Kupunduka kwa Pensulo-mu-Cup

Zamkati

• Chidule
• Zomwe zimayambitsa kusokonekera kwa pensulo-mu-chikho
• Zizindikiro za kupindika kwa pensulo-mu-chikho
• Kuzindikira kupindika kwa pensulo-mu-chikho
• Kusamalira zolakwika za pensulo-mu-chikho
• Maganizo ake

Chidule

Kupunduka kwa pensulo-mu-chikho ndikumafupa osowa kwambiri komwe kumalumikizidwa ndimatenda a psoriatic arthritis (PsA) otchedwa arthritis mutilans. Zitha kukhalanso ndi matenda a nyamakazi (RA) ndi scleroderma. "Pensulo-chikho" amafotokoza momwe fupa lomwe lakhudzidwa likuwonekera mu X-ray:

• Mapeto a fupa adasanduka mawonekedwe a pensulo akuthwa.
• “Pensulo” imeneyi yawononga mafupa omwe analumikizana nawonso ngati kapu.

Kupunduka kwa pensulo-mu-chikho ndikosowa. Matenda a nyamakazi amakhudza pafupifupi 5% ya anthu omwe ali ndi PsA komanso anthu omwe ali ndi nyamakazi. Tiona makamaka zolakwika za pensulo-chikho ndi PsA.

Ngati ma X-ray kapena sikani zanu zikuwonetsa kuwonongeka kwa pensulo-mu-chikho, ndikofunikira kuyamba chithandizo mwachangu kuti muchepetse kapena kusiya kuwonongeka kwina. Popanda chithandizo, chiwonongeko chophatikizika chitha kupitilira mwachangu.

Malo oyamba kukhudzidwa nthawi zambiri amakhala chala chachiwiri ndi chachitatu (distal interphalangeal joints). Vutoli limakhudzanso ziwalo zanu zazala.

Ngakhale kuwonongeka kwa pensulo-kapu kumawonekera kwambiri ku PsA, mitundu ina ya nyamakazi yomwe imakhudza mafupa a msana ndi ziwalo zanu (spondyloarthropathies) amathanso kuyambitsa vuto la zala ndi zala. Komanso, zimachitika kawirikawiri mu:

• systemic sclerosis (scleroderma)
• Matenda a Behcet
• zokhudza zonse lupus erythematosus

Zomwe zimayambitsa kusokonekera kwa pensulo-mu-chikho

Matenda a nyamakazi ndi kupindika kwake kwa pensulo-mu-chikho ndiye mtundu wovuta kwambiri wa PsA wosachiritsidwa.

Zomwe zimayambitsa PsA sizimamveka bwino. Amawonedwa ngati mgwirizano wovuta wa majini, kusowa kwa chitetezo chamthupi, komanso zinthu zachilengedwe. Za anthu omwe ali ndi psoriasis amapanga PsA.

Kukhala ndi mbiri yabanja ya psoriasis kumawonjezera chiopsezo chanu chopeza psoriasis ndi PsA. Koma pali kusiyana kosiyana pakati pa psoriasis ndi PsA. Muli ndi mwayi wokulirapo wa PsA katatu kapena kasanu kuposa momwe mungalandire psoriasis.

Kafukufuku wa chibadwa wapeza kuti anthu omwe ali ndi PsA omwe ali ndi majini awiri apadera (HLA-B27 kapena DQB1 * 02) ali ndi chiopsezo chowonjezeka chokhala ndi mitilans ya nyamakazi.

Zinthu zachilengedwe zomwe zimaganiziridwa kuti zimathandizira ku PsA ndi izi:

• nkhawa
• matenda (monga HIV kapena matenda a streptococcal)
• kukhumudwa kwamafundo (makamaka ndi ana)

Zizindikiro za kupindika kwa pensulo-mu-chikho

'Kupunduka kwa pensulo-mu-chikho ndikosowa mafupa. X-ray yowonongeka iyi imawonetsa fupa lomwe lakhudzidwa ndikumapeto kwa fupalo kukhala kofanana ndi pensulo. “Pensulo” imeneyi yawononga mafupa omwe analumikizana nawonso ngati kapu. '

Anthu omwe ali ndi vuto la pensulo-mu-chikho chochokera ku PsA amatha kuwona zizindikilo za nyamakazi iyi. Zizindikiro za PsA ndizosiyanasiyana ndipo zitha kufanana ndi matenda ena:

• kutupa zala kapena zala (dactylitis); Kafukufuku adapeza kuti dactylitis ilipo mwa anthu omwe ali ndi PsA
• kuuma molumikizana, kutupa, ndi kupweteka, nthawi zambiri m'magulu anayi kapena ochepera komanso osagwirizana (osaphatikizana mbali zonse ziwiri za thupi lanu)
• kusintha kwa misomali, kuphatikiza kukhomedwa ndi kulekanitsidwa kwa misomali pa bedi la msomali
• kupweteka kwa khosi
• kutupa nyamakazi ya msana ndi mafupa akulu (spondylitis)
• kutupa kwa chimodzi kapena zonse ziwiri za sacroiliac (sacroiliitis); kafukufuku wina adapeza kuti mwa anthu omwe ali ndi PsA anali ndi sacroiliitis
• kutupa kwa ma entheses, malo omwe tendon kapena ligament imalowa m'mafupa anu (enthesitis)
• kutupa kwapakati pa diso, kuchititsa kufiira ndi kusawona bwino (uveitis)

Ngati muli ndi vuto la pensulo-mu-chikho, mungakhalenso ndi izi:

• Kuchulukitsa kwa minofu yolumikizana ndi olumikizana
• kuwonongeka kwakukulu kwa mafupa (osteolysis)
• "Galasi la opera" kapena zala za "telescopic", momwe minofu ya mafupa imagwera, ndikusiya khungu lokha

Kuzindikira kupindika kwa pensulo-mu-chikho

PsA nthawi zambiri imadziwika, chifukwa cha zizindikilo zake zosiyanasiyana komanso kusowa mgwirizano pamalingaliro. Pofuna kuthandizira kuzindikira, gulu lapadziko lonse la akatswiri amisala linapanga njira za PsA zotchedwa CASPAR, zomwe zimafanana ndi psoriatic nyamakazi.

Chimodzi mwazovuta ndikuti nyamakazi imayamba kupezeka kwa psoriasis pakhungu mwa anthu omwe ali ndi PsA. Chifukwa chake zizindikiro za khungu sizingakupatseni chidziwitso. Kuphatikiza apo, zizindikiro za psoriasis ndi PsA sizichitika nthawi zonse - zimatha kuyaka ndikuchepa.

Dokotala wanu atenga mbiri yakuchipatala, kuphatikiza mbiri yakuchipatala ya banja lanu. Akufunsani pazizindikiro zanu:

• Kodi ndizolimba motani?
• Kodi mwakhala nawo nthawi yayitali bwanji?
• Kodi amabwera ndikumapita?

Adzawunikanso bwinobwino.

Kuti mutsimikizire kuti ali ndi matenda a nyamakazi komanso kupunduka kwa pensulo-mu-chikho, dokotala wanu adzagwiritsa ntchito mitundu ingapo yoyesa kujambula, kuphatikiza:

• X-ray
• Chithunzi:
• Kujambula kwa MRI

Dokotala wanu adzawona kuopsa kwa kuwonongeka kwa mafupa. Zithunzi za Sonography ndi MRI zitha kupereka chithunzi chabwino cha zomwe zikuchitika. Mwachitsanzo, Sonography itha kuzindikira kutupa komwe sikunapezebe chilichonse. MRI ikhoza kupereka chithunzi chatsatanetsatane cha kusintha kwakung'ono m'mafupa anu ndi minofu yoyandikana nayo.

Pali matenda ochepa kwambiri omwe atha kuphatikizidwa ndi kupindika kwa pensulo. Ngati mulibe zizindikiro zakhungu za psoriasis, dokotala wanu atha kuyang'ana ngati ali ndi magazi a nyamakazi ndi matenda ena omwe angayambitse vutoli.

PsA imadziwika molakwika. Koma kusazindikira molakwika pensulo-mu-chikho kuwonongeka sikungatheke, chifukwa cha chithunzi chake cha X-ray. Zizindikiro zanu zina zithandizira adotolo kuti adziwe matendawa.

Kusamalira zolakwika za pensulo-mu-chikho

Cholinga chothandizira kupunduka kwa pensulo-mu-chikho ndi:

• pewani kuwonongeka kulikonse kwa mafupa
• perekani ululu
• perekani chithandizo chakuthupi ndi pantchito kuti magwiridwe antchito a manja anu ndi mapazi anu

Chithandizo chapadera chimadalira kuuma kwa kupunduka kwanu komanso pazomwe zimayambitsa.

Kuwonongeka kwa pensulo-mu-chikho chokhudzana ndi PsA, dokotala wanu akhoza kukupatsani mankhwala osagwiritsa ntchito zotupa (NSAIDs) kuti athetse vuto. Koma mankhwalawa saletsa kuwonongeka kwa mafupa.

Pochepetsa kapena kusiya kutayika kwa mafupa, adokotala amatha kupereka mankhwala osokoneza bongo (DMARDs) kapena ma molekyulu ang'onoang'ono (OSMs) monga:

• methotrexate
• alirazamalik (Alirazamalik)
• chifuwa chachikulu (Otezla)

Gulu la mankhwala otchedwa biologics amaletsa chotupa necrosis factor (TNF-alpha), yomwe imathandizira ku PsA. Zitsanzo ndi izi:

• etanercept (Enbrel)
• infliximab (Remicade, Inflectra, Renflexis)
• adalimumab
• golimumabu
• chitsimikizo pegol

Biologics yomwe imaletsa interleukin 17 (IL-17), yomwe imalimbikitsa kutupa, imaphatikizapo:

• secukinumab (Cosentyx)
• ixekizumab (Taltz)
• brodalumab (Siliq)

Zamoyo zina zomwe dokotala angakupatseni ndi izi:

• ustekinumab (Stelara), yomwe imatseka ma molekyulu otupa a IL-23 ndi IL-12
• abatacept (CTLA4-Ig), yomwe imalepheretsa kutsegula kwa ma T, mtundu wamaselo wofunikira kuyankha chitetezo chamthupi

Mankhwala osakanikirana angafunike pamavuto akulu kwambiri. Mankhwala ochulukirachulukira akukonzedwa kapena m'mayesero azachipatala omwe amayang'ana ma cell kapena zinthu zomwe akuganiza kuti zimayambitsa kutupa ndi kuwonongeka kwa mafupa.

Thandizo lakuthupi ndi pantchito lingakhale lothandiza kuti muchepetse zizindikilo, kukhalabe osinthasintha, kuchepetsa nkhawa m'manja ndi kumapazi, komanso kuteteza mafupa kuvulala.

Kambiranani ndi dokotala wanu za mankhwala omwe angakhale abwino kwa inu. Funsani ngati kuyesedwa kwachipatala kungakhale kotheka. Onetsetsani kuti mukambirane zovuta za ma DMARD, mamolekyulu amlomo (OSMs), ndi biologics. Onaninso mtengo wake, chifukwa mankhwala ena atsopano ndiokwera mtengo kwambiri.

Nthawi zina, opaleshoni yokonzanso kapena kulumikizana palimodzi ikhoza kukhala njira.

Kuchita opaleshoni ya PsA sikofala: Kafukufuku wina adapeza kuti 7 peresenti yokha ya anthu omwe ali ndi PsA adachitidwa opaleshoni ya mafupa. Kuwunikiridwa kwa PsA ndi opaleshoni ya 2008 kunawonetsa kuti maopareshoni nthawi zina amathetsa bwino kupweteka ndikulimbitsa thupi.

Maganizo ake

Kupunduka kwa pensulo-mu-chikho sikungachiritsidwe. Koma mankhwala ambiri omwe alipo amatha kuchepetsa kapena kuyimitsa kuwonongeka kwa mafupa. Ndipo ngakhale mankhwala atsopano odalirika akupangidwa.

Thandizo lakuthupi lingathandize kulimbitsa minofu ndikusunga mafupa, manja, ndi mapazi anu kuti azitha kusintha. Wothandizira pantchito atha kuthandiza ndi zida zothandizira kuyenda komanso kuchita ntchito za tsiku ndi tsiku.

Kudya zakudya zotsutsana ndi zotupa komanso kuchita masewera olimbitsa thupi nthawi zonse kumatha kuthandiza thanzi lanu.

Kuyambitsa upangiri kapena kulowa nawo gulu lothandizira kungakuthandizeni kuthana ndi kupsinjika ndi kulemala. Arthritis Foundation ndi National Psoriasis Foundation onse amapereka chithandizo chaulere.