray, biye da MRI, CT kirji, PET/CT. A kan x-ray: OSA na iya rinjayar kowane kashi amma mafi yawan kasancewa a matsayin ƙashi mai tsanani da ke haifar da neoplasms game da gwiwa (50%) musamman kamar yadda osteoid ke haifar da mummunan rauni a cikin metaphysis tare da speculated / sunburst periostitis & Codman triangle. Alamar mamaye nama mai laushi.
ES na iya kasancewa a cikin ramin kuma ya nuna yaduwa mai laushi da wuri. MRI yana da mahimmanci don bayyana girman kashi da ST mamayewa, MRI da ake buƙata don shirin tiyata
OSA & ES Rx: Haɗin tiyata, radiation, chemo. Ana yin dabarun ceton hannu a wasu lokuta. Rashin hasashe idan an gano shi a makara.
Hoton Ewing's sarcoma
Shagaltuwar kashi
Farko da yawa mamayewar nama mai laushi
M periosteal dauki tare da laminated (albasa fata) amsa
Saucerisation na cortical kashi (kiban orange)
Lesion yawanci diaphyseal ne tare da tsawaita metaphyseal
An san shi azaman ƙwayar ƙwayar ƙwayar ƙwayar cuta tare da Multiple Myeloma da Lymphoma
Maganganun Yaro gama gari
Neuroblastoma (NBL) M/C rashin lafiyar jariri. Ya samo daga ƙwayoyin jijiyoyi na jijiyoyi aka PNET (misali, ganglia mai tausayi). Yawancin suna faruwa a cikin yara <24-watanni. Wasu suna nuna kyakkyawan hasashe amma> 50% lokuta suna tare da ci-gaba cuta. 70-80% a shekaru 18-watanni ko fiye suna tare da ci-gaba metastasis. NBL na iya haɓakawa a cikin medulla na adrenal, ganglia mai tausayi da sauran wurare. Yana gabatarwa azaman ƙwayar ciki, amai. > 50% yana gabatar da ciwon kashi d/t metastasis. A asibiti: jarrabawar jiki, dakunan gwaje-gwaje, hoto: kirji da kuma abd x-ray, CT ciki da ƙirji suna da mahimmanci ga Dx. MRI na iya taimakawa. NBL na iya daidaitawa zuwa kwanyar kuma ya shigar da sutures tare da sifa mai siffa azaman cututtukan sutural diastasis.
Murar cutar sankarar Lymphoblastic mai m shine m/c malignancy na yara. Pathology: ƙwayar cutar sankarar bargo na ƙwayar kasusuwa wanda ke haifar da ciwon kashi da maye gurbin sauran kwayoyin halitta na al'ada tare da anemia, thrombocytopenia, neutropenia da rikice-rikice masu dangantaka. Kwayoyin cutar sankarar bargo na iya kutsawa cikin wasu rukunin yanar gizo da suka hada da CNS, saifa, kashi da sauran yankuna. Dx: CBC, matakan jini na lactate dehydrogenase, biopsy buri na kasusuwa shine mabuɗin. Hoto na iya taimakawa amma ba mahimmanci ga ganewar asali ba. A kan rediyo, kutsewar cutar sankarar bargo na kashi na iya zama yawanci bayyana azaman makaɗaɗɗen radiyo tare da farantin girma na physeal. Rx: chemotherapy da magance rikitarwa
Medulloblastoma: M / C m CNS neoplasm a cikin yara
Yawancin suna haɓaka kafin 10-yo
M/C wurin: cerebellum da fossa na baya
A tarihi yana wakiltar nau'in ciwon daji na PNET ba glioma ba kamar yadda aka yi tunani a farko
MBL, da Ependymoma da CNS lymphoma, na iya haifar da sauke metastasis ta hanyar CSF kuma suna wakiltar wani na musamman wanda ba kamar sauran ciwace-ciwacen CNS ba suna nuna yaduwar ƙwayar cuta a waje da CNS, m / c zuwa kashi.
50% na MBL na iya zama cikakkiyar sakewa
Idan Dx da jiyya sun fara kafin metastasis, rayuwa na shekaru 5 shine 80%
Hoto yana da mahimmanci: Ana iya amfani da sikanin CT amma yanayin hoton zaɓi shine MRI wanda zai kuma ba da ƙarin ƙimar ƙimar gabaɗayan neuraxis don metastasis.
MBL yawanci yana bayyana azaman nau'in hypo, iso da ciwon hyperintense akan T1, T2 da FLAIR scans (hotunan sama) idan aka kwatanta da naman kwakwalwa da ke kewaye. Sau da yawa matsawa 4th ventricle tare da obstructive hydrocephalus. Ciwon daji yawanci yana nuna haɓakar bambanci akan T1+C gad (hoton hagu na ƙasa). Sauke metastasis daga MBL tare da T1+C mai haɓaka rauni a cikin igiya
Muhimman Cututtukan Yara
A cikin jariri/jariri <1month: zazzabi>100.4 (38C) na iya nuna kamuwa da cutar kwayan cuta da wasu ƙwayoyin cuta. Strep B, Listeria, E. Coli na iya haifar da sepsis, meningitis. Hanya: x-ray na kirji, huda lumbar tare da al'ada, al'adun jini, CBC, nazarin fitsari.
A cikin ƙananan yara, nau'in mura na Hemophilus na B (HIB) na iya haifar da Epiglottitis mai wuya amma mai tsanani. Alurar riga kafi na yanzu yana taimakawa wajen rage adadin cutar Epiglottitis da sauran cututtuka masu alaƙa da HIB.
Parainfluenza ko RSV Kwayar cuta na iya haifar da Croup ko m Laryngotracheobronchitis.
Epiglottitis da Croup sune Dx na asibiti amma AP da wuyansa mai laushi na gefe x-haskoki suna taimakawa sosai
Epiglottis yana gabatar da sifa mai alamar yatsan yatsa wanda ya yi daidai da kauri epiglottis d/t epiglottic edema. Wannan na iya zama hanyoyin gaggawar da ke barazana ga rayuwa (saman hagu)
Croup na iya nuna alamar steeple ko alamar kwalban ruwan inabi tare da distended hypopharynx azaman matsananciyar kunkuntar hanyar iska ta subglottic akan AP da x-ray na gefe mai laushi (saman dama)
Kwayar cutar Syncytia na numfashi (RSV) da mura na iya haifar da ciwon huhu na hoto ko bidiyo mai zagaya yanar gizo da sauri mai yuwuwa tare da rikice-rikice masu barazanar rayuwa a cikin marasa lafiya, ƙanana da yara masu kamuwa da cuta. CXR yana da mahimmanci (hagu ta tsakiya)
Streptococcal pharyngitis tare da ciwon GABHS na iya haifar da wasu rikice-rikice masu tsanani ko jinkirta (misali, zazzabin Rheumatic)
Peritonsillar ƙurji (a sama na tsakiya dama) na iya haɓakawa a wasu lokuta kuma ya zama mai rikitarwa ta hanyar yada tare da jirage masu laushi a cikin wuyansa wanda zai iya haifar da yadawa zuwa cikin sublingual / submandibular spaces (Ludwig Angina) lokacin da hanyoyin iska suna buƙatar sarrafa d / t tushe na edema harshe.
Haɓaka ƙwayar ƙwayar cuta na retropharyngeal na iya haifar da yaduwar kamuwa da cuta ta hanyar sadarwa na wuyan hannu kyauta wanda ke haifar da necrotizing mediastinitis, Lemmier ciwo da mamaye wuraren carotid (duk suna da yiwuwar rikitarwa masu haɗari).
Grisel Syndrome- (sama da hagu na hagu) Rashin rikitarwa na cututtukan tonsillar na yanki / pharyngeal na baka wanda zai iya yada zuwa sararin prevertebral wanda zai haifar da C1-2 ligaments laxity da rashin zaman lafiya.
Sauran cututtuka masu mahimmanci a cikin yara sun hada da ciwon huhu na huhu (Pneumococcal), ciwon huhu da ƙwayar fitsari da kuma Pyelonephritis mai tsanani (musamman a cikin 'yan mata) da Meningococcal Meningitis.
Ciwon Jiki na Yara
Rickets: an yi la'akari da osteomalacia a cikin skeletally rashin girma. Yankin ƙididdiga na wucin gadi na farantin girma na epiphyseal ya shafi musamman
A asibiti yana ba da jinkirin girma, ruku'u na iyaka, rosary mai rachitic, ƙirjin tattabara, haƙarƙari, girma da kumbura wuyan hannu, da idon sawu, nakasar kwanyar.
Pathology: Vit D da ƙarancin calcium shine dalilin m / c. Rashin fitowar rana esp. mutum mai duhun fata, ƙuntataccen sutura ga haske, tsawaita shayarwa na musamman, cin ganyayyaki, cututtukan hanji, lalacewar koda da sauransu.
Hoto: frayed metaphysis aka fenti metaphysis fenti tare da walƙiya, faɗaɗa farantin girma, mahadar costochondral bulbous azaman rosary rachitic, ruku'u mai tsayi.
Rx: bi da dalilai na asali, daidaitaccen ƙarancin abinci mai gina jiki, da sauransu.
Rashin al'ada na gastrointestinal maƙarƙashiya (esophagus, ciki, ƙananan & babban hanji, da ƙari)
Abubuwan da ba a saba da su ba na kayan abinci masu narkewa (cututtukan Hepatobiliary & pancreatic)
Rashin al'ada na genitourinary & gabobin haihuwa
Rashin al'ada na bangon ciki da manyan tasoshin
Wannan gabatarwa yana nufin samar da mafi mahimmancin fahimtar gabaɗaya ganewar asali kusanci da kulawar da ya dace na asibiti na marasa lafiya tare da cututtukan da suka fi yawa na ciki
Hanyoyin hoto da aka yi amfani da su yayin bincike na gunaguni na ciki:
AP ciki (KUB) da kuma madaidaiciyar CXR
Binciken CT na ciki (tare da bambancin baka da na IV da w / o bambanci)
Haɗa kimantawar farko na iskar hanji a cikin yanayin gaggawa. Misali, binciken mara kyau a cikin ƙaramin yuwuwar mai haƙuri na iya kawar da buƙatar CT ko wasu hanyoyin ɓarna.
Kimanta bututun rediyopaque, layuka, da jikin waje na rediyopaque
Bayan aiwatar da kimantawa na intraperitoneal/retroperitoneal gas kyauta
Kula da adadin iskar hanji da ƙuduri na postoperative (adynamic) ileus
Kulawa da nassi na bambanci ta cikin hanji
Nazarin zirga-zirgar mulkin mallaka
Kula da lissafin koda
Abin da za a lura akan Ciki na AP: Supine vs. Madaidaici vs. Decubitus
Free Air (pneumoperitoneum)
Ƙunƙarar hanji: madaukai masu lalacewa: SBO vs LBO (dokar 3-6-9) SB- babba iyaka-3-cm, LB-naman iyaka-6-cm, Caecum- babba iyaka-9-cm. Bayanan hasara na haustra, bayanin kula (gabatar) na valvule conivente (plica semilunaris) a cikin SBO
SBO: lura da tsayi daban-daban matakan ruwa-ruwa akan matakan matakan fim madaidaiciya, kamannin SBO
Lura ƙarancin iskar dubura/maɓalli (wanda aka kwashe) a cikin SBO
Binciken CT na ciki -Hanyoyin zaɓin zaɓi yayin bincike na ƙararrakin ciki da kuma na yau da kullun musamman a cikin manya. Alal misali, ana iya samun nasarar gano cutar ciwon ciki da kuma tsara tsarin samar da bayanan asibiti don tsara kulawa
Ciki, na koda da duban dan tayi Ana iya yin shi don taimakawa wajen gano cutar appendicitis (esp. a cikin yara), m & na kullum jijiyoyin bugun gini Pathology, hepatobiliary abnormalities, obstetric da gynecological Pathology.
Ya kamata a rage yawan amfani da ionizing radiation (x-ray & CT) a cikin yara da sauran ƙungiyoyi masu rauni.
Binciken Bincike na Manyan Cututtuka na Tsarin Gastrointestinal
1) Ciwon ciki
2) Gastric carcinoma
3) Gluten Sensitive Enteropathy
4) Ciwon hanji mai kumburi
5) Pancreatic ductal adenocarcinoma
6) Cutar sankarau
7) Ciwon ciki mai tsanani
8) Karamin toshewar hanji
9) Volvulus
Ciwon ciki
Achalasia (achalasia na farko): gazawar tsarin peristalsis na esophageal d / t naƙasasshen shakatawa na ƙananan ƙwayar ƙwayar cuta (LOS) tare da alamar dilatation na esophagus da stasis na abinci. Toshewar esophagus mai nisa (sau da yawa saboda ƙari) an kira shi "achalasia na biyu" ko "pseudoachalasia." Peristalsis a cikin sashin tsoka mai santsi na esophagus na iya ɓacewa saboda rashin daidaituwa na Auerbach plexus (wanda ke da alhakin shakatawa mai santsi) . Vagus neurons kuma na iya shafa
Farko: 30 -70s, M: F daidai
Cutar Chagas (Trypanosoma Cruzi kamuwa da cuta) tare da lalata Myenteric plexus neurons na tsarin GI (megacolon & esophagus)
Duk da haka, zuciya ita ce sashin da ya shafi M/C
A asibiti: Dysphagia ga duka daskararru da ruwaye, idan aka kwatanta da dysphagia don daskararru kawai a lokuta na carcinoma na esophageal. Ciwon kirji da regurgitation. M/C tsakiyar esophageal squamous cell carcinoma a cikin kusan 5% saboda rashin jin daɗi na mucosa na yau da kullun ta hanyar tsayawar abinci da ɓoyewa. Ciwon huhu na iya tasowa. Candida esophagitis
Hoto: �Tsuntsaye-beak� akan babban GI barium swallow, faduwar esophagus, asarar peristalsis. Gwajin endoscopic yana da mahimmanci.
Rx: wahala. Calcium tashar blockers (gajeren lokaci). Allurar gubar Botulinum tana ɗaukar kusan kusan. Watanni 85 a kowace magani. Yana iya cutar da submucosa wanda zai haifar da ƙarin haɗarin ɓarna yayin myotomy na gaba. Myotomy na tiyata (Heller myotomy)
10-30% na marasa lafiya suna haɓaka reflux gastroesophageal (GERD)
Presbyesophagus: da aka yi amfani da shi don bayyana bayyanar cututtuka na aikin motsa jiki a cikin tsofaffin esophagus> 80-yo Saboda katsewar arc reflex tare da raguwar hankali ga distension da canji a cikin peristalsis.
Marasa lafiya na iya yin gunaguni na dysphagia ko ciwon ƙirji, amma yawancin suna asymptomatic
Yaduwa/Distal esophageal spasm (DES) cuta ce ta motsi na esophagus wanda zai iya bayyana azaman abin toshe baki ko rosary bead esophagus akan hadiye barium.
2% na ciwon ƙirji mara zuciya
Manometry shine gwajin gwajin ma'aunin gwal.
Zenker diverticulum (ZD) aka jakar pharyngeal
Fitowa a matakin hypopharynx, kusa da babban sphincter na esophageal, wanda ake kira Killian dehiscence ko Killian triangle.
Marasa lafiya suna 60-80 yo kuma suna tare da dysphagia, regurgitation, halitosis, jin globus
Zai iya yin rikitarwa tare da buri da rashin daidaituwa na huhu
Marasa lafiya na iya tara magunguna
ZD- shi ne pseudodiverticulum ko pulsion diverticulum sakamakon herniation na submucosa ta hanyar Killian dehiscence, samar da jakar inda abinci da sauran abubuwan ciki zasu iya taruwa.
Mallory-Weiss ciwo yana nufin hawayen mucosal da submucosal na ɗigon jini na oesophageal venous plexus mai alaƙa da tashin hankali retching / amai da tsinkayar abubuwan ciki a kan ƙananan esophagus. Masu shaye-shaye suna cikin haɗari na musamman. Abubuwan da ke faruwa tare da hematemesis mara zafi. Jiyya yawanci tallafi ne.
Dx: Hoto yana taka rawa kadan, amma bambancin esophagram na iya nuna wasu hawaye na mucosal cike da bambanci (hoton dama na kasa). Binciken CT na iya taimakawa wajen ware wasu abubuwan da ke haifar da zubar jini na GI
Boerhaave ciwo: fashewar esophageal na biyu zuwa amai mai ƙarfi
Hanyoyi sun haɗa da fitar da abin da ke cikin ciki da ƙarfi musamman tare da manyan abinci marasa narkewa lokacin da esophagus da ƙarfi ya yi yarjejeniya da rufaffiyar glottis tare da 90% yana faruwa tare da bangon baya na hagu.
Hiatus hernias (HH): herniation na abun ciki na ciki ta hanyar katsewar esophageal na diaphragm a cikin rami na thoracic.
Yawancin marasa lafiya da ke da HH ba su da asymptomatic, kuma bincike ne na bazata. Duk da haka, alamun bayyanar cututtuka na iya haɗawa da epigastric / ciwon ƙirji, cikawa na postprandial, tashin zuciya da amai
Wani lokaci ana ɗaukar HH daidai yake da cututtukan gastro-oesophageal reflux (GORD), amma akwai rashin daidaituwa tsakanin yanayin biyu!
2-iri: zamiya hiatus hernia 90% & rolling (paraoesophageal) hernia 10%. Wannan na iya haifar da ischemia da rikitarwa.
Esophageal Leiomyoma shine M/C benign esophageal neoplasm. Yawancin lokaci yana da girma amma duk da haka ba ya hana. Ciwon daji na hanji (GIST) sune mafi ƙanƙanta a cikin esophagus. Ya kamata a bambanta daga Esophageal carcinomas.
Hoto: bambanci esophagram, babba GI barium haɗiye, CT scanning. Gastroesophagoscopy shine hanyar Dx na zabi.
Ciwon daji na Esophageal: an gabatar da shi tare da haɓaka dysphagia, da farko zuwa daskararru da ci gaba zuwa ruwa tare da toshewa a cikin lokuta masu tasowa
<1% na duk cututtukan daji da 4-10% na duk cututtukan GI. An san girman girman mazaje tare da nau'in kwayar halitta ta squamous saboda shan taba da barasa. Barrett esophagus da adenocarcinoma
M: F 4:1. Baƙaƙen mutane sun fi kamuwa da fararen fata 2:1. Rashin hasashe!
Haɗewar barium na iya zama mai hankali wajen gano yawan ƙwayar hanji. Gastroesophagoscopy (endoscopy) yana tabbatar da ganewar asali tare da biopsy nama
Squamous cell ana samun yawanci a tsakiyar esophagus, Adenocarcinoma a cikin yanki mai nisa
Ciwon daji na ciki: na farko malignancy na ciki epithelium. Rare kafin shekaru 40. Tsakanin shekarun da aka gano a cikin Amurka shine shekaru 70 ga maza da shekaru 74 ga mata. Japan, Koriya ta Kudu, Chile, da kasashen gabashin Turai suna daya daga cikin mafi yawan masu fama da cutar kansar ciki a duniya. Yawan ciwon daji na ciki yana raguwa a duniya. Ciwon daji na ciki shine sanadi na 5 na mutuwar da ke da alaƙa da kansa. Haɗin kai tare da kamuwa da cutar Helicobacter pylori 60- 80%, amma kawai 2% yawan mutanen da ke da H. Pyloris suna haɓaka ciwon daji na ciki. 8-10% suna da bangaren iyali da aka gada.
Hakanan Lymphoma na ciki yana da alaƙa da kamuwa da cutar H. Pyloris. Gastrointestinal Stromal Cell Tumor ko GIST wani neoplasm ne da ke shafar ciki
A asibiti: Babu alamun bayyanar cututtuka lokacin da yake sama kuma yana iya warkewa. Har zuwa 50% na marasa lafiya na iya samun gunaguni na GI marasa takamaiman. Marasa lafiya na iya gabatar da anorexia da asarar nauyi (95%) da kuma ciwon ciki mara kyau. Tashin zuciya, amai, da farkon satiety d/t toshewa na iya faruwa tare da manya-manyan ciwace-ciwace ko raunin da ya faru wanda ke cutar da kumburin ciki.
Hasashen: Yawancin cututtukan daji na ciki an gano su a makare kuma suna iya bayyana mamayewar gida tare da adenopathy na yanki, hanta, da yaduwar mesenteric. Adadin rayuwa na shekaru 5 na 20% ko ƙasa da haka. A Japan da Koriya ta Kudu, shirye-shiryen tantancewa da wuri sun karu da rayuwa zuwa 60%
hoto: Barium babba GI binciken, CT scanning. Binciken endoscopic shine hanyar zaɓi don ganewar asali. A kan Hoto, Ciwon daji na ciki na iya bayyana azaman nau'in exophytic (polypoid) ko nau'in Fungative, Ulcerative ko Infiltrative/nau'in yaduwa (Linitis Plastica). Binciken CT yana da mahimmanci don kimanta mamayewar gida (nodes, mesentery, hanta, da sauransu).
Celiac cuta aka wadanda ba na wurare masu zafi sprue aka Gluten-sensitive enteropathy: T-cell mai daidaitawa autoimmune na yau da kullun wanda ya haifar da lalacewar mucosal wanda ke haifar da asarar villi a cikin ƙananan hanji na kusa da malabsorption na gastrointestinal (watau sprue). Ana la'akari da shi a wasu lokuta na ƙarancin ƙarfe anemia na dalilin da ba a tantance ba. Na kowa a cikin Caucasians (1 a cikin 200) amma ba kasafai ba a cikin mutanen Asiya da baƙi. Kololuwa biyu: ƙaramin gungu a farkon ƙuruciya. Yawanci a cikin shekaru 3rd da 4th na rayuwa.
A asibiti: Ciwon ciki shine alamar m / c, malabsorption na abubuwan gina jiki / bitamin: IDA da guaiac-positive stools, zawo, maƙarƙashiya, steatorrhea, asarar nauyi, osteoporosis / osteomalacia, dermatitis herpetiformis. Ƙarfafa haɗin gwiwa tare da lymphoma na T-cell, Ƙarfafa haɗin gwiwa tare da ciwon daji na squamous cell carcinoma, SBO.
Dx: Babban GI endoscopy tare da biopsies duodenal da yawa ana ɗaukar a ma'aunin bincike don cutar celiac. Histology ya nuna shigar T-cell da lymphoplasmacytosis, Villi atrophy, Crypts hyperplasia, Submucosa, da Serosa sun tsira. Rx: kawar da samfurori masu dauke da alkama
Hoto: Ba a buƙata don Dx amma akan Barium haɗiye fluoroscopy: atrophy na mucosal da shafewar mucosal folds (ci gaba kawai). SB dilation shine mafi yawan ganowa. Nodularity na duodenum (bubbly duodenum). Juyawa na jejunal da na gida mucosal folds:
�A jejunum yayi kama da ileum, gida kuma yayi kama da jejunum, duodenum kuma yayi kama da jahannama.
CD: na kullum relapsing-remitting autoimmune kumburi da shafi kowane bangare na GI fili daga baki zuwa dubura amma a farkon mafi yawanci ya shafi m ileum. Gabatarwar M/C: ciwon ciki/ciwon ciki da gudawa. Hanya: granulomata samuwar wanda ba kamar UC ba shine transmural, mai yuwuwar haifar da tsauraran matakai. Wuraren da kumburin ya shafa yawanci ba su da ƙarfi
Matsaloli suna da yawa: malabsorption na abinci mai gina jiki / bitamin (anemia, osteoporosis, jinkirin ci gaba a cikin yara, mai saukin kamuwa da cutar GI, toshewar hanji, samuwar fistula, bayyanar cututtuka na ciki: uveitis, arthritis, AS, erythema nodosum da sauransu. 10-20% na iya buƙatar tiyata na ciki bayan shekaru 10 na CD yawanci don tsananin, fistiluzation, BO.
Dx: na asibiti, CBC, CMP, CRP, ESR, serological gwaje-gwaje: DDx na IBD: anti-Saccharomyces cerevisiae antibodies (ASCA), perinuclear antineutrophil cytoplasmic antibody (p-ANCA) histologically ko a cikin jini. Gwajin Calprotectin na Fecal yana taimakawa DDx IBS da kimanta martani ga jiyya, ayyukan cuta / sake dawowa.
Dx na zabi: endoscopy, ileoscopy, da kuma biopsies da yawa na iya bayyana endoscopic da canje-canje na tarihi. Bidiyon capsule endoscopy (VCE), Hoto na iya taimakawa tare da Dx na rikitarwa. Rx: magungunan rigakafi, ƙarin magani, abinci, probiotics, mai aiki. Babu magani amma manufar ita ce haifar da gafara, sarrafa alamun cutar da hana/mayar da rikitarwa
Hoto Dx: KUB zuwa DDx SBO, Barium enema (banbanta ɗaya da biyu), ƙananan hanji ya biyo baya. Abubuwan da aka gano: ƙetare raunuka, ciwon ciki mai zurfi, fistula/sinus tracts, Alamar igiya, kitse mai tura madaukai na LB, bayyanar dutsen dutse d/t fissures/ulcers tura mucosa, CT scanning tare da baka da kuma IV bambanci.
Hoto daga majinyacin Crohn wanda ke da ɗan ƙaramin hanji don toshewa.
(A) CT scan yana nuna kumburin da ba takamaiman ba alhali
(B) MRE na wannan yanki yana nuna tsananin fibrostenotic
UC: Halayen ya ƙunshi hanji kawai amma ciwon baya na iya tasowa. Yawan farawa yana da shekaru 15-40 kuma ya fi yawa a cikin maza, amma farawa bayan shekaru 50 yana da yawa. Yafi kowa a Arewacin Amurka da Turai (hasashen tsafta). Etiology: Haɗin mahalli, kwayoyin halitta da canje-canjen microbiome sun haɗa. Shan taba da farkon appendectomy suna nuna rashin haɗin gwiwa tare da UC, sabanin yadda CD yayi la'akari da wasu abubuwan haɗari.
Siffofin asibiti: Zubar da jini na dubura (na kowa), gudawa, zubar da kumburin dubura, tenesmus (wani lokaci), ciwon ciki na kasa da tsananin bushewar ruwa daga magudanar hanji (a lokuta masu tsanani, musamman a cikin tsofaffi), fulminant colitis da megacolon mai guba na iya zama tayin amma suna da wuyar rikitarwa. . Pathology: Babu granulomata. Ciwon ciki yana shafar mucosa da submucosa. Pseudopolyps yana ba da matsayin mucosa mai girma.
Tsarin farko koyaushe yana shafar dubura kuma ya kasance cuta ta gida (proctitis) a cikin (25%). 30% Ƙwararren cuta na kusa zai iya faruwa. UC na iya gabatarwa azaman gefen hagu (55%) da pancolitis (10%). Yawancin shari'o'in suna da sauƙi zuwa matsakaici
Dx: colonoscopy tare da ileoscopy tare da biopsies da yawa sun tabbatar da Dx. Labs: CBC, CRP, ESR, Fecal calprotectin, Matsaloli: anemia, megacolon mai guba, ciwon daji na hanji, cututtukan cututtuka masu yawa: arthritis, uveitis, AS, Pyoderma gangrenosum, Primary sclerosing cholangitis. Rx: 5-aminosalicylic acid na baka ko na dubura magani, corticosteroids, magungunan immunomodulatory, colectomy yana warkarwa.
Hoto: ba a buƙata don Dx amma barium enema na iya bayyana ciwon ciki, bugun yatsan yatsa, a cikin lokuta masu tasowa asarar haustra da kunkuntar hanjin da ke haifar da bututun gubar. lokuta. CT na iya taimakawa tare da Dx na rikitarwa. Hoton fina-finai na fili yana bayyana �aurar bututun gubar da sacroiliitis a matsayin cututtukan cututtuka na Enteropathic (AS)
Colourectal carcinoma (CRC) m/c ciwon daji na GI da kuma 2nd mafi yawan malignancy a cikin manya. Dx: endoscopy da biopsy. CT shine hanyoyin da aka fi amfani da su akai-akai don tsarawa. Maganin tiyata na iya zama magani ko da yake adadin rayuwa na shekaru biyar ya kasance 40-50% ya danganta da tsari. Abubuwan haɗari: ƙananan fiber da babban mai da abinci mai gina jiki na dabba, kiba (musamman a cikin maza), cututtuka na ulcerative colitis. Colonic adenomas (polyps). Iyali adenomatous polyposis syndromes (Gardener ciwo) da Lynch ciwo a matsayin marasa na iyali polyposis.
A asibiti: fara wayo tare da canza dabi'ar hanji, sabon jini ko melena, karancin ƙarfe anemia daga asarar jinin sihiri na yau da kullun musamman a ciwace-ciwacen gefen dama. Ƙunƙarar hanji, hana hanji, zubar da jini mai yawa da cututtukan ƙwayar cuta musamman ga Hanta na iya zama farkon gabatarwa. Hanyar: 98% sune adenocarcinomas, sun taso daga adenoma na colonic (neoplastic polyps) da suka kasance tare da mummunan canji. Adadin rayuwa na shekaru biyar shine 40-50%, tare da mataki yayin aiki guda ɗaya mafi mahimmancin abin da ke shafar hasashen. M/C rectosigmoid ciwace-ciwace (55%),
NB Wasu adenocarcinomas esp. Nau'in mucinous yawanci ana gabatar da su a makare kuma yawanci suna ɗauke da tsinkaye mara kyau saboda ƙarshen gabatarwa da ƙwayar mucin da yaɗuwar gida / nesa.
Hoto: Barium enema yana da hankali ga polyps> 1 cm, bambanci guda: 77-94%, bambanci biyu: 82-98%. Colonoscopy wani tsari ne na zaɓi don rigakafi, ganowa, da gano ciwon daji na colorectal. Ana amfani da bambance-bambancen CT scanning don ƙididdigewa da ƙima na mets.
Nunawa: colonoscopy: maza 50 yo-10-shekaru idan al'ada, 5- shekaru idan polypectomy, FOB, 1st digiri dangi da CA fara sa ido a 40 yo
Ciwon daji na Pancreatic: ductal epithelial adenocarcinoma (90%), rashin fahimta sosai tare da yawan mace-mace. 3rd M/C kansar ciki. Colon shine #1, ciki #2. Ciwon daji na Pancreatic yana da kashi 22% na duk mace-mace saboda rashin lafiyar gastrointestinal, da kuma 5% na duk mutuwar ciwon daji. 80% na lokuta a cikin 60+. Shan taba sigari shine mafi girman haɗarin muhalli, abinci mai wadatar kitsen dabbobi da furotin. Kiba. Tarihin iyali. An gano M/C a cikin kai da tsarin da bai dace ba.
Dx: Binciken CT yana da mahimmanci. Carry mamayewa ta ficewar Artery (Sma) yana nuna cutar da ba a fahimta ba. 90% na pancreatic adenocarcinomas ba a iya gano su a Dx. Yawancin marasa lafiya suna mutuwa a cikin shekara 1 na Dx. Clinically: jaundice mara zafi, abd. Pain, Courvoisier's gallbladder: jaundice mara raɗaɗi da haɓakar gallbladder, ciwo na Trousseau: thrombophlebitis mai ƙaura, sabon farkon ciwon sukari mellitus, yanki da kuma metastasis mai nisa.
CT Dx: pancreatic taro tare da karfi desmoplastic dauki, matalauta haɓakawa, da kuma dan kadan rage attenuation idan aka kwatanta da kusa da al'ada gland shine yake, SMA mamayewa.
Appendicitis: yanayin da ya zama ruwan dare gama gari a aikin rediyo kuma shine babban dalilin tiyatar ciki ga matasa marasa lafiya
CT shine hanya mafi mahimmanci don gano appendicitis
Ya kamata a yi amfani da Ultrasound a cikin ƙananan marasa lafiya da yara
KuB Radiographs bai kamata su taka rawar gani ba a cikin ganewar asali na appendicitis
A kan hoto, appendicitis yana bayyana kumburin appendix tare da kauri na bango, haɓakawa, da kitse na gefe. An lura da irin wannan binciken na kauri da haɓaka bango akan Amurka. Alamar maƙasudi na yau da kullun ana lura dashi akan gajeriyar wurin binciken Amurka.
Idan kari ne na retro-caecal fiye da Amurka na iya kasa samar da ingantaccen Dx kuma ana iya buƙatar sikanin CT
Rx: mai aiki don guje wa rikitarwa
Ƙananan hanyoyi (SBO) - 80% na duk toshewar hanji na inji; ragowar kashi 20% na sakamakon babban hanji. Yana da adadin mace-mace na 5.5%
M/C yana haifar da: kowane Hx na tiyata na ciki da ya gabata da mannewa
Gabatarwar gargajiya ita ce maƙarƙashiya, ƙara kumburin ciki tare da tashin zuciya da amai
Radiyon radiyo suna da 50% kawai masu kula da SBO
CT zai nuna dalilin SBO a cikin 80% na lokuta
Akwai ma'auni masu ma'ana don mafi girman toshewar hanji, amma 3.5 cm shine ƙididdigar ra'ayin mazan jiya na faɗaɗa hanji.
Akan Abd x-ray: supine vs. tsaye. Dirartaccen hanji, shimfiɗar valvulae conivente (mucosal folds), madadin matakan ruwan iska �Mataki.
Rx: mai aiki kamar � matsanancin ciki.�
Volvulus-m/c a cikin Sigmoid colon esp. a cikin tsofaffi. Babban dalili: maƙarƙashiya na yau da kullun tare da jujjuya sigmoid akan sigmoid mesocolon. Yana kaiwa ga babban toshewar hanji (LBO). Wasu dalilai na yau da kullun: kumburin hanji. Sigmoid vs. Caecum volvulus
A asibiti: alamun LBO tare da maƙarƙashiya, kumburin ciki, zafi, tashin zuciya, da amai. Farawa na iya zama m ko na yau da kullun
Ta hanyar rediyo: asarar haustra a cikin LB, LB distension (> 6-cm), alamar kofi na kofi
NB: Dokar babban yatsan hanji ya kamata ya zama 3-6-9 inda 3-cm SB, 6-cm LB & 9-cm Coecum
Kula da tsararraki na bishiyar tracheal-bronchial, lobes, segments, da fissures. Kula da lobule na huhu na biyu (1.5-2-cm) - ainihin sashin aikin huhu da aka lura akan HRCT. Yi la'akari da mahimman tsarin tsarin sararin samaniya tare da sadarwa tsakanin (pores na Kohn & canals na Lambert) waɗanda ke ba da izinin motsin iska kuma ta hanyar guda ɗaya yana ba da damar fitar da ruwa mai fitar da ruwa ko transudative ya yadu ta cikin huhu kuma ya tsaya a fissure. Yi la'akari da yanayin halittar pleura: parietal wanda ke wani yanki na endothoracic fascia da visceral wanda ke samar da gefen huhu - sararin sararin samaniya a tsakanin.
Mediastinum: kewaye da pleura da huhu. Yana ɗaukar manyan sifofi yana ƙunshe da nodes masu yawa (duba zane mai nuna nodes na mediastinal da shigarsu cikin Lymphoma).
Gabaɗaya Hanyar Binciko Ƙorafi na Ƙirji
Gwajin rediyo (Chest X-ray CXR); kyakkyawan mataki na 1st. Ƙananan farashi, ƙarancin hasashewar radiation, ƙima na gunaguni na asibiti da yawa
CT scanning: kirji CT, High-Resolution CT (HRCT)
Hanyar ƙirji:
rauni
kamuwa da cuta
Neoplasms
Harshen kwaminis
Phymonary emphysema
Atelectasis
Pleural Pathology
Mediastinum
PA & Lateral CXR
Ana iya amfani da ƙarin ra'ayoyi:
Ra'ayin Lordotic: yana taimakawa wajen kimanta yankuna apical
Decubitus ra'ayi dama da hagu: taimako don kimanta da dabara pleural effusion, pneumothorax da sauran Pathology.
CXR PA na al'ada & Ra'ayoyi na gefe. Tabbatar da kyawu mai kyau: fayafai na T-spine da tasoshin ta cikin zuciya ana gani akan kallon PA. Ƙidaya 9-10 haƙarƙari na dama na baya don tabbatar da isasshen ƙoƙari. Fara cikakken bincike ta amfani da hanya mai zuwa: Akwai Cututtukan Huhu da yawa A-ciki/diaphragm, bangon T-thorax, M-mediastinum, L-huhu daban-daban, huhu-duka. Ƙirƙirar ƙirar bincike mai kyau
1) Ciwon sararin samaniya aka cutar huhu? Cika alveoli na huhu, acini kuma daga baya gabaɗayan lobe tare da ruwa ko wani abu na kowane abun da ke ciki (jini, mugunya, ruwa, kayan furotin ko ma sel) Radiyo: lobar ko rarraba sassan, ana iya lura da nodules na sararin samaniya, yanayin coalesce, iska. bronchograms da alamar silhouette sun kasance. Rarraba Batwing (malam buɗe ido) da aka lura kamar a cikin (CHF). Canje-canje da sauri akan lokaci, watau karuwa ko raguwa (kwanaki)
2) Ciwon tsaka-tsaki: shigar da interstitium na huhu (alveoli septum, parenchyma na huhu, bangon jirgin ruwa, da dai sauransu) ta misali ta hanyar ƙwayoyin cuta, ƙananan ƙwayoyin cuta, protozoans. Har ila yau shigar da ƙwayoyin sel kamar ƙwayoyin kumburi/mummuna (misali, lymphocytes) An Gabatar da shi azaman ƙarar interstitium na huhu tare da nau'in reticular, nodular, gauraye tsarin reticulonodular. Daban-daban etiologies: kumburi cututtuka na autoimmune, Fibrosing huhu cuta, sana'a huhu cuta, viral / mycoplasma kamuwa da cuta, TB, sarcoidosis lymphoma / cutar sankarar bargo da sauran su.
Gane alamu daban-daban na cututtukan huhu na iya taimakawa tare da DDx. Mass vs. Ƙarfafawa (hagu). Kula da nau'ikan cututtukan huhu daban-daban: cutar sararin samaniya azaman haɓakar lobar mai nuni da ciwon huhu, haɓakar haɓakar huhu mai nuni da edema na huhu. Atelectasis (rushewa da asarar girma). Hanyoyin tsaka-tsaki na cututtukan huhu: reticular, nodular ko gauraye. SPN vs. Ƙirar haɗin kai da yawa (nodules) mai yiwuwa wakiltar mets infiltrates vs. septic infiltrates
A = intraparenchymal
B = rudu
C = karin haske
Gane muhimmin wuri na raunukan ƙirji
Alamu masu mahimmanci: Alamar silhouette: taimako tare da gurɓatawa da DDx. Misali: Hoton hagu na kasa: radiyo a cikin huhu na dama, a ina yake? Dama MM saboda madaidaicin iyakar zuciyar da ke kusa da lobe na tsakiya na dama ba a gani (silhouetted) Air bronchograms: iska mai dauke da bronchi/bronchioles kewaye da ruwa.
Cutar Kwana
Pneumothorax (PTX): iska (gas) a cikin sararin samaniya. Dalilai da yawa. Matsaloli:
Tashin hankali PTX: ci gaba da karuwa da iska a cikin sararin samaniya wanda ke saurin matsawa mediastinum da huhu da sauri yana rage dawowar venous zuwa zuciya. Yana iya zama mai mutuwa idan ba a yi masa magani cikin sauri ba
PTX mara kyau: na farko (matasa (30-40) musamman tsayi, maza masu sirara. Ƙarin dalilai: ciwo na Marfan, EDS, Homocystinuria, a - 1 -rashin antitrypsin. Na biyu: tsofaffin pts tare da cututtukan parenchymal: neoplasms, abscess, emphysema , huhu fibrosis da saƙar zuma, catamenial PTX d/t endometriosis da sauransu.
Traumatic pneumothorax: huhu laceration, m rauni, iatrogenic (kirji tubes, da dai sauransu) acupuncture, da dai sauransu.
CXR: bayanin kula visceral pleural line aka lung gefen. Rashin nama / ruwa na huhu fiye da layin visceral pleural. Za a iya rasa pneumothorax mai hankali. A kan madaidaiciyar matsayi, iska ta tashi kuma ya kamata a nemi PTX a saman.
Karayar haƙarƙari: v.common. Traumatic ko pathological (misali, mets, MM) Rib jerin x - haskoki ba su da amfani sosai saboda CXR da / ko CT scan sun fi mahimmanci don kimanta PTX (a hagu na hagu) na huhu da kuma wata babbar hanya.
kamuwa da cuta
Ciwon huhu: ƙwayoyin cuta vs. hoto ko bidiyo mai zagaya yanar gizo da sauri ko kuma a cikin majiɓinci marasa lafiya (misali, Cryptococcus a cikin HIV/AIDS) TB na huhu
Ciwon huhu: al'umma-samu vs. asibiti-samu. Cutar huhu na kwayan cuta na yau da kullun ko Lobar (marasa sashi) ciwon huhu tare da kayan purulent wanda ya cika alveoli kuma yana yaduwa zuwa gabaɗayan lobe. M/C kwayoyin cutar Streptococcus Pneumonia ko Pneumococcus
Wasu: (Staph, Pseudomonas, Klebsiella esp. a cikin masu shan giya mai yuwuwar haifar da necroSIS / gangrene huhu) Mycoplasma (20-30s) aka tafiya ciwon huhu, da dai sauransu.
CXR: haɗe-haɗen sararin samaniya wanda aka keɓe ga dukan lobe. Air bronchograms. Taimakon alamar silhouette tare da wuri.
Kwayoyin cuta: mura, VZV, HSV, EBV, RSV, da dai sauransu suna gabatar da cutar huhu mai tsaka-tsaki wanda zai iya zama na biyu. Zai iya haifar da daidaitawar numfashi
Ciwon huhu na huhu da ciwon huhu na Fungal: Mycoplasma, cutar Legionnaire, da wasu fungal/Cryptococcus ciwon huhu na iya kasancewa tare da cututtukan huhu na tsaka-tsaki.
Ƙunƙarar huhu: tarin ƙwayoyin cuta na kayan purulent a cikin huhu wanda sau da yawa necrotizes. Zai iya haifar da gagarumin rikice-rikice na huhu da tsarin / barazanar rai.
A kan CXR ko CT: tarin zagaye tare da iyakoki masu kauri da tsakiyar necrosis mai ɗauke da matakin ruwan iska. DDx daga empyema wanda ke gurbata huhu da tushen pleural
Ana buƙatar bin ciwon huhu tare da maimaita CXR don tabbatar da cikakken ƙuduri
Rashin ingantaccen aikin rediyo na ciwon huhu na iya wakiltar rashin rigakafi, juriya na ƙwayoyin cuta, ciwon daji na huhu ko wasu dalilai masu rikitarwa.
Tarin fuka
Cutar sankara ta kowa a duniya (kasashen duniya na 3). 1 cikin mutane 3 a duniya na fama da tarin fuka. Mycobacterium TB ne ke haifar da tarin fuka ko Mycobacterium Bovis. Intracellular bacillus. Macrophage yana taka muhimmiyar rawa.
Tarin Fuji na Farko & Tarin Tarin Jiki na Bayan Farko. Yana buƙatar sake bayyanawa ta hanyar numfashi. A yawancin rundunonin rigakafi, kamuwa da cuta mai aiki ba ya tasowa
TB yana nunawa a matsayin 1) wanda mai gida ya share, 2) an danne shi zuwa cikin Latent Tuberculosis Infection (LTBI) 3) yana haifar da cutar tarin fuka. Marasa lafiya tare da LTBI ba sa yada tarin fuka.
Hoto: CXR, HRCT. TB na farko: Ƙarfafa sararin samaniyar huhu (60%) ƙananan lobes, lymphadenopathy (95% - hilar & paratracheal), zubar da ciki (10%). Yaɗuwar TB na farko a cikin marasa lafiya da yara.
Milliary TB: Yaduwa da rikice-rikice na huhu da na tsarin da zai iya zama m
Bayan firamare (na biyu) ko kamuwa da cuta ta sake kunnawa: Mafi yawa a cikin Apices da na baya na lobes na sama ) high PO2), 40% - raunuka masu rauni, patchy ko confluent sararin samaniya cuta, fibrocalcific. Siffofin latent: ƙididdiga na nodal.
Dx: Bacilli mai saurin acid (AFB) smear da al'ada (sputum). Kwayar cutar kanjamau a duk majinyata da ke da tarin fuka kuma ba a san matsayin HIV ba
Rx: 4-tsarin magunguna: isoniazid, rifampin, pyrazinamide, da ko dai ethambutol ko streptomycin.
Pulmonary Neoplasms (primary huhu cancer vs. pulmonary metastasis)
Ciwon daji na huhu: m/c kansar a cikin maza da kuma 6th mafi yawan ciwon daji a cikin mata. Ƙarfafan haɗin gwiwa tare da shakar carcinogens. A asibiti: gano marigayi, ya danganta da wurin da ƙari. Pathology (nau'ukan): Ƙananan ƙwayoyin cuta (SCC) vs. Carcinoma mara ƙaranci
Ƙananan tantanin halitta: (20%) yana tasowa daga neuroendocrine aka Kultchitsky cell, don haka yana iya ɓoye abubuwa masu aiki da ilimin halitta waɗanda ke nunawa tare da ciwo na paraneoplastic. Yawanci yana tsakiya (95%) a ko kusa da babban tushe/lobar bronchus. Yawancin suna nuna rashin hasashe mara kyau kuma ba a sake su ba.
Karamin tantanin halitta: huhu adenocarcinoma (40%) (M/C ciwon huhu), M/C a cikin mata da marasa shan taba. Wasu: Squamous cell (na iya zuwa tare da cavitating raunuka), Large cell da wasu wasu
Fim na fili (CXR): sabon ko ƙara girman rauni mai zurfi, faɗaɗa mediastinum mai nuni da shigar kumburin lymph, zubar da jini, atelectasis, da ƙarfafawa. SPN-zai iya wakiltar yuwuwar cutar kansar huhu musamman idan ta ƙunshi iyakoki marasa daidaituwa, tasoshin ciyarwa, bango mai kauri, a cikin huhu na sama. Yawancin nodules na huhu suna iya wakiltar metastasis.
Mafi kyawun Modali: HRCT tare da bambanci.
Sauran nonoplasms na ƙirji: Lymphoma v. na kowa a cikin ƙirji musamman a cikin bayanan tsakiya da na ciki na mammary.
Gabaɗaya M/C neoplasms na huhu sune metastasis. Wasu ciwace-ciwacen ciwace-ciwacen daji suna nuna mafi girman tsinkaya ga saduwar huhu, misali, Melanoma, amma duk wani ciwon daji na iya shiga cikin huhu. Wasu saduwa da ake kira �Cannonball� metastasis
Rx: radiation, chemotherapy, resection
Pulmonary edema: kalma na gaba ɗaya yana bayyana tarin ruwa mara kyau a waje da tsarin jijiyoyin jini. Ya rarraba zuwa Cardiogenic (misali, CHF, mitral regurgitation) da marasa cardiogenic tare da dalilai masu yawa (misali, yawan ruwa, bayan jini, abubuwan da ke haifar da jijiya, ARDS, kusa da nutsewa/asphyxiation, yawan maganin tabar heroin, da sauransu)
Dalilai: ƙãra a cikin Hydrostatic matsa lamba vs. rage a oncotic matsa lamba.
Hoto: CXR da CT: 2-type Interstitial da Alveolar ambaliya. Gabatarwar hoto ya dogara da matakai
A cikin CHF: Mataki na 1: sake rarraba kwararar jijiyoyin jini (10-18-mm Hg) an lura da shi azaman �cephalization� na vasculature na huhu. Mataki na 2: Ciwon daji na tsaka-tsaki (18-25-mm Hg) Ƙunƙarar tsaka-tsakin tsaka-tsakin tsaka-tsakin tsaka-tsakin tsaka-tsakin: ƙwanƙwasa na peribronchial, layin Kerley (lymphatics cike da ruwa) Lines A, B, C. Mataki na 3: Alveolar edema: cutar sararin samaniya: ɓangarorin haɗin gwiwa masu tasowa zuwa cututtukan sararin samaniya: Batwing edema, iska bronchograms.
Rx: Babban burin 3: Na farko O2 don kiyaye O2 a 90% jikewa
Na gaba: (1) raguwar dawowar venous na huhu (raguwa mai ɗaukar nauyi), (2) rage juriya na tsarin jijiyoyin jini (raguwar raguwa), da (3) goyon bayan inotropic. Magance abubuwan da ke faruwa (misali, CHF)
Huhu atelectasis: rashin cikar fadada parenchyma na huhu. Kalmar “huhun da ya ruguje” ana keɓe shi ne don lokacin da huhu ya faɗi
1) Resorptive (obstructive) atelectasis yana faruwa ne sakamakon cikar toshewar hanyar iska (misali ƙari, abubuwan da aka shaka, da sauransu).
2) Atelectasis mai wucewa (na shakatawa) yana faruwa lokacin da aka rushe lamba tsakanin parietal da visceral pleura (zubar da jini da pneumothorax)
3) Matsanancin atelectasis yana faruwa ne sakamakon duk wani rauni na thoracic sararin samaniya yana matsawa huhu da tilasta iska daga alveoli.
4) Cicatricial atelectasis: yana faruwa ne sakamakon tabo ko fibrosis wanda ke rage haɓakar huhu kamar cutar granulomatous, ciwon huhu, da fibrosis na radiation.
5) Adhesive huhu atelectasis yana faruwa daga rashi surfactant da rushewar alveolar.
6)-kamar Plate ko discoid sau da yawa suna tasowa bayan an gama maganin sa barci
7) Siffofin hoto: rugujewar huhu, ƙaura na huhu na huhu, karkatar da mediastinum, tashin diaphragm, hauhawar hauhawar huhu da ke kusa da shi.
Mediastinum: Pathology za a iya raba zuwa wadanda ke haifar da taro mai mahimmanci ko wadanda ke haifar da cututtuka masu yaduwa da suka shafi mediastinum. Bugu da ƙari, iska na iya shiga cikin mediastinum a cikin pneumomediastinum. Ilimin ilimin jiki na mediastinal yana taimakawa Dx.
Emphysema na huhu: asarar nama na al'ada na al'ada / farfadowa na huhu na huhu tare da lalata capillaries da alveolar septum / interstitium.
Rushewar parenchyma na huhu saboda kumburi na yau da kullun. Lalacewar elastin mai tsaka-tsaki mai ƙarfi. Tarkon iska/ faɗaɗa sararin sama, hauhawar farashin kaya, hauhawar jini, da sauran canje-canje. Clinical: dyspnea mai ci gaba, wanda ba zai iya jurewa ba. A lokacin da ƙarar ƙaƙƙarfan tilastawa a cikin 1 seconds (FEV1) ya faɗi zuwa 50% mara lafiya ba shi da numfashi a kan ƙaramin aiki kuma ya dace da salon rayuwa.
COPD ita ce ta uku da ke haddasa mutuwar mutane a duniya. Yana shafar 1.4% na manya a Amurka. M:F = 1: 0.9. Pts mai shekaru 45 da haihuwa
Dalilai: Shan taba da rashi a-1-Antitrypsin (an raba su zuwa centrilobular (shan taba) da panacinar.
SKULL FX: Na kowa a cikin ginshiƙan Raunin KA. SKULL FX YANA NUNA ZUWA GA SAURAN ABUBUWA DA KE CIKI: INTRA-CRANIALHEMORRHAGING, RUFE RUNUN KWAKWALWA DA SAURAN MAGANGANUN CIKI
X-rays KWANKA SUN WUCE WUTA WAJEN KIMANIN RAUNIN KAI. CT SCANNING W/O CONTRAST SHINE MAFI MUHIMMAN MATAKI NA FARKO WAJEN KIMANIN KAI. rauni. MRI HASA TALAUCI WUTA DOMIN BAYYANA KARSHEN KWANKWA, KUMA BA A YAWAN YI AMFANI DA DX NA FARKO NA CUTE KAI rauni.
SKULL FX ANA GANO AS FXS NA KWANKWAYAR KWALLIYA, KWALLIYAR KWALLIYA DA KWALLON FUSKAR KOWANNE MAI HADAKAR DA SIFFOFI NA MUSAMMAN DA TAIMAKA DOMIN HANA CUTAR CUTARWA.
LINEAR SKULL FX: KUNGIYAR KWALLIYA. M/C FX. CT SCANNING shine mabuɗin don kimanta ɗimbin jini na ARTERIALEXTRADURAL
X-RAY DDX: SUTURES VS. LINEAR SKULL FX. FX YA KARA KIRKI, BLACKER, watau MORE LUCENT, COLOSSUTURES, DA RUWAN jijiyoyi, RASHIN WUTA.
RX: IDAN BABU JININ ZIKIRI DA BABU MAGANI. CIWON JINI IDAN HANYAR CT SCANNING YA GAME DA JINI
DAN KWANTA FX: 75% A CIKIN KYAUTA. ZAI IYA YI MATA. LA'akari BUDE FX. YAWANCIN AL'AMURAN BUKATAR NEUROSURGICALEXPLORATION MUSAMMAN CUTUTTUKA MAI RUWA> 1-CM.CIKI: Raunin jijiyoyi/HEMATOMAS, PNEUMOCEPHALUS, Meningitis, TBI, CSF LEAK, BRAIN HERNIATION ETC.
HOTO: CT SCANNING W/O CONTRAST
BASILAR SKULL FX: ZAI IYA YI MATA. Sau da yawa tare da SAURAN BABBAN CIWON KAI NA VAULT DA FACIALSKELETON, YAWAN YIWA TBI DA CIWON jini. YAWAN FARUWA AS � Headband� ILLAR ILLAR TASIRI DA JINI NA KANKANIN TA HANYAR FARUWA DA KASHI NA WUTA TA SPHENOID DA SAURAN TUSHEN KWANKWASO. CLINICally: RACCOON EYES, BATTEL ALAMOMIN, CSFRHINO/OTORRHEA.
Karyewar fuska
NASAL BONES FX: 45% NA ALLFACEFXM/C TASIRI NE NA BAYA (FIST BOW ETC.) IDAN BABU MAGANI BA, IDAN TURARE NA IYA rikitar da kwararar iska da shayarwar numfashi, ana iya haɗewa da SAURAN CIN FUSKA. X-RAYS 80% M, BIN CT INCOMPLEX RUNI.
ORBITAL FARUWA FX: RAUNIN JAMA'A D/T TASIRI A DUNIYA DA/KO KASHIN DUNIYA. FX NA BAKIN ORBITAL INTOMAXILLARY SINUS VS. BANGON MEDIAL ZUWA ETHMOID SINUS. CIGABA: ENTRAPPEDINFERIOR RECTUS M, PROLAPSEORBITAL FAT, DA KYAUTA MAI KYAU, CIWON jini DA ILLAR JIRGIN gani. RX: DAMUWA DA RUNUWA DUNIYA NA DA MUHIMMANCI, GABATARWA ANA YI MASA MAGANA IDAN BABU RASHIN HANKALI
TRIPOD FX: 2ND M/C FACIAL FX#BAYAN NASAL (40% OF MIDFACEFX) 3-POINT FX-ZYGOMATICARCH, ORBITAL PROCESS OF ZYGOMATIC BONE & GEFE MAXILLARY SINUS WALL, MAXILLARY EXESS OF ZYGOMATIC BONE.COMPLICATED BY MAGANGAN KASHI. CT SCANNING YA FI BAYYANA CEWA X-rays (MAGANIN RUWA).
LEFORT FX: KYAUTATA KYAUTA KOYAUSHE YANA FARUWA DA FALALAR PTERYGOID, IYAWAR RABUWAR TSAKI DA HANYA TARE DA HAKORI DAGA KWANKA. DAMUWA: HANYOYIN SAUKI, HEMOSTASIS, Raunin Jijiya. ANA BUKATAR CT SCANNING. HADARI MAI WUYA NA BASILAR SKULL FX
PING-PONG FX:�KAWAI A CIKIN JARIRI. BAN CIKAKKEN FX D/T FOCALDEPRESSION: ISAR DA KARFI, MASU WUYA DA SAURAN LABARI. FOCALTRABECULAR MICROFRACTURIING BAR ɓacin rai mai kama da APING-PONG. DX YAFI SANARWA ILMI A MATSAYIN RASHIN HANKALI A KWANKA. YAWAN JINI RASHIN CUTAR. CT na iya TAIMAKA IDAN ANA SHAHUN RUNIN KWALLIYA. RX: LURA VS. TATTA A CIKIN Raunin Raunin Raunin. AN RUWAITO YIN KYAUTA BATSA
CYSTIN LEPTOMINGEAL (GROWING SKULL FX) - SUNE KARSHEN KWANKWAYAR KWALLIYA WANDA YA CI GABA DA POSTTRAUMATIC ENCEPHALOMALACIA.
BA CYST BA NE, AMMA ƘARUWA NA THEENCEPHALOMALACIA WANDA YA GA 'YAN WATANNI POST-RASHIN LAFIYA TARE DA SKULL FX BAYA HERNIATION OF THE meninges DA ADJACENTBRAIN DA PULSATIONS OF CSF. CT NE MAFI KYAU ATDX WANNAN PATHOLOGY. NUNA: GIRMAN FX DA M ENCEPHALOMALACIA AS FOCALHYPOATTENUATING LESION.
DDX: CUTAR KWALLIYA/METS/SAURAN NEOPLASMSINTO SUTURES, MISALI, INFECTION ETC.
MANDIBULAR FXS: YAWA. MAI YIWU KYAU BUDE FX D/T INTRA-ORALEXTENSION. 40% KARSHEN HANKALI RASHEWAR WUCE ZUWAN ZUWA. TAsirin kai tsaye (MASAULT) M/C MECHANISM
PATHOLOGICAL FX D/T KASHI NEOPLASMS, INFECTION ETC. IATROGENIC A LOKACIN FITAR BAKI (CIWON HAKORI)
HOTO: MANDIBLE X-rays, PANOREX, CT SCANNING ESP. A CIKIN AL'AMURAN ASSOCIATEDFACE/CIWON KAI
CUTAR: RASHIN KASHE HANYAR JIRGIN SAMA, HEMOSTASIS BABBAN LA'AHI NE, LALATA GA MANDIBULAR N, OSTEMYELITIS/CELLULITIS DA WUYA YAWA TA BAKIN BAKI (LUDWIGANGINA) DA WUYA DA SAMUN SAMUN SAMUN KWANA. BA AZA KI KWANCE D/T MATSALAR MASU WUTA BA.
RX: CONSERVative VS. MAI AIKI
Mugun zubar jini na ciki
EPI aka EXTRADURAL: (EDH) MATSALOLIN FARUWA NA RUWAN jijiyoyi (MMA CLASSIC) TAREDA SAMUN CIWON TSAFIYA TSAKANIN KWAYOYIN CIKI DA WAJEN DURA. CT SCANNING shine mabuɗin DX: GABATARWA AS �LENTIFORM� watau BICONVEX COLLECATION OF CUTE (HYPERDENSE) JINI WANDA BAYA CIN CIKI KUMA YANA TAIMAKA DA DDX NA MATSALAR KASA. CLINICALY: HA, LUCID EPISODE DA FARKO KUMA YANA RUWA A CIKIN SA'O'I KADAN. CIGABA: BRAIN HERNIATION, CN PALY. KYAUTA MAI KYAU IDAN AKA FITAR DA SAURI.
SUBDURAL HEMATOMA (SDH): FARUWA DA JINI NA CIKI TSAKANIN DURA NA CIKI DA ARACHNOID.JININ CI GABA. MUSAMMAN ZAI IYA GYARA MATASAN MATASA DA TSOFI DA DUKKAN SHEKARU (MVA, Falls ETC.) na iya tasowa a cikin SHAKEN BABY SYNDROME�. ANA YIWU DX YA YI JINKIRI KUMA YA CI GABATAR DA SABUWA TARE DA MANYAN MASU FATALILI. A CIKIN TSOHON CIWON KAI NA iya YI KANANA KO BA A TUNA BA. FARKO DA CT yana da mahimmanci. YANA GABATAR A KAMAR KIRSENTIN TARIN WANDA ZAI IYA TSAYA SUTURES AMMA A TSAYA A WAJEN NAZARI. BABBAN MAGANA AKAN CT D/T MATAKAN DABAN DABAN NA RUWAN JINI: CUTE, SUBACUTE, DA CHRONIC.NAI IYA SAMUN TARIN KYAUTATA-CYSTICHYGROMA. CLINCLYY: BAYANI MAI BANZA, 45-60% ANA NAN TARE DA MATSALAR CNS MAI RAUNI, RASHIN ARZIKI. YAWA DA CIWON KWALLIYA NA FARKO, SANNAN LABARI MAI KYAU KAFIN YA CI GABA. A cikin kashi 30% na MASU RAUNIN KWALLIYA MASU SAMU SDH. RX: GAGGAN JAWABI.
SUBARACHNOID HEMORRHAGE (SAH): JINI A SARKIN SUB-ARACHNOID , SAKAMAKON CUTUTTUKA KO RA'AYI: BERRY ANEURYSMS A KEWAJEN DA'IRIN WILLIS.SAH 3% NA CIN TSOROKI, 5% NA RASHIN SAMUN CIKI. ciwon kai PT YA RAGE YIWU KO BAYA SAMU HANKALI. PATHOGY: YAWAN JINI INSA SARKI 1) SUPRASELLAR CISTERN TARE DA YAWAN WUYA, 2) PERIMESENCEPHALIC, 3) BASAL CISTERNS. JININ DA YAZO ZUWA SARARIN SA MATSALAR MATSALAR KASAR DUNIYA YANA HADA KARUWA A DUNIYA A CIKIN MATSALAR MATSALAR MATSALAR MATSALAR DUNIYA, MATSALAR ISCHEMIA TA DUNIYA DA VASOSPASM DA SAURAN CANJI.
DX: KYAUTA: GAGGAUTA CT SCANNING W/O CONTRAST, CT ANGIOGRAPHY NA IYA TAIMAKA DOMIN MULKI 99% NA SAH. LUMBAR PUNCURE NA IYA TAIMAKA GA GABATAR DA AKA JIRA. BAYAN FARKO DX: MR ANGIOGRAPHY YANA TAIMAKA GA NEMAN DALILAI DA SAURAN FALALAR MUHIMMAN
SIFFOFIN HOTO: MASU CUTAR JINI YANAYIN ZUWA AKAN CT. SUNA A CIKIN BANBANCIN: PERIMESENCEPHALIC, SUPRASELLA, BASAL, VENTRICLES,
CIWON KWALLIYA WAKILAN 2% NA DUKKAN CANCES. DAYA UKU SUNA MASU CUTARWA, DAGA CIKIN WADANDA RUWAN KWALLIYA SUKE YAWAN YAWA.
ILMI YAKE BABBAN TARE DA CUTAR CNS na gida, ƘARUWA ICP, CIWON CIWON INTRACEREBRAL da dai sauransu. IYALI: VON-HIPPEL-LANDAU, TUBEROUS SCLEROSIS, TURCOT SYNDROME, NF1 & NF2 ARARA HADARI. A CIKIN YARA: M/C Astrocytomas, EPENDYMOMAS, PNETNEOPLASMS (Misali MEDULOLOBLASTOMA) DA sauransu. DX: GAME DA WANE RABO.
MANYAN: M/C BENIGN NEOPLASM: MENINGIOMA. M/C PRIMARY: GLIOBLASTOMA MULTIFORME (GBM) MUSAMMAN DAGA HUHU, MELANOMA, DA NONO. SAURAN: CNS LYMPHOMA
HOTO YANA DA MUHIMMANCI: ALAMOMIN FARKO ZAI IYA GABATAR A MATSAYIN KAMUWA, ALAMOMIN ICP HA. KIMANIN CT DA MRI TARE DA IV GADOLInium.
HUKUNCI HOTO: INTRA-AXIAL VS. EXTRA-AXIALNEOPLASMS. SAMUN FARKO DAGA BRAIN NEOPLASMS MAYO CCUR TA CSF DA MASU SHIGA ARANA JINI.
NOTE AXIAL CT YANKI NA MENGIOMA TARE DA INGANTACCEN AVIDCONTRAST.
AXIAL MRI AKAN SAURAN FUSKA TA BAYYANA EXENSIVE NEOPLASM DA ALAMOMIN CYTOTOXIC EDEMA NA BRAIN PARENCHYMA HALAYEN GRADE IV GLIOMA (GBM) TARE DA SOSAI TALAUCI. A SAMA HOTO NA DAMA: AXIAL MRI FLAIR: BRAIN METASTASIS DAGA CIWON NONO. MELANOMA YAWANCIN METASTASIZESTO BRAIN (DUBI MISALIN HANYA) MRI ANA IYA ZAMA GANGANUN D/T BABBAN ALAMOMIN T1 DA KYAUTA KWANTA.
Yawancin masu ba da lafiya suna amfani da su x-haskoki azaman kayan aikin bincike don magance nau'ikan gunaguni na haƙuri, gami da chiropractors. Za su iya taimaka wa likitoci su gano tushen matsalar ko kuma idan akwai wani abu da ke faruwa. Hakanan X-haskoki na iya taimakawa masu chiropractors su ƙayyade mafi kyawun tsarin aiki don jiyya. Don ƙarin fahimta, bari mu dubi abin da suke da kuma yadda ake amfani da su a yawancin ofisoshin chiropractic.
Menene X-rays?
X-ray wani nau'i ne mai ƙarfi na electromagnetic radiation wanda yayi kama da raƙuman rediyo, ultraviolet radiation, microwaves, ko haske mai gani wanda ake amfani da shi don duba abubuwan ciki na mutum ko abu. Ana mai da hankali kan katako a wani yanki na musamman na jikin mutum, kamar baya, yana samar da hoton dijital. kwarangwal tsarin.
Ƙunshin yana wucewa cikin sauƙi ta cikin fata da sauran laushi masu laushi amma ya kasa wucewa ta kashi da hakora. Nama mai laushi wanda ya fi yawa, kamar gabobin jiki, ligaments, da tsokoki, za a iya gani –amma za a kama su cikin inuwar launin toka. Wurare kamar hanji ko huhu suna fitowa akan fim ɗin a matsayin baki.
Yin amfani da x-ray na chiropractic
Rayukan x-ray na chiropractic suna ba da mahimman bayanai waɗanda zasu iya rinjayar yadda chiropractor ya zaɓa don bi da mai haƙuri. A wasu lokuta, kulawar chiropractic ko magudi na kashin baya bazai zama hanyar da ta dace ba a wancan lokacin, kuma ana iya farawa mai haƙuri a kan wani nau'i daban-daban, mai laushi.
Wasu lokuta, zai iya nuna wa chiropractor yadda za a ci gaba da kyau a kula da majiyyaci. A taƙaice, marasa lafiya na iya samun ingantacciyar kulawa, mafi kyawun kulawa wanda zai iya sauƙaƙe sauƙaƙe waraka da kula da ciwo.
Gano wani yanayi ko alama, kamar kumburin kashin baya ko rauni wanda zai ba da dalilin likita wanda bai kamata a yi takamaiman hanyar kulawa ba.
Sami mahimman bayanai na biomechanical waɗanda zasu iya taimakawa wajen jagorantar jiyya.
Don a fayyace da kiyaye rikodin tsarin lalacewa na majiyyaci.
Taimako don gano abubuwan da ba su da kyau a cikin kashin baya da haɗin gwiwa waɗanda zasu iya shafar jiyya.
Yana ba marasa lafiya damar fahimtar yanayin su da tsarin kulawa da kyau, yana ba su damar mallakar tsarin kuma su ƙara shiga cikin jiyya da warkarwa.
Menene mai chiropractor ke nema akan fim din x-ray?
Lokacin da chiropractor yana ɗaukar x-ray na majiyyaci, suna neman abubuwa a wurare da yawa. Abu na farko da suke dubawa shine don tabbatar da cewa babu rabuwa, karaya, ciwon daji, cututtuka, ciwace-ciwacen daji, ko wasu yanayi masu haɗari.
Sannan suna neman tsayin faifai da sauran alamun ɓarkewar faifai, ƙarancin ƙashi, ƙashin ƙashi, wuraren haɗin gwiwa, da daidaitawa. Wannan yana ba su damar gano yanayi kamar scoliosis da sauran yanayi waɗanda zasu buƙaci takamaiman nau'ikan jiyya.
Yawancin masu chiropractors sun fi son cewa mai haƙuri yana cikin matsayi mai nauyi lokacin ɗaukar nauyi x-ray na kashin baya. Wannan ya bambanta da yawancin wuraren kiwon lafiya waɗanda ke da majiyyaci ya kwanta.
Amfanin x-ray mai ɗaukar nauyi azaman kayan aikin bincike shine yana ba da damar aunawa, watau, ƙarancin tsayin ƙafafu, scoliosis, da kunkuntar sararin haɗin gwiwa. Hakanan zai iya nuna cewa wasu ƙasusuwa, irin su tibia da fibula, suna rarrabuwar su wanda zai iya zama alamar tsagewar tsoka ko matsala tare da haɗin gwiwa. X-ray mara nauyi ba zai iya ba da hangen nesa iri ɗaya ba, kuma ana iya rasa mahimman alamu ga yanayin majiyyaci.
IFM's Find A Practitioner tool is the most referral network in the Functional Medicine, halitta don taimaka wa marasa lafiya gano Aiki Magunguna a ko'ina cikin duniya. IFM Certified Practitioners an jera farko a cikin sakamakon bincike, da aka ba su ilimi mai yawa a cikin Magungunan Aiki
