Gwaje-gwajen Nuna Asibitin Baya. Gwajin dubawa yawanci ƙima ta farko da aka kammala kuma ana amfani da ita don tantance ko ana iya buƙatar ƙarin gwajin cutar. Saboda gwaje-gwajen tantancewa shine mataki na farko don gano cutar, an tsara su don a iya ƙididdige ainihin abin da ke faruwa na cuta. An ƙera su don bambanta da gwaje-gwajen bincike ta yadda za su iya nuna kyakkyawan sakamako fiye da gwajin ganowa.
Wannan na iya haifar da duka biyun tabbataccen gaskiya da kuma na ƙarya. Da zarar gwajin gwaji ya tabbata yana da inganci, sai a kammala gwajin gwaji don tabbatar da ganewar asali. Na gaba, za mu tattauna kimanta gwajin gwaji. Yawancin gwaje-gwaje na nunawa suna samuwa ga likitoci da masu aikin chiropractic masu ci gaba don amfani da su a cikin aikin su. Ga wasu gwaje-gwaje, akwai ɗan bincike kaɗan da ke nuna fa'idar irin waɗannan gwaje-gwaje akan ganewar asali da magani da wuri. Dokta Alex Jimenez ya gabatar da kima mai dacewa da kayan aikin bincike da aka yi amfani da su a cikin ofis don ƙarin fayyace da kuma ƙaddamar da ƙididdigar ƙididdiga.
Haɗin hip ɗin haɗin gwiwa ne na ball-da-socket wanda ya ƙunshi kan femur da soket, wanda ke cikin ɓangaren ƙashin ƙugu. Labrum zobe ne na guringuntsi a sashin soket na haɗin gwiwa na hip wanda ke taimakawa kiyaye ruwan haɗin gwiwa a ciki don tabbatar da motsi mara ƙarfi da daidaitawa yayin motsi. Yagawar hip shine rauni ga labrum. Girman lalacewa na iya bambanta. Wani lokaci, labrum na hip yana iya samun ƙaramin hawaye ko ɓarna a gefuna, yawanci lalacewa da tsagewar sannu a hankali. A wasu lokuta, sashe na labrum na iya rabuwa ko ya tsage daga kashin soket. Wadannan nau'ikan raunin da ya faru yawanci saboda rauni ne. Akwai gwaje-gwajen hawaye na hip na mazan jiya don tantance nau'in rauni. Raunin da aka raunana Chixractic da asibitin magani magani na iya taimakawa.
Alamun
Alamun suna kama da juna ba tare da la'akari da nau'in hawaye ba, amma inda aka ji su ya dogara ne akan ko hawaye a gaba ko baya. Alamomin gama gari sun haɗa da:
Taurin hip
Iyakantaccen kewayon motsi
Abin jin dannawa ko kullewa a cikin haɗin gwiwa lokacin motsi.
Ciwo a kwatangwalo, makwancin gwari, ko gindi, musamman lokacin tafiya ko gudu.
Rashin jin daɗi na dare da alamun zafi lokacin barci.
Wasu hawaye ba za su iya haifar da wata alama ba kuma suna iya wucewa ba a san su ba har tsawon shekaru.
Gwajin Hawaye na Hip Labral
Hawaye na hip na iya faruwa a ko'ina tare da labrum. Ana iya kwatanta su a matsayin gaba ko na baya, dangane da wane bangare na haɗin gwiwa ya shafi:
Hawaye na gaba na hip: Mafi yawan nau'in tsagewar labral na hip. Wadannan hawaye suna faruwa a gaban haɗin gwiwa na hip.
Na baya hip labral hawaye: Wannan nau'in yana bayyana a bayan haɗin gwiwa na hip.
Gwaje-gwaje
Mafi yawan gwaje-gwajen hawaye na hip sun haɗa da:
Gwajin Ciwon Hip
Gwajin Tada Kafa Madaidaici
The FABAR Gwaji - yana nufin Juyawa, Sacewa, da Juyawar Waje.
The Uku Gwaji - yana nufin Jujjuyawar Ciki na Hip tare da karkatarwa.
Gwaje-gwajen Ciwon Hip
Akwai nau'ikan gwaje-gwajen impingement na hip.
Ciwon Hip na Gaba
Wannan gwajin ya ƙunshi mara lafiya kwance a bayansu tare da durƙusa gwiwa a digiri 90 sannan kuma ya juya ciki zuwa jiki.
Idan akwai ciwo, ana ɗaukar gwajin tabbatacce.
Ciwon Hip na baya
Wannan gwajin ya haɗa da majiyyacin kwance a bayansu tare da shimfiɗa kwatangwalo kuma gwiwoyin su sun lanƙwasa a digiri 90.
Sannan ana juya kafa zuwa waje daga jiki.
Idan ya haifar da ciwo ko tsoro, ana ɗaukar shi tabbatacce.
Gwajin Tada Kafa Madaidaici
Ana amfani da wannan gwajin akan yanayin kiwon lafiya daban-daban waɗanda suka haɗa da ciwon baya.
Ana fara gwajin tare da majiyyaci zaune ko kwance.
A gefen da ba a shafa ba, ana bincika kewayon motsi.
Sannan hip yana jujjuyawa yayin da gwiwa ta mike akan kafafu biyu.
Ana iya tambayar majiyyaci don jujjuya wuyansa ko mika ƙafa don shimfiɗa jijiyoyi.
Gwajin FABER
Yana nufin Flexion, Sacewa, da Juyawar Waje.
An fara gwajin tare da marasa lafiya kwance a baya tare da kafafun su a mike.
An sanya ƙafar da aka shafa a cikin siffa guda hudu.
Likitan zai yi amfani da matsa lamba na ƙara ƙasa zuwa gwiwa.
Idan akwai ciwon hip ko kugu, gwajin ya tabbata.
Gwaji na UKU
Wannan yana nufin - da Juyawar Cikin Hip tare da shagala
An fara gwajin tare da marasa lafiya kwance a bayansu.
Sa'an nan majinyacin ya jujjuya gwiwa zuwa digiri 90 kuma ya juya shi ciki a kusa da digiri 10.
Sannan ana juyawa hip zuwa ciki tare da matsa lamba na ƙasa akan haɗin gwiwa na hip.
Ana maimaita motsa jiki tare da haɗin gwiwa ɗan ɗan ja da baya.
An yi la'akari da tabbatacce idan zafi yana kasancewa lokacin da hip ɗin ya juya kuma ya rage zafi lokacin da aka shagala da juyawa.
Maganin Chiropractic
Maganin chiropractic ya ƙunshi daidaitawar hip don daidaita kasusuwa a kusa da hip da sama ta hanyar kashin baya, maganin tausa mai laushi mai laushi don shakatawa da tsokoki a kusa da ƙashin ƙugu da cinya, ƙaddamar da ƙaddamarwa da aka yi niyya don mayar da motsi na motsi, motsa jiki na motsa jiki, da ƙarfafa motsa jiki don gyara rashin daidaituwa na muscular.
Magani da Farfaji
References
Chamberlain, Rachel. "Ciwon Hip a cikin Manya: Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwaƙwalwa na Ƙwaƙwalwa na Ƙaƙa ) . Likitan iyali na Amurka vol. 103,2 (2021): 81-89.
Groh, MM, Herrera, J. Cikakken bita na hawaye labral na hip. Curr Rev Musculoskelet Med 2, 105-117 (2009). doi.org/10.1007/s12178-009-9052-9
Roanna M. Burgess, Alison Rushton, Chris Wright, Cathryn Daborn, Inganci da daidaito na gwaje-gwajen gwaje-gwaje na asibiti da aka yi amfani da su don gano cututtukan cututtuka na hip: nazari na yau da kullun, Farfajiyar Manual, Volume 16, fitowar 4, 2011, Shafukan 318-326 , ISSN 1356-689X, doi.org/10.1016/j.math.2011.01.002 (www.sciencedirect.com/science/article/pii/S1356689X11000038)
Su, Tiao, et al. "Diagnosis da kuma maganin hawaye na labral." Mujallar likitancin kasar Sin vol. 132,2 (2019): 211-219. doi: 10.1097/CM9.0000000000000020
Wilson, John J, Masaru Furukawa. "Kimanin majiyyaci tare da ciwon hip." Likitan iyali na Amurka vol. 89,1 (2014): 27-34.
Diagnosing anwashing spondylitis yawanci ya ƙunshi gwaji da yawa. Lokacin da likitoci suka ba da umarnin gwaje-gwajen jini don gano cututtukan ankylosing spondylitis, mutum yana fuskantar mummunan bayyanar cututtuka a baya da haɗin gwiwa. Sau da yawa, gwajin gwajin jini yana nufin likita yana neman shaidar wani abu da zai iya haifar da alamun. Duk da haka, gwaje-gwajen jini da kansu ba zai iya tabbatar da ganewar asali na ankylosing spondylitis ba, amma idan aka haɗa su tare da hoto da kima, za su iya samar da mahimman alamu waɗanda ke nuna amsoshin.
Ankylosing Spondylitis Binciken Gwajin Jini
Ankylosing spondylitis shine amosanin gabbai da farko yana shafar kashin baya da kwatangwalo. Yana iya zama da wahala a gano cutar saboda babu gwaji ɗaya da zai iya ba da cikakkun bayanai don takamaiman ganewar asali. Ana amfani da haɗin gwaje-gwajen bincike, gami da gwajin jiki, hoto, da gwajin jini. Likitoci ba wai kawai suna neman sakamakon da zai nuna alamun ankylosing spondylitis ba, amma suna neman duk wani sakamakon da zai iya nunawa daga sakamakon spondylitis wanda zai iya ba da bayani daban-daban don bayyanar cututtuka.
Jarrabawar Jiki
Tsarin gano cutar zai fara ne da tarihin lafiyar mutum, tarihin iyali, da gwajin jiki. Yayin jarrabawar, likita zai yi tambayoyi don taimakawa wajen kawar da wasu sharuɗɗa:
Yaya tsawon lokacin bayyanar cututtuka ke nunawa?
Shin bayyanar cututtuka suna samun sauki tare da hutawa ko motsa jiki?
Shin alamun suna daɗa muni ko zama iri ɗaya?
Shin alamun sun fi muni a wani lokaci na rana?
Likitan zai bincika iyakoki a cikin motsi da palpate masu laushi. Da yawa yanayi na iya haifar da alamomi iri ɗaya, don haka likita zai duba don ganin idan zafi ko rashin motsi ya dace da ciwon huhu. Alamar alamar ankylosing spondylitis shine zafi da taurin kai a cikin haɗin gwiwa na sacroiliac. Hanyoyin sacroiliac suna cikin ƙananan baya, inda tushen kashin baya da ƙashin ƙugu suka hadu. Likitan zai duba sauran yanayin kashin baya da alamomi:
Alamun ciwon baya wanda ya haifar da - raunin da ya faru, yanayin matsayi, da/ko matsayi na barci.
Halin HLA-B27 yayi daidai da ankylosing spondylitis; idan mutum yana da shi, daya daga cikin iyayensu yana da shi.
hoto
Hasken X-ray yakan zama mataki na farko zuwa ganewar asali.
Yayin da cutar ke ci gaba, sabbin ƙasusuwan ƙasusuwa suna tasowa tsakanin kashin baya, a ƙarshe suna haɗa su.
X-haskoki suna aiki mafi kyau wajen tsara ci gaban cutar fiye da ganewar asali na farko.
MRI yana ba da hotuna masu haske a farkon matakai kamar yadda ƙananan bayanai ke bayyane.
Gwajin jini
Gwajin jini na iya taimakawa wajen kawar da wasu yanayi kuma duba alamun kumburi, samar da shaida mai goyan baya tare da sakamakon gwajin hoto. Yawanci yana ɗaukar kusan kwana ɗaya ko biyu kawai don samun sakamako. Likita na iya yin odar ɗayan gwajin jini masu zuwa:
Antinuclear rigakafi, ko ANA, suna bin sunadaran da ke cikin tsakiya na tantanin halitta, suna gaya wa jiki ƙwayoyinsa abokan gaba ne.
Wannan yana kunna amsawar rigakafi wanda jiki ke yaƙi don kawar da shi.
Wani bincike ya ƙaddara cewa ana samun ANA a cikin kashi 19 cikin dari na mutanen da ke fama da ciwon ankylosing spondylitis kuma ya fi girma a cikin mata fiye da maza.
Haɗe tare da wasu gwaje-gwaje, kasancewar ANA yana ba da wata alama ga ganewar asali.
Lafiya Jiki
The microbiome na ciki yana taka muhimmiyar rawa wajen haifar da ci gaban spondylitis na ankylosing spondylitis da maganin sa.
Gwaje-gwaje don tantance lafiyar hanji na iya baiwa likita cikakken hoton abin da ke faruwa a cikin jiki.
Gwajin gwajin jini don ankylosing spondylitis da sauran yanayin kumburi sun dogara sosai akan haɗa gwaje-gwaje daban-daban tare da gwaje-gwajen asibiti da hoto.
Dalilai, Alamu, Ganowa, da Jiyya
References
Cardoneanu, Anca, et al. "Halayen microbiome na hanji a cikin ankylosing spondylitis." Gwaji da magungunan warkewa vol. 22,1 (2021): 676. doi:10.3892/etm.2021.10108
Prohaska, E et al. "Antinukleäre Antikörper bei Spondylitis ankylosans (Morbus Bechterew)" Wiener klinische Wochenschrift vol. 92,24 (1980): 876-9.
Sheehan, Nicholas J. "Hanyoyin HLA-B27." Jaridar Royal Society of Medicine vol. 97,1 (2004): 10-4. doi:10.1177/014107680409700102
Wenker KJ, Quint JM. Ankylosing Spondylitis. [An sabunta 2022 Afrilu 9]. A cikin: StatPearls [Internet]. Tsibirin Treasure (FL): Bugawa na StatPearls; 2022 Jan-. Akwai daga: www.ncbi.nlm.nih.gov/books/NBK470173/
Xu, Yong-Yue, et al. "Matsayin microbiome na gut a cikin ankylosing spondylitis: nazarin karatu a cikin wallafe-wallafe." Maganin ganowa vol. 22,123 (2016): 361-370.
The Adams gaba lankwasawa gwajin hanya ce mai sauƙi mai sauƙi wanda zai iya taimakawa tare da ganewar asali na scoliosis da taimakawa wajen bunkasa tsarin kulawa. An sanya wa jarrabawar suna bayan da Likitan Ingila William Adams. A matsayin wani ɓangare na jarrabawa, likita ko chiropractor za su nemi lankwasa mara kyau na gefe zuwa gefe a cikin kashin baya.
Binciken Scoliosis
Jarabawar Adams gaba-lankwasawa na iya taimakawa wajen tantance ko akwai alamun scoliosis.
Ba ganewar asali ba ne, amma ana iya amfani da sakamakon a matsayin mafari.
Ana yin gwajin tare da shekarun makaranta yara tsakanin 10 zuwa 18 don gano samari idiopathic scoliosis ya da AIS.
Gwajin tabbatacce alama ce ta asymmetry a cikin haƙarƙari tare da lanƙwasa gaba.
Yana iya gano scoliosis a kowane bangare na kashin baya, musamman a tsakiyar thoracic da babba baya.
Gwajin ba kawai ga yara ba ne; scoliosis na iya tasowa a kowane zamani, don haka yana da tasiri ga manya.
Adams Forward Bend Test
Gwajin yana da sauri, sauƙi, kuma mara zafi.
Mai jarrabawa zai bincika don ganin ko wani abu bai yi daidai ba lokacin da ya miƙe tsaye.
Sa'an nan kuma za a ce majiyyaci ya lanƙwasa gaba.
Ana tambayar mai haƙuri ya tsaya tare da ƙafafu tare, yana fuskantar nesa daga mai binciken.
Sa'an nan marasa lafiya sun durƙusa gaba daga kugu, tare da rataye hannayensu a tsaye zuwa ƙasa.
Mai jarrabawa yana amfani da a scoliometer- kamar matakin gano asymmetry a cikin kashin baya.
Hakanan za'a iya amfani da gwajin don nemo matsalolin curvature na kashin baya da yanayi kamar:
Kyphosis ko hunchback, inda babba baya ya lankwashe gaba.
Cutar Scheuermann wani nau'i ne na kyphosis inda thoracic vertebrae zai iya girma ba daidai ba yayin girma girma kuma ya sa vertebrae ya girma ya zama siffar kama.
Hakanan ana iya amfani da na'urar daukar hoto ko CT da hoton maganadisu ko sikanin MRI.
Gwajin Lanƙwasa Gaba
References
Glavaš, Josipa et al. "Matsayin likitancin makaranta a farkon ganowa da sarrafa scoliosis idiopathic na matasa." Wiener klinische Wochenschrift, 1–9. 4 Oktoba 2022, doi:10.1007/s00508-022-02092-1
Grossman, TW et al. "Kimanin gwajin lanƙwasawa na gaba Adams da scoliometer a cikin saitin gwajin scoliosis." Jaridar orthopedics na yara vol. 15,4 (1995): 535-8. doi:10.1097/01241398-199507000-00025
Letts, M et al. "Na'ura mai kwakwalwa na ultrasonic digitization a cikin ma'auni na kashin baya." Kashin baya vol. 13,10 (1988): 1106-10. doi: 10.1097/00007632-198810000-00009
Senkoylu, Alpaslan, et al. "Hanya mai sauƙi don tantance sassaucin juyawa a cikin scoliosis idiopathic na matasa: gyara gwajin lankwasawa na gaba na Adam." Nakasar kashin baya vol. 9,2 (2021): 333-339. doi:10.1007/s43390-020-00221-2
Ƙananan ciwon baya yana ɗaya daga cikin cututtuka na yau da kullum ga mutanen da ke ziyartar likita ko asibitin kulawa na gaggawa. Lokacin da ciwon baya ya zama mai tsanani, zai iya sa ka tunanin wani abu ba daidai ba ne a bayanka. Likita na iya bayar da wani x-ray ko MRI scan don sanya damuwa a cikin sauƙi.
Abin farin ciki, yawancin lokuta na ƙananan ciwon baya, har ma da ciwo mai tsanani, inganta a cikin kwanaki ko 'yan makonni. Yawancin lokuta ana magance su da chiropractic, gyaran jiki, maganin zafi/kankara, da hutawa. Kuma yawancin waɗannan lokuta ba sa buƙatar kowane nau'i na hoto na kashin baya. Duk da haka, waɗannan shine dalilin da ya sa X-ray, MRI, da CT scans ya zama dole don gano abin da ke faruwa.
Ƙunƙarar tsoka
Jijiya mai yatsa
Matsayi mara kyau
Wadannan abubuwan da ke haifar da ƙananan ciwon baya na iya zama mai raɗaɗi da iyakance ayyukan.
Ciwon Baya Ya Tsawon Sati 2/3
Ciwo mai zurfi yana tsakanin makonni 4 da 12, yayin da ciwon baya na tsawon watanni uku ko fiye. Waɗannan ba alamun mummunan yanayin kashin baya ba ne.
Kasa da 1% na mutanen da ke da ƙananan ciwon baya an gano su da yanayin da zai buƙaci tiyatar kashin baya:
Doctors na iya ba da shawarar x-ray ko MRI idan ƙananan ciwon baya ya kasance daga rauni mai rauni, kamar:
Slip
Fall
Hadarin mota
Sauran abubuwan da zasu iya haifar da ƙananan ciwon baya na iya ba da garantin hoto na likita nan da nan ko kuma daga baya.
Tsarin binciken yana farawa tare da kimanta ƙananan alamun baya da kuma yadda suke da alaƙa da abin da aka samo a lokacin:
Gwajin jiki
Gwajin jijiyoyi
Tarihin likita
Likita yana amfani da waɗannan sakamakon don sanin ko hotunan kashin baya ya zama dole, tare da nau'in gwajin hoto, x-ray, ko MRI da lokaci don tabbatar da ganewar asali.
Ƙananan X-ray / MRI
Hoton X-ray na kashin baya mafi kyau yana gano matsalolin tsarin kasusuwa amma shine ba mai girma sosai tare da raunin nama mai laushi ba. Za a iya yin jerin x-ray don gano karayar matsawar vertebral.
A baya
Na baya
Ra'ayi na gefe
MRI gwaji ne mara radiation. MRIs halitta 3-D ra'ayoyin anatomical na kasusuwan kashin baya da laushin kyallen takarda. Rini mai bambanci kamar gadolinium ana amfani da shi don haɓakawa da haɓaka ingancin hotuna. Ana allurar da bambanci ta hanyar layin jijiya a hannunka ko hannunka kafin ko yayin gwajin. An MRI na iya kimanta bayyanar cututtuka na jijiya, kamar radiating zafi ko ciwon da ke tasowa bayan gano ciwon daji.
Alamu, Ciwon Magungunan Magunguna, da Sharuɗɗa waɗanda zasu buƙaci Hoto na Spine
Alamun jijiya
Ƙananan ciwon baya wanda ke haskakawa, magoya baya, ko ƙasa zuwa gindi, ƙafafu, da ƙafafu
Abubuwan da ba su dace ba a cikin ƙananan jiki na iya nuna rushewar jijiya
Radiation ga dukan jikinka ana auna ta hanyar millisievert (mSv), wanda kuma aka sani da tasiri mai tasiri. Adadin radiation daidai yake a duk lokacin da kuka sami x-ray. Lokacin jurewa x-ray, da radiation da jiki bai sha ba yana haifar da hoton.
Matsakaicin tasiri yana taimaka wa likita auna haɗarin yiwu sakamako masu illa na hoton rediyo:
CT scans kuma suna amfani da radiation
Takamaiman kyallen jikin jiki da gabobin da ke cikin kasan baya suna da hankali ga fallasa hasken rana, kamar gabobin haihuwa.
MRI Radiation-Free Me yasa Ba Kawai Amfani da Wannan Gwajin Koda yaushe ba
Ba za a iya amfani da MRI akan duk marasa lafiya ba saboda fasahar maganadisu mai ƙarfi. Mata masu juna biyu ko mutanen da ke da ƙarfe a cikin jikinsu, kamar na'urar motsa jiki ta kashin baya, bugun zuciya, da sauransu, ba za a iya duba su da MRI ba.
Gwajin MRI kuma yana da tsada; likitoci ba sa so su rubuta gwaje-gwajen da ba dole ba wanda ke kara farashin. Ko kuma saboda cikakkun bayanai da MRIs ke bayarwa, wani lokaci batun kashin baya na iya zama mai tsanani amma ba.
Example: MRI na ƙananan baya yana nuna a diski herniated a cikin mara lafiya ba tare da ciwon baya / ƙafa ba ko wasu alamomin.
Wannan shine dalilin da ya sa likitoci ke kawo duk binciken su kamar alamun bayyanar cututtuka, jarrabawar jiki, da tarihin likita don tabbatar da ganewar asali da kuma haifar da tsarin kulawa na al'ada.
Hanyoyin Gwajin Hoto
Idan ƙananan ciwon baya ya ɗauki nauyinsa, saurari abin da likita ya ba da shawarar. Wataƙila ba za su yi odar x-ray na lumbar ko MRI nan da nan ba amma ku tuna abubuwan da aka ambata a sama, kamar alamun cututtukan jijiyoyin jiki da yanayin kiwon lafiya tare. Amma waɗannan gwaje-gwajen suna taimakawa gano sanadin ko musabbabin ciwon. Ka tuna wannan shine don taimakawa marasa lafiya zuwa lafiyar su mafi kyau kuma ba tare da jin zafi ba.
Yadda ake kawar da Ciwon Baya a zahiri | (2020) Masu Levelers | El Paso, Tx
Abubuwan da aka bayar na NCBI Resources
Binciken hoto wani muhimmin abu ne a cikin kimanta raunin kashin baya. Saurin juyin halitta na fasaha na hoto ya canza sosai da ƙima da kuma kula da raunin kashin baya. Binciken hoto na yin amfani da CT da MRI, da sauransu, suna taimakawa a cikin m kuma na yau da kullum saituna. An yi la'akari da raunin kashin baya da nama mai laushi ta hanyar hoton maganadisu, ko MRI, alhãli kuwa Na'urar daukar hoto ko CT scans mafi kyawun kimanta raunin kashin baya ko karaya.
Wani lokaci akwai rashin daidaituwa na kashin baya kuma yana haifar da rashin daidaituwa na yanayin dabi'a ko wasu curvatures na iya wuce gona da iri. Waɗannan ɓangarorin kashin baya da ba su dace ba suna da yanayin lafiya guda uku da ake kira lordosis, kyphosis, da scoliosis.
Ba a yi nufin a lanƙwasa, murɗawa, ko lanƙwasa ba. Halin yanayi na lafiyayyen kashin baya yana da ɗan miƙewa tare da ƴan lankwasa suna gudana gaba da baya ta yadda hangen nesa zai bayyana su.
Duban kashin baya daga baya, yakamata ku ga wani abu daban-daban - kashin baya wanda ke gudana kai tsaye ƙasa, sama zuwa ƙasa ba tare da lanƙwasa gefe zuwa gefe ba. Wannan ba koyaushe yana faruwa ba.
Kashin baya ya ƙunshi kashin baya, ƙananan ƙasusuwa waɗanda aka jera saman juna tare da fayafai masu tasiri tsakanin kowannensu. Wadannan kasusuwa suna aiki azaman haɗin gwiwa, suna barin kashin baya ya lanƙwasa da karkatarwa ta hanyoyi daban-daban.
Suna lanƙwasa a hankali, suna zazzagewa kaɗan a cikin ƙananan baya, kuma kaɗan a wuyansa. Jigilar nauyi, haɗe tare da motsi na jiki, na iya sanya damuwa mai yawa a kan kashin baya kuma waɗannan ƙananan ƙananan hanyoyi suna taimakawa wajen shawo kan tasirin.
Sharuɗɗa daban-daban don nau'ikan nau'ikan curvatures na kashin baya
Kowanne daga cikin wadannan cututtukan curvature na kashin baya guda uku yana shafar wani yanki na kashin baya ta wata hanya ta musamman.
Hypo Lordosis � Wannan cuta ta lankwasa ta kashin baya tana shafar kasan baya, yana sa kashin baya ya karkata zuwa ciki ko waje sosai.
Hyper ko Hypo Kyphosis � Wannan cuta ta lankwashewar kashin baya tana shafar baya na sama, yana haifar da ruku'u, yana haifar da zagayawa ko lallausan waje.
scoliosis � Wannan cuta ta lankwasa ta kashin baya na iya shafar kashin bayanta gaba daya, ta sa ta karkade gefe, ta yi siffar C ko S.
Mene ne bayyanar cututtuka?
Kowane nau'in curvature yana nuna nasa alamun alamun. Yayin da wasu alamomin na iya haɗuwa, da yawa sun keɓanta da takamaiman cuta na curvature.
Lordosis
�swayback� bayyanar inda duwaiwai suka fito ko sun fi fitowa fili.
Rashin jin daɗi a baya, yawanci a yankin lumbar
Lokacin da yake kwance akan ƙasa mai wuya a baya, ƙananan baya baya taɓa saman, koda lokacin yunƙurin ƙulla ƙashin ƙugu da daidaita ƙananan baya.
Wahala tare da wasu motsi
Binciken baya
Kyphosis
Mai lankwasa ko dunƙule zuwa babba baya
Ciwon baya da gajiya bayan zaune ko tsaye na dogon lokaci (Scheuermann kyphosis)
Gajiyar kafa ko baya
Kai yayi nisa a gaba maimakon zama a tsaye
scoliosis
Hips ko kugu ba daidai ba ne
Gilashin kafada ɗaya ya fi ɗayan
Mutum ya karkata gefe guda
Mene ne dalilai?
Yawancin al'amurran kiwon lafiya daban-daban na iya sa kashin baya ya zama mara kyau ko kuma ya haifar da lankwasa na kashin baya. Kowane daga cikin yanayin kashin baya da aka ambata yana shafar yanayi da yanayi daban-daban.
Lordosis
osteoporosis
Achondroplasia
discitis
kiba
Spondylolisthesis
Kyphosis
Kyphosis
amosanin gabbai
Ciwon daji a kan ko a cikin kashin baya
kyphosis na haihuwa (haɓaka ci gaban vertebrae yayin da mutum yake cikin mahaifa)
Spina bifida
Cutar Scheuermann
Spine cututtuka
osteoporosis
Lalacewar ɗabi'a ko rashin kyawun matsayi
scoliosis har yanzu wani ɗan asiri ne ga likitoci. Ba su da tabbacin abin da ke haifar da mafi yawan nau'in scoliosis wanda yawanci ana gani a yara da matasa. Wasu daga cikin dalilan da suka bayyana sun hada da:
akwai screenings samuwa ga yara da manya don gano duk wani curvatures na kashin baya a farkon matakan su ta hanyar chiropractor. Ganowa da wuri na waɗannan cututtuka yana da mahimmanci wajen gano su kafin su yi tsanani.
Keɓaɓɓen Spine & *MAGANIN SCIATICA* | El Paso, TX (2019)
An kiyasta cewa scoliosis yana shafar ko'ina daga kashi 2 zuwa 3 na yara da manya a Amurka. Wato kusan mutane miliyan shida zuwa tara. Yayin da ake ganin ya fi girma a cikin takamaiman shekarun maza da mata, yana iya haɓakawa tun yana ƙuruciya. Kowace shekara, kimanin yara 30,000 suna sanye da takalmin gyaran kafa na scoliosis na baya yayin da mutane 38,000 ke yin tiyatar haɗin gwiwa don gyara matsalar. Binciken scoliosis na iya samun fa'idodi masu yawa ta hanyar gano abubuwan haɗari ga scoliosis da ba da izinin jiyya da wuri.
Da farko da kuka gano scoliosis, mafi sauƙin magani.
Scoliosis yawanci yana tasowa a lokacin ƙuruciya. Ga 'yan mata, yawanci yana faruwa tsakanin shekaru 7 zuwa 14. Yara maza suna haɓaka shi kaɗan daga baya, tsakanin shekaru 6 zuwa 16.
Samun gwajin scoliosis a kowace shekara a lokacin waɗannan ma'auni masu mahimmanci yana ba likitoci damar gano yanayin da wuri kuma su fara magance shi kafin ya yi tsanani. Babban scoliosis na iya buƙatar jiyya mai yawa, takalmin gyaran kafa, har ma da tiyata.
An nuna Chiropractic don taimakawa scoliosis, kamar yadda ake yin shimfidawa, motsa jiki na musamman, da farfadowa na jiki. Akwai gyare-gyare na kashin baya da chiropractors ke yi wanda ke da mahimmanci ga maganin scoliosis.
Lokacin da ake magance yanayin da wuri, ana iya dakatar da kusurwar Cobb daga ci gaba har ma da ragewa don kashin baya ya sami yanayin yanayi. Magungunan da ba a yi amfani da su ba suna da tasiri sosai a cikin matakan farko na scoliosis, don haka gano wuri da farkon ganewar asali yana da mahimmanci.
Gano lamurra masu haɗari da wuri zai iya magance al'amuran yau da kullun kuma ya hana masu zuwa nan gaba.
Chiropractors na iya ganewa wasu abubuwan haɗari na scoliosis a cikin yara kafin yanayin ya ci gaba. Binciken scoliosis yana ba su damar tabo tashin hankali a cikin kashin bayan yara � Alamar gama gari cewa za su kamu da scoliosis.
Lokacin da iyaye suka san cewa yaron ya kasance a cikin wani nau'i mai haɗari don bunkasa scoliosis, za su iya ɗaukar matakan da suka dace tare da kula da gida don alamun scoliosis da kuma ci gaba da bin hanyoyin da aka ba da shawarar. Za su san su nemo alamun kuma za su iya magance su da sauri don a iya fara magani a farkon lokaci.
Taimaka wa masu bincike da likitoci su zama mafi inganci wajen magance scoliosis.
Matakan farko da ci gaban scoliosis har yanzu suna ɓoye a asirce ga masu bincike da likitoci. Yayin da aka sami babban ci gaba da aka samu wajen fahimtar yanayin, akwai sauran abubuwa da yawa da za a koya.
An yi nazari da yawa da suka taimaka wa likitoci wajen gano yara masu haɗari da kuma yin bincike a farkon matakai, kamar yadda.kusurwar idon sawu da ƙafa suna da alaƙa da scoliosis. Koyaya, dubawa, ganewar asali, da magani suna da mahimmanci don kiyaye kwararar bayanai don ƙarin nazarin da za a gudanar da ƙarin bincike da za a yi.
Ƙarin gwaje-gwaje na yau da kullun yana nufin gano ƙarin lokuta na scoliosis a farkon matakai. Wannan zai yi tasiri mai tasiri biyu akan bincike. Zai ba da ƙarin bayanan da za a sake dubawa da kuma nazarin, kuma zai ƙara sha'awar yanayin yayin da aka sami ƙarin lokuta na farkon scoliosis. Wannan zai kara zaburar da bincike.
Ka guji wasan jira� don ganin ko scoliosis zai ci gaba.
Duk iyayen da suka jira sakamakon gwaji ko kuma su ga ko yanayin zai iya tasowa ko kuma ya tsananta ya san damuwar yin wasan da ake jira. Iyali yawanci shine mutum na farko da ya fara gano scoliosis a cikin yaro.
Yayin da za su iya zargin matsala, ko kuma sun san cewa akwai matsala, za su iya jira su ga hanyar samun magani. Idan lanƙwan ya tsananta za su iya neman magani, amma kullun rashin sanin ko tsarin zai yi muni - kuma damuwa da yake haifarwa zai iya tasiri ba kawai iyaye ba - natsuwar zuciya - har ma da yara.
Binciken scoliosis yana ba da kwanciyar hankali da lura da ci gaban yaro ta yadda idan scoliosis ya ci gaba ko ya zama matsala ana iya magance shi cikin sauri, mafi inganci hanya mai yiwuwa.
Kimanin mutane miliyan 1.5 a Amurka suna fama da cututtukan cututtuka na rheumatoid. rheumatoid amosanin gabbai, ko RA, ciwo ne na yau da kullum, cututtuka na autoimmune wanda ke nuna ciwo da kumburi na haɗin gwiwa. Tare da RA, tsarin rigakafi, wanda ke kare lafiyar mu ta hanyar kai hari ga abubuwa na waje kamar kwayoyin cuta da ƙwayoyin cuta, kuskuren ya kai hari ga gidajen abinci. Rheumatoid amosanin gabbai ya fi shafar haɗin gwiwar hannu, ƙafafu, wuyan hannu, gwiwar hannu, gwiwoyi da idon sawu. Yawancin masu sana'a na kiwon lafiya suna ba da shawarar ganewar asali da wuri da jiyya na RA.
Abstract
Rheumatoid amosanin gabbai shine mafi yawan cututtukan cututtukan cututtukan cututtukan ƙwayoyin cuta. Mata, masu shan taba, da wadanda ke da tarihin iyali na cutar sun fi kamuwa da su. Ma'auni don ganewar asali sun haɗa da samun aƙalla haɗin gwiwa ɗaya tare da tabbataccen kumburi wanda ba a bayyana shi ta hanyar wani cuta ba. Yiwuwar kamuwa da cututtukan cututtukan cututtukan cututtukan fata yana ƙaruwa tare da adadin ƙananan haɗin gwiwa. A cikin majiyyaci tare da cututtukan cututtuka na kumburi, kasancewar wani abu na rheumatoid ko anti-citrullinated protein antibody, ko girman girman furotin C-reactive ko erythrocyte sedimentation rate yana nuna alamar cututtuka na rheumatoid arthritis. Ƙimar dakin gwaje-gwaje na farko ya kamata kuma ya haɗa da cikakken ƙididdigar jini tare da bambanta da kimanta aikin koda da hanta. Ya kamata a gwada marasa lafiya masu shan kwayoyin halitta don cutar hanta, hepatitis C, da tarin fuka. Tun da farko ganewar asali na rheumatoid amosanin gabbai yana ba da damar yin magani a baya tare da abubuwan da ke canza cututtuka na antirheumatic. Ana amfani da haɗin magunguna sau da yawa don sarrafa cutar. Methotrexate yawanci magani ne na layi na farko don cututtukan arthritis na rheumatoid. Ma'aikatan ilimin halitta, irin su masu hana cutar necrosis factor, gabaɗaya ana ɗaukar wakilai na layi na biyu ko kuma ana iya ƙara su don jiyya biyu. Makasudin jiyya sun haɗa da rage yawan ciwon haɗin gwiwa da kumburi, rigakafin lalacewar rediyo da nakasar da ake gani, da ci gaba da aiki da ayyukan sirri. Ana nuna maye gurbin haɗin gwiwa ga marasa lafiya tare da mummunan lalacewar haɗin gwiwa wanda alamun rashin kulawa da kulawar likita ba su da kyau. (Am Fam Likita. 2011; 84 (11): 1245-1252. Haƙƙin mallaka � 2011 American Academy of Family Physicians.)
Rheumatoid amosanin gabbai (RA) shine mafi yawan cututtukan cututtuka na kumburi, tare da yawancin rayuwa har zuwa 1 bisa dari a dukan duniya.1 Farko zai iya faruwa a kowane zamani, amma kololuwa tsakanin 30 zuwa 50 shekaru.2 Nakasa yana da yawa kuma mai mahimmanci. A cikin babban ƙungiyar Amurka, 35 bisa dari na marasa lafiya tare da RA suna da nakasa aiki bayan shekaru 10
Etiology da Pathology
Kamar yawancin cututtuka na autoimmune, etiology na RA yana da yawa. Halittar kwayoyin halitta yana bayyana a cikin tarin iyali da kuma nazarin tagwayen monozygotic, tare da 50 bisa dari na RA hadarin da ke tattare da kwayoyin halitta. 4 Nazarin ƙungiyar Genome-wide sun gano ƙarin sa hannu na kwayoyin halitta waɗanda ke ƙara haɗarin RA da sauran cututtukan autoimmune, gami da STAT45 gene da CD1 locus.6,7 Shan taba shine babban abin da ke haifar da muhalli ga RA, musamman a cikin waɗanda ke da yanayin yanayin halitta.4 Ko da yake cututtuka. na iya buɗewa da amsawar autoimmune, babu wani takamaiman ƙwayoyin cuta da aka tabbatar don haifar da RA.40 RA da ke da alaƙa da hanyoyin kumburi waɗanda ke haifar da haɓakar ƙwayoyin synovial a cikin gidajen abinci. Samuwar pannus na gaba na iya haifar da lalatawar guringuntsi da zaizayar ƙashi. Yawan haɓakar cytokines masu kumburi, gami da ƙari necrosis factor (TNF) da interleukin-5, suna tafiyar da tsari mai lalacewa.8
Dalili na Hadarin
Tsofaffi, tarihin iyali na cutar, da jima'i na mata suna haɗuwa da haɗarin RA, kodayake bambancin jima'i ba shi da mahimmanci a cikin tsofaffin marasa lafiya.1 Dukansu shan taba na yanzu da na baya suna ƙara haɗarin RA (haɗarin dangi [RR] = 1.4, har zuwa 2.2 don fiye da masu shan taba na shekaru 40).11 Ciki sau da yawa yana haifar da remission na RA, mai yiwuwa saboda rashin haƙuri na immunologic.12 Parity na iya samun tasiri mai dorewa; RA ba shi da yuwuwar kamuwa da cutar a cikin mata masu ban tsoro fiye da na mata masu ɓarna (RR = 0.61).13,14 Shayarwa tana rage haɗarin RA (RR = 0.5 a cikin matan da suke shayarwa aƙalla watanni 24), yayin da farkon haila�(RR) = 1.3 ga masu ciwon haila a shekara 10 ko kasa da haka) da kuma lokacin haila (RR = 1.5) yana kara haxari.14 Amfani da maganin hana haihuwa na baka ko bitamin E baya shafar hadarin RA.15
ganewar asali
Gabatarwa Na Musamman
Marasa lafiya tare da RA yawanci suna tare da zafi da taurin kai a cikin gidajen abinci da yawa. Hannun wuyan hannu, haɗin gwiwar interphalangeal na kusa, da haɗin gwiwar metacarpophalangeal sun fi shiga ciki. Ƙunƙarar safiya da ke daɗe fiye da sa'a ɗaya yana nuna alamar cututtuka mai kumburi. Ƙunƙarar ƙura saboda synovitis na iya zama bayyane (Hoto na 1), ko kauri na synovial na dabara na iya zama mai iya gani akan gwajin haɗin gwiwa. Har ila yau, marasa lafiya na iya gabatar da ƙwararrun arthralgias kafin fara bayyanar kumburin haɗin gwiwa na asibiti. Alamun tsari na gajiya, asarar nauyi, da ƙananan zazzabi na iya faruwa tare da ciwo mai aiki.
Matsalar Magana
A cikin 2010, Kwalejin Rheumatology da Liberungiyar Turai da huhun doka sun yi ƙoƙari don gano korafin Rheumatal na Amurka na Rheumatology ma'auni. Ma'auni na 1 ba su haɗa da kasancewar nodules na rheumatoid ko canje-canje na radiyo ba, dukansu biyu ba su da wuya a farkon RA. Hakanan ba a buƙatar alamar cututtukan arthritic a cikin ka'idojin 16, yana ba da damar gabatar da asymmetric na farko. Bugu da ƙari, masu bincike na Holland sun haɓaka da kuma tabbatar da ka'idodin tsinkaya na asibiti don RA (Table 1987) .2010 Manufar wannan ka'idar ita ce don taimakawa wajen gano marasa lafiya da cututtukan cututtuka marasa bambanci wanda zai iya ci gaba zuwa RA, da kuma jagoranci masu biyo baya. sama da mikawa.
bincike gwaje-gwaje
Cututtukan autoimmune irin su RA galibi ana siffanta su ta kasancewar jikunan autoanti. Rheumatoid factor ba takamaiman ga RA ba kuma yana iya kasancewa a cikin marasa lafiya da wasu cututtuka, irin su hepatitis C, da kuma a cikin tsofaffi masu lafiya. Anti-citrullinated protein antibody ya fi takamaiman ga RA kuma yana iya taka rawa a cikin cututtukan cututtuka.6 Kimanin kashi 50 zuwa 80 na mutanen da ke da RA suna da rheumatoid factor, anti-citrullinated protein antibody, ko duka biyu.10 Marasa lafiya tare da RA na iya samun. tabbataccen sakamakon gwajin antinuclear antinuclear, kuma gwajin yana da mahimmancin tsinkaye a cikin nau'ikan yara na wannan cuta.19 C-reactive matakan furotin da erythrocyte sedimentation rate suna sau da yawa yana ƙaruwa tare da RA mai aiki, kuma waɗannan m lokaci reactants wani bangare ne na sabon. RA rarrabuwa ka'idojin.16 C-reactive furotin matakan da erythrocyte sedimentation kudi kuma za a iya amfani da su bi da cututtuka da kuma mayar da martani ga magani. Baseline cikakken adadin jini tare da bambance-bambance da kimanta aikin koda da hanta yana taimakawa saboda sakamakon zai iya yin tasiri akan zaɓuɓɓukan magani (misali, majiyyaci tare da ƙarancin koda ko babban thrombocytopenia mai yiwuwa ba za a rubuta masa maganin hana kumburin ƙwayar cuta ba [NSAID]). Ƙananan anemia na cututtuka na yau da kullum yana faruwa a cikin 33 zuwa 60 bisa dari na duk marasa lafiya tare da RA,20 ko da yake ya kamata a yi la'akari da asarar jinin gastrointestinal a cikin marasa lafiya da ke shan corticosteroids ko NSAIDs. Methotrexate an hana shi a cikin marasa lafiya da cututtukan hanta, irin su hepatitis C, da kuma marasa lafiya da ke fama da rashin lafiya mai mahimmanci.21 Magungunan ilimin halitta, irin su mai hana TNF, yana buƙatar gwajin tarin fuka mara kyau ko magani don tarin fuka. Har ila yau, sake kunnawar cutar hepatitis B na iya faruwa tare da amfani da masu hana TNF.22 Ya kamata a yi aikin rediyo na hannaye da ƙafafu don auna canje-canje masu banƙyama na periarticular, wanda zai iya zama alamar wani ƙananan RA mai tsanani.10
Binciken Daban-daban
Sakamakon fata yana nuna tsarin lupus erythematosus, sclerosis, ko psoriatic amosanin gabbai. Polymyalgia rheumatica ya kamata a yi la'akari da shi a cikin tsofaffin majiyyaci tare da alamun bayyanar cututtuka da farko a cikin kafada da hip, kuma ya kamata a tambayi mai haƙuri tambayoyin da suka shafi haɗin gwiwa na wucin gadi. Gidan rediyo na ƙirji yana taimakawa don kimanta sarcoidosis a matsayin etiology na arthritis. Mutanen da ke da ƙasa da makonni shida na bayyanar cututtuka na iya samun tsarin kwayar cuta, kamar parvovirus. Abubuwan da ke faruwa a kai a kai na matsanancin kumburin haɗin gwiwa suna ba da shawarar arthropathy na crystal, kuma arthrocentesis yakamata a yi don kimanta monosodium urate monohydrate ko calcium pyrophosphate dihydrate crystals. Kasancewar yawancin abubuwan da ke haifar da myofascial da alamun bayyanar cututtuka na iya nuna fibromyalgia, wanda zai iya zama tare da RA. Don taimakawa jagorar ganewar asali da kuma ƙayyade dabarun jiyya, marasa lafiya da cututtukan cututtukan ƙwayar cuta ya kamata a gaggauta tura su zuwa ga masanin ilimin rheumatology.16,17
Rheumatoid amosanin gabbai, ko RA, shine mafi yawan nau'in arthritis. RA cuta ce mai saurin kamuwa da cuta, wacce ke haifar da ita lokacin da tsarin garkuwar jiki, tsarin garkuwar jikin dan adam, ya kai hari ga kwayoyin halittarsa da kyallen jikinsu, musamman ma gabobin jiki. Rheumatoid amosanin gabbai ana gano su akai-akai ta bayyanar cututtuka na ciwo da kumburi, sau da yawa yana shafar ƙananan haɗin gwiwar hannu, wuyan hannu da ƙafafu. Bisa ga yawancin masu sana'a na kiwon lafiya, farkon ganewar asali da magani na RA yana da mahimmanci don hana ƙarin lalacewar haɗin gwiwa da rage alamun cututtuka. Dr. Alex Jimenez DC, CCST Insight
Jiyya
Bayan an gano RA kuma an fara kimantawa na farko, yakamata a fara jiyya. Sharuɗɗa na baya-bayan nan sun magance kulawar RA,21,22 amma zaɓin haƙuri kuma yana taka muhimmiyar rawa. Akwai la'akari na musamman ga matan da suka kai shekarun haihuwa saboda yawancin magunguna suna da illa ga ciki. Manufofin jiyya sun haɗa da rage ciwon haɗin gwiwa da kumburi, hana nakasa (kamar ulnar karkacewa) da lalacewar rediyo (kamar yashwa), kiyaye ingancin rayuwa (na sirri da aiki), da kuma sarrafa karin bayyanar cututtuka. Magunguna masu gyara cututtuka na antirheumatic (DMARDs) sune jigon jiyya na RA.
DMARDs
DMARDs na iya zama masu ilimin halitta ko marasa halitta (Table 3) .23 Ma'aikatan Halittu sun haɗa da kwayoyin halitta na monoclonal da masu karɓa na recombinant don toshe cytokines wanda ke inganta ƙwayar kumburi da ke da alhakin alamun RA. Ana ba da shawarar Methotrexate azaman jiyya na farko a cikin marasa lafiya tare da RA mai aiki, sai dai in an hana shi ko ba a yarda da shi ba.21 Leflunomide (Arava) ana iya amfani da shi azaman madadin methotrexate, kodayake illar gastrointestinal sun fi yawa. Sulfasalazine (Azulfidine) ko hydroxychloroquine (Plaquenil) pro-mai kumburi a matsayin monotherapy a cikin marasa lafiya tare da ƙarancin aiki ko kuma ba tare da fa'ida mara kyau ba (misali, seronegative, RA mara kyau) . fiye da monotherapy; duk da haka, illa masu illa kuma na iya zama mafi girma.21,22 Idan RA ba a sarrafa shi da kyau tare da DMARD mara kyau ba, ya kamata a fara DMARD mai ilimin halitta. Idan masu hana TNF ba su da tasiri, za a iya la'akari da ƙarin hanyoyin ilimin halitta. Ba a ba da shawarar yin amfani da magungunan ilimin halitta fiye da ɗaya a lokaci ɗaya (misali, adalimumab [Humira] tare da abatacept [Orencia]) ba saboda rashin karɓuwa na tasirin illa.24
NSAIDs da Corticosteroids
Magungunan ƙwayoyi don RA na iya haɗawa da NSAIDs da na baka, intramuscular, ko intra-articular corticosteroids don sarrafa ciwo da kumburi. Da kyau, ana amfani da NSAIDs da corticosteroids kawai don gudanarwa na ɗan gajeren lokaci. DMARDs sune mafificin magani.21,22
Karin Magunguna
Abubuwan da ake amfani da su na cin abinci, ciki har da kayan cin ganyayyaki da na Rum, an yi nazari a cikin maganin RA ba tare da tabbataccen shaida na fa'ida ba. tare da RA.25,26 Bugu da ƙari, thermotherapy da duban dan tayi na warkewa don RA ba a yi nazari sosai ba.27,28 A Cochrane review na ganye jiyya ga RA kammala cewa gamma-linolenic acid (daga maraice primrose ko baki currant iri mai) da Tripterygium wilfordii (Allah na tsawa) yana da fa'idodi masu yawa.29,30 Yana da mahimmanci a sanar da marasa lafiya cewa an sami rahoton mummunan sakamako tare da yin amfani da maganin ganye.31
Motsa jiki da Magungunan Jiki
Sakamakon gwaje-gwajen da aka bazu na bazuwar yana tallafawa motsa jiki na jiki don inganta yanayin rayuwa da ƙarfin tsoka a cikin marasa lafiya tare da RA.32,33 Shirye-shiryen horarwa na motsa jiki ba a nuna su suna da mummunar tasiri akan ayyukan cutar RA, ƙananan ciwo, ko lalacewar haɗin gwiwa na rediyo. 34 Tai chi an nuna don inganta motsin idon kafa a cikin mutanen da ke tare da RA, ko da yake bazuwar gwaji yana da iyaka.
Duration of Treatment
Ana iya samun gafara a cikin 10 zuwa 50 bisa dari na marasa lafiya tare da RA, dangane da yadda aka ƙayyade gafara da kuma ƙarfin jiyya. marasa lafiya waɗanda suka girmi shekaru 10), tare da ɗan gajeren lokaci na cuta, tare da ƙarancin aiki mai sauƙi, ba tare da haɓakar lokaci mai ƙarfi ba, kuma ba tare da tabbataccen rheumatoid factor ko binciken anti-citrullinated protein antibody binciken. zuwa mafi ƙarancin adadin da ake bukata. Marasa lafiya za su buƙaci sa ido akai-akai don tabbatar da kwanciyar hankali, kuma ana ba da shawarar haɓaka magunguna da sauri tare da kumburin cututtuka.40
Haɗin gwiwa
Ana nuna maye gurbin haɗin gwiwa lokacin da akwai mummunar lalacewar haɗin gwiwa da rashin gamsuwa da kulawar bayyanar cututtuka tare da kulawar likita. Sakamakon dogon lokaci shine goyon baya, tare da kawai 4 zuwa 13 bisa dari na manyan masu maye gurbin haɗin gwiwa da ke buƙatar sake dubawa a cikin shekaru 10 Kwancen hip da gwiwa sune mafi yawan maye gurbin haɗin gwiwa.
Kulawa na Tsawon Lokaci
Kodayake ana ɗaukar RA cuta ce ta haɗin gwiwa, ita ma cuta ce ta tsarin da ke iya haɗawa da tsarin gabobin jiki da yawa. Ƙarin bayyanar cututtuka na RA an haɗa su a cikin Table 4.1,2,10 Marasa lafiya tare da RA suna da haɗarin ƙwayar lymphoma sau biyu, wanda ake tunanin ya haifar da tsarin kumburi, kuma ba sakamakon magani ba. RA kuma suna cikin haɗarin cututtukan cututtukan zuciya, kuma likitoci suyi aiki tare da marasa lafiya don gyara abubuwan haɗari, kamar shan taba, hawan jini, da high cholesterol.39 Class III ko IV congestive heart failure (CHF) ne contraindication don amfani da masu hana TNF, wanda zai iya haifar da sakamakon CHF.40,41 A cikin marasa lafiya tare da RA da malignancy, ana buƙatar taka tsantsan tare da ci gaba da amfani da DMARDs, musamman masu hana TNF. Kada a fara DMARDs na halitta, methotrexate, da leflunomide a cikin marasa lafiya da ke fama da cutar ta herpes zoster, babban kamuwa da cuta na fungal, ko kamuwa da kwayar cutar da ke buƙatar maganin rigakafi.21 Abubuwan da ke tattare da RA da magungunansa an jera su a cikin Table 21
hangen nesa
Marasa lafiya tare da RA suna rayuwa shekaru uku zuwa 12 kasa da yawan jama'a.40 Ƙara yawan mace-mace a cikin waɗannan marasa lafiya galibi saboda haɓakar cututtukan zuciya da jijiyoyin jini, musamman a cikin waɗanda ke da manyan ayyukan cuta da kumburi na yau da kullun. Sabbin hanyoyin kwantar da hankali na ilimin halitta na iya jujjuya ci gaban atherosclerosis da haɓaka rayuwa a cikin waɗanda ke da RA.41
Bayanin Bayanai: An kammala binciken PubMed a cikin Tambayoyi na Clinical ta amfani da mahimman kalmomi na rheumatoid amosanin gabbai, ƙarin bayyanar cututtuka, da magungunan antirheumatic masu gyara cututtuka. Binciken ya haɗa da meta-bincike, gwaje-gwajen da aka sarrafa bazuwar, gwajin asibiti, da sake dubawa. Hakanan an bincika Hukumar Binciken Kiwon Lafiyar Kiwon Lafiya da rahotannin shaida mai inganci, Shaidar asibiti, bayanan Cochrane, Hujja mai mahimmanci, da UpToDate. Kwanan bincike: Satumba 20, 2010.
Bayyanar marubuci: Babu alaƙar kuɗi da ta dace da za a bayyana. A ƙarshe, rheumatoid amosanin gabbai ciwo ne na yau da kullum, cututtuka na autoimmune wanda ke haifar da cututtuka masu zafi, irin su ciwo da rashin jin daɗi, kumburi da kumburin haɗin gwiwa, da sauransu. Lalacewar haɗin gwiwa da aka kwatanta a matsayin RA tana da ma'ana, ma'ana yana shafar bangarorin biyu na jiki gaba ɗaya. Ganewar farko yana da mahimmanci don maganin RA. Matsakaicin bayanin mu yana iyakance ga maganganun maganin chiropractic da na kashin baya. Don tattauna batun, da fatan za a ji daɗin tambayar Dr. Jimenez ko tuntuɓe mu a�915-850-0900�. Dr. Alex Jimenez ne ya shirya shi
Ƙarin Tattaunawa: Rage Ciwon Knee Ba tare da Tiyata ba
Ciwon gwiwa sanannen alama ne wanda zai iya faruwa saboda raunin gwiwa da/ko yanayi iri-iri, gami daraunin wasanni. Gwiwa na ɗaya daga cikin hadaddun haɗin gwiwa a cikin jikin ɗan adam kamar yadda ya ƙunshi mahaɗar ƙasusuwa huɗu, ligaments huɗu, tendons iri-iri, menisci biyu, da guringuntsi. A cewar Cibiyar Nazarin Iyali ta Amirka, mafi yawan abubuwan da ke haifar da ciwon gwiwa sun hada da subluxation patellar, patellar tendinitis ko jumper's gwiwa, da kuma Osgood-Schlatter cuta. Kodayake ciwon gwiwa yana iya faruwa a cikin mutane sama da shekaru 60, ciwon gwiwa kuma yana iya faruwa a cikin yara da matasa. Za a iya magance ciwon gwiwa a gida bayan hanyoyin RICE, duk da haka, raunin gwiwa mai tsanani na iya buƙatar kulawar likita nan da nan, ciki har da kulawar chiropractic.
1. Etiology da pathogenesis na rheumatoid amosanin gabbai. A cikin: Firestein GS, Kelley WN, ed. Kelley Littafin Rubutu na Rheumatology. 8 ta ed. Philadelphia, Pa.: Saunders/Elsevier; 2009: 1035-1086. 2. Bathon J, Tehlrian C. Rheumatoid amosanin gabbai na asibiti da bayyanuwar dakin gwaje-gwaje. A cikin: Klippel JH, Stone JH, Crofford LJ, et al., ed. Farko akan Cututtukan Rheumatic. ed 13. New York, NY: Springer; 2008: 114-121. 3. Allaire S, Wolfe F, Niu J, et al. Abubuwan haɗari na yanzu don nakasar aikin da ke da alaƙa da cututtukan cututtuka na rheumatoid. Arthritis Rheum. 2009;61 (3): 321-328. 4. MacGregor AJ, Snieder H, Rigby AS, et al. Halayen gudunmawar ƙididdiga na kwayoyin halitta ga cututtukan cututtuka na rheumatoid ta amfani da bayanai daga tagwaye. Arthritis Rheum. 2000; 43 (1): 30-37. 5. Orozco G, Barton A. Sabuntawa akan abubuwan da ke haifar da haɗarin ƙwayoyin cuta don cututtukan cututtukan rheumatoid. Kwararre Rev Clin Immunol. 2010; 6 (1): 61-75. 6. Balsa A, Cabezo?n A, Orozco G, et al. Tasirin HLA DRB1 alleles a cikin rashin lafiyar cututtukan cututtuka na rheumatoid da kuma ka'idojin rigakafi akan sunadaran citrullinated da factor rheumatoid. Arthritis Res Ther. 2010; 12 (2): R62. 7. McClure A, Lunt M, Eyre S, et al. Binciken yuwuwar gwajin gwajin kwayoyin halitta / gwaji don rashin lafiyar RA ta amfani da haɗe-haɗe na wuraren haɗari guda biyar da aka tabbatar. Rheuma-tology (Oxford). 2009;48 (11):1369-1374. 8. Bang SY, Lee KH, Cho SK, et al. Shan taba yana ƙara haɗarin cututtukan arthritis na rheumatoid a cikin mutane masu ɗauke da HLA-DRB1 da aka raba epitope, ba tare da la'akari da yanayin rheumatoid ba ko matsayin anti-cyclic citrullinated peptide antibody. Arthritis Rheum. 2010;62 (2):369-377. 9. Wilder RL, Crofford LJ. Shin cututtuka masu yaduwa suna haifar da cututtuka na rheumatoid? Clin Orthop Relat Res. 1991; (265): 36-41. 10. Scott DL, Wolfe F, Huizinga TW. Rheumatoid amosanin gabbai. Lancet. 2010;376(9746):1094-1108. 11. Costenbader KH, Feskanich D, Mandl LA, et al. Ƙarfin shan taba, tsawon lokaci, da dainawa, da haɗarin rheumatoid amosanin gabbai a cikin mata. Ina J Med. 2006;119 (6): 503.e1-e9. 12. Kaaja RJ, Greer IA. Bayyanar cututtuka na kullum a lokacin daukar ciki. JAMA. 2005;294 (21):2751-2757. 13. Guthrie KA, Dugowson CE, Voigt LF, et al. Yana yin ciki- Nancy tana ba da kariya kamar rigakafi daga rheuma- maganin arthritis? Arthritis Rheum. 2010;62 (7): 1842-1848. 14. Karlson EW, Mandl LA, Hankinson SE, et al. Shin shayarwar nono da sauran abubuwan haihuwa suna shafar haɗarin rheumatoid amosanin gabbai a nan gaba? Sakamako daga Nurses� Nazarin Lafiya. Arthritis Rheum. 2004;50 (11):3458-3467. 15. Karlson EW, Shadick NA, Cook NR, et al. Vitamin E a farkon rigakafin rheumatoid amosanin gabbai: Nazarin Lafiyar Mata. Arthritis Rheum. 2008; 59 (11): 1589-1595. 16. Aletaha D, Neogi T, Silman AJ, et al. 2010 rheumatoid Ma'auni na rarrabuwa na arthritis: Kwalejin Rheumatology ta Amirka / Ƙungiyar Turai ta Ƙaddamar da Rheumatism na haɗin gwiwa [gyara da aka buga ya bayyana a cikin Ann Rheum Dis. 2010;69 (10):1892]. Ann Rheum Dis. 2010;69 (9): 1580-1588. 17. van der Helm-van Mil AH, le Cessie S, van Dongen H, et al. Dokokin tsinkaya don sakamakon cutar a cikin marasa lafiya tare da cututtukan cututtukan cututtukan da ba su da bambanci a kwanan nan. Arthritis Rheum. 2007;56 (2):433-440. 18. Mochan E, Ebell MH. Hasashen haɗari na rheumatoid amosanin gabbai a cikin manya tare da cututtukan cututtuka marasa bambanci. Am Fam Likita. 2008;77 (10): 1451-1453. 19. Ravelli A, Felici E, Magni-Manzoni S, et al. Marasa lafiya da antinuclear antibody-tabbatacce matasa idiopathic arthritis sun zama ƙungiya mai kama da juna ba tare da la'akari da yanayin cututtukan haɗin gwiwa ba. Arthritis Rheum. 2005; 52 (3): 826-832. 20. Wilson A, Yu HT, Goodnough LT, et al. Yaduwa da sakamakon anemia a cikin cututtukan cututtuka na rheumatoid. Ina J Med. 2004; 116 (kayyade 7A): 50S-57S. 21. Saag KG, Teng GG, Patkar NM, et al. Kwalejin Kwalejin Rheumatology ta Amirka 2008 shawarwari don amfani da marasa ilimin halitta da cututtuka masu canza magungunan antirheumatic a cikin rheumatoid arthritis. Arthritis Rheum. 2008;59 (6):762-784. 22. Deighton C, O�Mahony R, Tosh J, da dai sauransu; Rukunin Ci gaban Jagora. Gudanar da cututtukan cututtuka na rheumatoid: taƙaitaccen jagorar NICE. BMJ. 2009;338:b702. 23. AHRQ. Zaɓin magunguna don cututtukan cututtuka na rheumatoid. Afrilu 9, 2008. www.effectivehealthcare.ahrq.gov/ ehc/samfuran/14/85/RheumArthritisClinicianGuide.pdf. An shiga Yuni 23, 2011. 24. Choy EH, Smith C, Dore? CJ, da al. Meta-bincike na inganci da guba na haɗa magunguna-gyaran ƙwayoyin cuta a cikin cututtukan cututtukan rheumatoid dangane da janyewar haƙuri. Rheumatology (Oxford). 2005; 4 4 (11): 1414 - 1421. 25. Smedslund G, Byfuglien MG, Olsen SU, et al. Inganci- da aminci na abubuwan da ake amfani da su na abinci don cututtukan cututtuka na rheumatoid. J Am Diet Assoc. 2010; 110 (5): 727-735. 26. Hagen KB, Byfuglien MG, Falzon L, et al. Hanyoyin abinci na abinci don cututtukan cututtuka na rheumatoid. Cochrane Database Syst Rev. 2009;21(1): CD006400. 27. Wang C, de Pablo P, Chen X, et al. Acupuncture don jin zafi a cikin marasa lafiya da cututtuka na rheumatoid: nazari na yau da kullum. Arthritis Rheum. 2008;59 (9): 1249-1256. 28. Kelly RB. Acupuncture don jin zafi. Am Fam Likita. 2009;80 (5):481-484. 29. Robinson V, Brosseau L, Casimiro L, et al. Thermother-apy don maganin rheumatoid amosanin gabbai. Cochrane Data-base Syst Rev. 2002; 2 (2): CD002826. 30. Casimiro L, Brosseau L, Robinson V, et al. Therapeutic duban dan tayi domin lura da rheumatoid amosanin gabbai. Cochrane Database Syst Rev. 2002;3(3): CD003787. 31. Cameron M, Gagnier JJ, Chrubasik S. Maganin ganya don magance cututtuka na rheumatoid. Cochrane Database Syst Rev. 2011; (2): CD002948. 32. Brodin N, Eurenius E, Jensen I, et al. Koyar da marasa lafiya masu fama da ciwon huhu na farko zuwa aikin lafiya na jiki. Arthritis Rheum. 2008;59 (3): 325-331. 33. Baillet A, Payraud E, Niderprim VA, et al. Tsarin motsa jiki mai ƙarfi don haɓaka nakasassu a cikin cututtukan arthritis na rheumatoid: gwajin da za a iya sarrafa bazuwar. Rheumatology (Oxford). 2009;48 (4): 410-415. 34. Hurkmans E, van der Giesen FJ, Vliet Vlieland TP, et al. Shirye-shiryen motsa jiki mai ƙarfi (ƙarfin motsa jiki da/ko horar da ƙarfin tsoka) a cikin marasa lafiya da ke da rheumatoid arthritis. Cochrane Database Syst Rev. 2009; (4): CD006853. 35. Han A, Robinson V, Judd M, et al. Tai chi don maganin rheumatoid amosanin gabbai. Cochrane Database Syst Rev. 2004; (3): CD004849. 36. Evans S, Cousins L, Tsao JC, et al. Gwajin da aka sarrafa bazuwar da ke bincika Iyengar yoga ga matasa masu fama da cututtukan rheumatoid. Gwaji. 2011; 12:19. 37. Katchamart W, Johnson S, Lin HJ, et al. Masu tsinkaya don raguwa a cikin marasa lafiya na arthritis na rheumatoid: nazari na yau da kullum. Maganin Arthritis Res (Hoboken). 2010;62 (8): 1128-1143. 38. Wolfe F, Zwillich SH. Sakamakon dogon lokaci na cututtukan cututtuka na rheumatoid: shekaru 23 mai yiwuwa, nazarin dogon lokaci na jimlar maye gurbin haɗin gwiwa da kuma tsinkayar sa a cikin marasa lafiya 1,600 tare da cututtuka na rheumatoid. Arthritis Rheum. 1998;41 (6): 1072-1082. 39. Baecklund E, Iliadou A, Tambaya J, et al. Ƙungiyar ƙumburi na yau da kullum, ba maganinta ba, tare da ƙara yawan haɗarin lymphoma a cikin cututtuka na rheumatoid. Arthritis Rheum. 2006;54 (3): 692-701. 40. Friedewald VE, Ganz P, Kremer JM, et al. Yarjejeniyar editan AJC: rheumatoid amosanin gabbai da cututtukan zuciya na atherosclerotic. Ina J Cardiol. 2010;106 (3): 442-447. 41. Atzeni F, Turiel M, Caporali R, et al. Tasirin maganin ilimin likitanci akan tsarin zuciya da jijiyoyin jini na marasa lafiya tare da cututtukan rheumatic. Autoimmun Rev. 2010; 9 (12): 835-839.
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