Nā ho'āʻo hoʻāʻo ʻana o ke kua. ʻO nā hoʻokolohua hōʻike maʻamau ka loiloi mua i hoʻopau ʻia a hoʻohana ʻia e hoʻoholo ai inā pono paha ka hoʻāʻo diagnostic hou. No ka mea, ʻo ka hoʻāʻo ʻana ke kaʻina mua i ka hōʻoia ʻana, ua hoʻolālā ʻia lākou e ʻoi aku ka nui o ka manaʻo nui o ka loaʻa ʻana o kahi maʻi. Hoʻolālā ʻia e ʻokoʻa mai nā hoʻokolohua diagnostic i hiki ke hōʻike i nā hopena maikaʻi aʻe ma mua o ka hoʻāʻo diagnostic.
Hiki i kēia ke alakaʻi i nā hopena ʻoiaʻiʻo a me nā hopena maikaʻi ʻole. Ke ʻike ʻia ka maikaʻi o ka hōʻike hōʻike ʻana, a laila hoʻopau ʻia kahi hoʻāʻo diagnostic e hōʻoia i ka ʻike. A laila, e kūkākūkā mākou i ka loiloi o nā hoʻokolohua diagnostic. Nui nā hoʻokolohua screening i loaʻa no nā kauka a me nā mea lapaʻau chiropractic kiʻekiʻe e hoʻohana i kā lākou hana. No kekahi mau ho'āʻo ʻana, aia kahi ʻano noiʻi e hōʻike ana i ka pōmaikaʻi o ia mau hoʻāʻo ʻana i ka maʻi maʻi mua a me ka mālama ʻana. Hāʻawi ʻo Kauka Alex Jimenez i ka loiloi kūpono a me nā mea hana diagnostic i hoʻohana ʻia i loko o ke keʻena e hoʻomaʻamaʻa hou aʻe i nā loiloi diagnostic.
ʻO ka hui pūhaka he hui pōpō a me ke kumu i haku ʻia me ke poʻo femur a me kahi kumu, ʻo ia kekahi ʻāpana o ke pelvis. ʻO ka labrum he apo cartilage ma ka ʻaoʻao kumu o ka hui pūhaka e kōkua i ka hoʻopaʻa ʻana i ka wai hui i loko e hōʻoia i ka neʻe ʻana o ka ʻūhā frictionless a me ka alignment i ka wā o ka neʻe. ʻO ka haehae labral o ka ʻūhā he hōʻeha i ka labrum. Hiki ke ʻokoʻa ka nui o ka pōʻino. I kekahi manawa, hiki i ka labrum hip ke loaʻa nā waimaka liʻiliʻi a i ʻole nā ʻeha ma nā ʻaoʻao, ma muli o ka ʻaʻahu a me ka waimaka. I nā hihia ʻē aʻe, hiki i kahi ʻāpana o ka labrum ke hoʻokaʻawale a hemo paha mai ka iwi kumu. ʻO kēia mau ʻano ʻeha ma muli o ka trauma. Aia nā ho'āʻo haʻihaʻi hip labral conservative e hoʻoholo i ke ʻano o ka ʻeha. Hiki ke kōkua i ka hui Injury Medical Chiropractic a me Functional Medicine Clinic.
Ōuli
Ua like nā hōʻailona me ka nānā ʻole i ke ʻano o ka waimaka, akā ʻo kahi e ʻike ʻia ai e pili ana i ka mua a i ʻole ke kua. ʻO nā ʻōuli maʻamau ka:
ʻoʻoleʻa hope
ʻO ka hāmeʻa holoʻokoʻa
ʻO ke kaomi ʻana a i ʻole ka laka ʻana i ka hui pūhaka i ka wā e neʻe ai.
ʻO ka ʻeha ma ka ʻūhā, ka ʻāʻī, a i ʻole ka ʻāʻī, ʻoi aku hoʻi i ka wā e hele ai a holo.
ʻO ka pōʻino a me nā hōʻailona ʻeha i ka wā e hiamoe ai.
ʻAʻole hiki i kekahi mau waimaka ke hōʻailona a hiki ke ʻike ʻole ʻia no nā makahiki.
Ho'āʻo Waimaka Hip Labral
Hiki ke haʻihaʻi ka hip labral ma nā wahi a pau o ka labrum. Hiki ke wehewehe ʻia ma mua a ma hope paha, e pili ana i kahi ʻāpana o ka hui i hoʻopili ʻia:
Nā waimaka labral hip mua: ʻO ke ʻano maʻamau o ka haʻalulu hip labral. Aia kēia mau waimaka ma ke alo o ka hui pūhaka.
Nā waimaka labral hope hope: Hōʻike ʻia kēia ʻano ma ke kua o ka hui pūhaka.
ho'āʻo ai i
ʻO nā hoʻāʻo haʻihaʻi hip labral maʻamau i loaʻa:
Ka Ho'āʻo Hip Impingement
ʻO ka ho'āʻo hoʻokiʻekiʻe wāwae pololei
ka FABER ʻO ka ho'āʻo - kū no Flexion, Abduction, a me waho.
ka KE KOLU Ho'āʻo - kū no ka Hip Internal Rotation with Distraction.
Nā hoʻāʻo ʻana i ka ʻūhā
ʻElua ʻano o ka hoʻāʻo ʻana i ka ʻūhā.
Hoʻopiʻi ʻAha Mua
ʻO kēia hoʻokolohua e pili ana i ka mea maʻi e moe ana ma ko lākou kua me ke kukuli ʻana o ko lākou kuli ma 90 degere a laila hoʻohuli i loko i ke kino.
Inā loaʻa ka ʻeha, manaʻo ʻia ka hōʻike he maikaʻi.
Hoʻopiʻi Hip Hope
ʻO kēia ho'āʻo e pili ana i ka mea maʻi e moe ana ma ko lākou kua me ko lākou ʻūhā i hohola ʻia a kūlou ko lākou kuli a kūlou i 90 degere.
Hoʻohuli ʻia ka wāwae ma waho o ke kino.
Inā loaʻa ka ʻeha a hopohopo paha, manaʻo ʻia he maikaʻi.
Ho'āʻo Hoʻokiʻekiʻe wāwae pololei
Hoʻohana ʻia kēia hoʻāʻo ma nā ʻano olakino like ʻole e pili ana i ka ʻeha hope.
Hoʻomaka ka hoʻāʻo me ka noho ʻana a i ʻole ka moe ʻana i lalo.
Ma ka ʻaoʻao i hoʻopilikia ʻole ʻia, nānā ʻia ka laulā o ka neʻe.
A laila, hoʻopololei ka ʻūhā a pololei ke kuli ma nā wāwae ʻelua.
Hiki ke noi ʻia ka mea maʻi e wili i ka ʻāʻī a i ʻole e hoʻolōʻihi i ka wāwae e hoʻolōʻihi i nā aʻalolo.
ʻO ka ho'āʻo FABER
Kū ia no Flexion, Abduction, and External Rotation.
Hoʻomaka ka hoʻāʻo me ka moe ʻana o ka mea maʻi ma ke kua me nā wāwae pololei.
Hoʻokomo ʻia ka wāwae i hoʻopili ʻia i kahi kūlana ʻehā.
A laila e hoʻopili ke kauka i ke kaomi hoʻohaʻahaʻa i lalo i ke kuli kulou.
Inā loaʻa ka ʻeha o ka ʻūhā a i ʻole ka ʻāʻī, maikaʻi ka hōʻike.
Ka Hoao Ekolu
Kū kēia - ka Hoʻololi ʻana i loko me Nā kūʻokoʻa
Hoʻomaka ka hoʻāʻo me ka moe ʻana o ka mea maʻi ma ko lākou kua.
A laila hoʻohuli ka mea maʻi i ko lākou kuli i 90 degere a hoʻohuli iā ia i loko ma kahi o 10 degere.
A laila hoʻohuli ʻia ka ʻūhā i loko me ke kaomi ʻana i lalo ma ka hui pūhaka.
Hoʻohana hou ʻia ka hana me ka hoʻokaʻawale iki ʻana o ka hui.
Manaʻo ʻia he maikaʻi inā loaʻa ka ʻeha i ka wā e hoʻohuli ʻia ai ka ʻūhā a hoʻemi ʻia ka ʻeha i ka wā e hoʻohuli ʻia a hoʻololi ʻia.
Hoʻoponopono Hua'ōlelo
Hoʻopili ʻia ka lāʻau Chiropractic hoʻoponopono ʻūhā e hoʻoponopono hou i nā iwi a puni ka ʻūhā a piʻi i luna o ka iwi kuamoʻo, ka hoʻomaʻamaʻa ʻana i nā ʻiʻo palupalu e hoʻomaha ai i nā ʻiʻo a puni ka pelvis a me ka ʻūhā, nā hoʻomaʻamaʻa maʻalahi i manaʻo ʻia e hoʻihoʻi hou i ke ʻano o ka neʻe ʻana, nā hoʻomaʻamaʻa kaʻa kaʻa, a me nā hoʻoikaika ikaika e hoʻoponopono i nā hemahema muscular.
Lapaʻau a me ka lāʻau lapaʻau
E hoʻomaopopo '
Chamberlain, Rahela. "Hip Pain in Adults: Evaluation and Differential Diagnosis." Kauka ʻohana ʻAmelika vol. 103,2 (2021): 81-89.
Groh, MM, Herrera, J. He loiloi piha o nā waimaka labral hip. Curr Rev Musculoskelet Med 2, 105–117 (2009). doi.org/10.1007/s12178-009-9052-9
ʻO Roanna M. Burgess, Alison Rushton, Chris Wright, Cathryn Daborn, Ka pono a me ka pololei o nā ho'āʻo diagnostics clinical i hoʻohanaʻia no kaʻikeʻana i ka pathology labral o ka'ūhā: He loiloi pūnaewele, Manual Therapy, Volume 16, Issue 4, 2011, Pages 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. "Ka ʻike a me ka mālama ʻana i ka waimaka labral." ʻO ka puke pai lapaʻau Kina vol. 132,2 (2019): 211-219. doi:10.1097/CM9.0000000000000020
Wilson, John J, a me Masaru Furukawa. "Ka loiloi o ka mea maʻi me ka ʻeha ʻūhā." Kauka ʻohana ʻAmelika vol. 89,1 (2014): 27-34.
ʻAihue ka spungylitis ankylosing pili pinepine i nā ho'āʻo he nui. Ke kauoha nā kauka i nā hoʻāʻo koko e ʻike i ka ankylosing spondylitis, ke ʻike nei kekahi kanaka i nā hōʻailona ʻino ma ko lākou kua a me nā hui. ʻO ka manawa pinepine, ʻo ka hōʻike hōʻike koko ʻo ia ke ʻimi nei ke kauka i nā hōʻike o kekahi mea ʻē aʻe i hiki ke kumu i nā hōʻailona. Eia nō naʻe, ʻaʻole hiki i nā hoʻāʻo koko ma o lākou iho ke hoʻomaopopo pono i ka spondylitis ankylosing, akā i ka hui pū ʻana me ke kiʻi a me ka loiloi, hiki iā lākou ke hāʻawi i nā hōʻailona koʻikoʻi e kuhikuhi i nā pane.
Ankylosing Spondylitis Ho'āʻo koko
ʻO ka ankylosing spondylitis ka arthritis pili mua i ka iwi kuamoʻo a me nā pūhaka. Hiki ke paʻakikī ke ʻike ʻana no ka mea ʻaʻohe hoʻāʻo hoʻokahi e hāʻawi i ka ʻike piha no kahi hōʻailona paʻa. Hoʻohana ʻia ka hui pū ʻana o nā hoʻokolohua diagnostic, me kahi hoʻokolohua kino, kiʻi kiʻi, a me nā hoʻāʻo koko. ʻAʻole ʻimi wale nā kauka i nā hopena e kuhikuhi ai i ka spondylitis ankylosing, akā ke ʻimi nei lākou i nā hopena e kuhikuhi ana mai nā hopena spondylitis e hāʻawi i kahi wehewehe ʻokoʻa no nā hōʻailona.
Hoʻokolo kino
E hoʻomaka ana ke kaʻina hana diagnostic me ka mōʻaukala olakino o kēlā me kēia kanaka, ka mōʻaukala ʻohana, a me ka nānā kino. I ka wā o ka hoʻokolokolo, e nīnau ke kauka i nā nīnau e kōkua i ka hoʻoholo ʻana i nā kūlana ʻē aʻe:
Pehea ka lōʻihi o ka hōʻike ʻana o nā hōʻailona?
E ʻoi aku ka maikaʻi o nā hōʻailona me ka hoʻomaha a i ʻole ka hoʻoikaika kino?
Ke piʻi aʻe nei nā hōʻailona a mau paha?
Ua ʻoi aku ka maikaʻi o nā hōʻailona i kekahi manawa o ka lā?
E nānā ke kauka i nā palena o ka neʻe ʻana a me nā wahi palupalu palpate. Nui hiki i nā kūlana ke hana i nā hōʻailona like, no laila e nānā ke kauka e ʻike inā pili ka ʻeha a i ʻole ka neʻe ʻana me ka spondylitis ankylosing. ʻO ka hōʻailona o ka ankylosing spondylitis ka ʻeha a me ka ʻoʻoleʻa i nā hui sacroiliac. Aia nā hui sacroiliac ma ke kua i lalo, kahi e hui ai ke kumu o ke kuamoʻo a me ke pelvis. E nānā ke kauka i nā maʻi a me nā hōʻailona ʻē aʻe.
Nā hōʻailona ʻeha hope i hoʻokumu ʻia e - nā ʻeha, ke ʻano o ke kūlana, a/a i ʻole kahi moe.
Hoʻopili ka gene HLA-B27 me ka spondylitis ankylosing; inā loaʻa i kekahi, loaʻa i kekahi o nā mākua.
Ke kiʻi
Hoʻohana pinepine nā X-ray i ka hana mua i kahi hōʻailona.
I ka holo ʻana o ka maʻi, kūkulu ʻia nā iwi liʻiliʻi hou ma waena o ka vertebrae, a laila hui pū lākou.
ʻOi aku ka maikaʻi o nā kukui X i ka palapala ʻana i ka holomua o ka maʻi ma mua o ka ʻike mua.
Hāʻawi kahi MRI i nā kiʻi ʻoi aku ka maʻalahi i ka wā mua ke ʻike ʻia nā kikoʻī liʻiliʻi.
Nā ho'āʻo koko
Hiki i nā hoʻāʻo koko ke kōkua i ka hoʻoponopono ʻana i nā kūlana ʻē aʻe a nānā i nā hōʻailona o ka mumū, hāʻawi i nā hōʻike kākoʻo me nā hopena o nā hoʻokolohua kiʻi. Hoʻokahi wale nō lā a ʻelua paha e loaʻa ai nā hopena. Hiki i ke kauka ke kauoha i kekahi o keia mau hooia koko:
ʻO ka ho'āʻo ESR e ana i ka mumū i loko o ke kino ma ka helu ʻana i ka helu a i ʻole ka wikiwiki o ka waiho ʻana o nā ʻulaʻula ʻulaʻula i lalo o kahi laʻana koko.
Inā noho wikiwiki lākou ma mua o ka maʻamau, piʻi ka hopena i ka ESR.
ʻO ia hoʻi ke ʻike nei ke kino i ka mumū.
Hiki ke kiʻekiʻe ka hopena o ka ESR, akā ʻaʻole kēia wale nō e hōʻoia i ka AS.
ʻO nā mea ʻeleʻele antinuclear, a i ʻole ANA, e hele ma hope o nā protein i loko o ka nucleus cell, e haʻi ana i ke kino ʻo kona mau cell ka ʻenemi.
Hoʻoulu kēia i kahi pane immune e hakakā ke kino e hoʻopau.
Ua hoʻoholo ʻia kahi haʻawina e loaʻa ana ka ANA ma 19% o nā poʻe i loaʻa i ka spondylitis ankylosing a ʻoi aku ka kiʻekiʻe o nā wahine ma mua o nā kāne.
Hoʻohui ʻia me nā hoʻokolohua ʻē aʻe, hāʻawi ka hele ʻana o ANA i kahi hōʻailona ʻē aʻe i kahi hōʻailona.
Kau olakino
ka pepelu ʻaila He kuleana koʻikoʻi ia i ka hoʻoulu ʻana i ka ankylosing spondylitis a me kāna mālama ʻana.
ʻO nā hoʻāʻo e hoʻoholo ai i ke olakino o ka ʻōpū e hiki ke hāʻawi i ke kauka i ke kiʻi piha o nā mea e hana nei i loko o ke kino.
Ke hilinaʻi nui nei nā ʻike hoʻāʻo koko no ka spondylitis ankylosing a me nā maʻi ʻeha ʻē aʻe i ka hui pū ʻana i nā hoʻokolohua like ʻole me nā hoʻokolohua lapaʻau a me nā kiʻi.
Nā kumu, nā hōʻailona, ka ʻike, a me ka mālama ʻana
E hoʻomaopopo '
Cardoneanu, Anca, et al. "Nā ʻano o ka microbiome intestinal i ka spondylitis ankylosing." ʻO ka lāʻau hoʻokolohua a me ka lāʻau lapaʻau vol. 22,1 (2021): 676. doi:10.3892/etm.2021.10108
Prohaska, E et al. “Antinukleäre Antikörper bei Spondylitis ankylosans (Morbus Bechterew)” [Antinuclear antibodies in ankylosing spondylitis (transl a ka mea kākau)]. Wiener klinikche Wochenschrift vol. 92,24 (1980): 876-9.
Sheehan, Nicholas J. "The ramifications of HLA-B27." Journal of the Royal Society of Medicine vol. 97,1 (2004): 10-4. doi:10.1177/014107680409700102
Xu, Yong-Yue, et al. "Ke kuleana o ka microbiome gut i ka spondylitis ankylosing: kahi loiloi o nā haʻawina i ka palapala." ʻIke lāʻau lapaʻau vol. 22,123 (2016): 361-370.
ka ʻO ka hoʻāʻo ʻana i ka piʻo mua ʻana o Adams He ala maʻalahi ka nānā ʻana i hiki ke kōkua i ka ʻike scoliosis a kōkua i ka hoʻomohala ʻana i kahi hoʻolālā lapaʻau. Kapa ʻia ka hōʻike ma hope o ka Kauka Pelekane ʻo William Adams. Ma ke ʻano o ka hoʻokolokolo ʻana, e ʻimi ke kauka a chiropractor paha i kahi ʻaoʻao ʻaoʻao ma ka ʻaoʻao ʻokoʻa i ka iwi kuamoʻo.
ʻIkepili Scoliosis
Hiki ke kōkua i ka ho'āʻo mua ʻana o Adams e hoʻoholo inā he mau hōʻailona no ka scoliosis.
ʻAʻole ia he hōʻailona mana, akā hiki ke hoʻohana ʻia nā hopena i wahi hoʻomaka.
Hana ʻia ka hoʻāʻo me nā makahiki kula keiki ma waena o 10 a me 18 e ʻike i ka ʻōpio idiopathic scoliosis aiʻole AIS.
ʻO ka hoʻāʻo maikaʻi he asymmetry ʻike ʻia i nā iwi ʻaoʻao me kahi piʻo i mua.
Hiki iā ia ke ʻike i ka scoliosis ma kekahi ʻāpana o ka iwi kuamoʻo, ʻoi aku hoʻi ma ka ʻōpū waena a me ke kua i luna.
ʻAʻole no nā keiki wale nō ka hoʻāʻo; Hiki ke ulu ka scoliosis i kēlā me kēia makahiki, no laila ua kūpono no nā mākua.
Hoʻāʻo ʻo Adams Forward Bend
He wikiwiki ka ho'āʻo, maʻalahi, a me ka ʻeha ʻole.
E nānā ka mea nāna e ʻike inā ʻaʻohe mea like ke kū pololei.
A laila e noi ʻia ka mea maʻi e kūlou i mua.
Noi ʻia ka mea maʻi e kū pū me nā wāwae, e kū pono ana i ka mea nānā.
A laila, kūlou ka poʻe maʻi mai ka pūhaka mai, me nā lima e kau pololei ana i lalo.
Hoʻohana ka mea nānā i a scoliometer-like pae e ʻike i nā asymmetries i loko o ka iwi kuamoʻo.
Na ka ho'āʻo Adams e hōʻike i nā hōʻailona o ka scoliosis a / a i ʻole nā deformes ʻē aʻe e like me:
ʻAʻohe poʻohiwi
ʻAʻohe pūwae
Ka nele o ka like ʻole ma waena o ka vertebrae a i ʻole nā poʻohiwi.
ʻAʻole laina ke poʻo me ka iwi ʻaoʻao a i ʻole ka pelvis.
ʻIke ʻana i nā pilikia ʻē aʻe o ke kuamoʻo
Hiki ke hoʻohana ʻia ka hoʻāʻo e ʻike i nā pilikia curvature spinal a me nā kūlana e like me:
ʻO Kyphosis a i ʻole ke kua hope, kahi e kulou ai ke kua i mua.
ʻO ka maʻi o Scheuermann he ʻano kyphosis kahi e ulu like ʻole ai ka vertebrae thoracic i ka wā o ka ulu ʻana a hoʻoulu ʻia ka vertebrae i ke ʻano like me ka wede.
ʻAʻole lawa ka hoʻāʻo ʻana iā Adams e hōʻoia i ka scoliosis.
Pono ka X-ray kū me nā ana kihi Cobb ma luna o 10 degere no ka ʻike ʻana i ka scoliosis.
ʻO ka huina Cobb e hoʻoholo i ka vertebrae i hili nui ʻia.
ʻO ke kiʻekiʻe o ke kihi, ʻoi aku ka koʻikoʻi o ke kūlana a ʻoi aku ka nui o ka hiki ke hana i nā hōʻailona.
Hiki ke hoʻohana pū ʻia ka tomography computed a i ʻole CT a me ka magnetic resonance imaging a i ʻole MRI scans.
Hoʻāʻo Piʻo i mua
E hoʻomaopopo '
Glavaš, Josipa et al. "ʻO ke kuleana o ka lāʻau lapaʻau kula i ka ʻike mua ʻana a me ka hoʻokele ʻana i ka scoliosis idiopathic ʻōpio." Wiener klinikche Wochenschrift, 1–9. 4 ʻOkakopa 2022, doi:10.1007/s00508-022-02092-1
Grossman, TW et al. "He loiloi o ka ho'āʻo ʻana i mua o Adams a me ka scoliometer i kahi hoʻonohonoho screening kula scoliosis." Nūpepa o nā pediatric orthopedic vol. 15,4 (1995): 535-8. doi:10.1097/01241398-199507000-00025
Letts, M et al. "Ka hoʻopaʻa ʻia ʻana o ka ultrasonic i ke ana o ka curvature spinal." iwi kuamoʻo vol. 13,10 (1988): 1106-10. doi:10.1097/00007632-198810000-00009
Senkoylu, Alpaslan, et al. "He ala maʻalahi no ka loiloi ʻana i ka hiki ke hoʻololi ʻia i ka scoliosis idiopathic adolescent: hoʻololi i ka hoʻāʻo ʻana i mua o Adamu." Hoʻohaʻahaʻa iwi kuamoʻo vol. 9,2 (2021): 333-339. doi:10.1007/s43390-020-00221-2
ʻO ka ʻeha hope haʻahaʻa kekahi o nā maʻi maʻamau no ka poʻe e kipa ana i ke kauka a i ʻole ke keʻena mālama koʻikoʻi. Ke piʻi nui ka ʻeha hope, hiki iā ia ke noʻonoʻo i kekahi mea i hewa nui i kou kua. Hāʻawi paha ke kauka i kahi x-ray a i ʻole MRI scan e hoʻonoho i kāu mau hopohopo.
ʻO ka mea pōmaikaʻi, ʻo ka hapa nui o nā ʻeha haʻahaʻa haʻahaʻa, ʻoi aku ka ʻeha nui, e hoʻomaikaʻi i loko o nā lā a i ʻole kekahi mau pule. Hoʻoponopono ʻia ka hapa nui o nā hihia ke kupikipiki, hoʻomaʻamaʻa kino, lāʻau wela/hau, a hoʻomaha. A ʻo ka hapa nui o kēia mau hihia ʻaʻole koi i kekahi ʻano o ka spinal imaging. Eia nō naʻe, ʻo ia ke kumu e pono ai nā X-ray, MRI, a me CT scans e ʻike i ka mea e hana nei.
Hoʻopaʻa pololei
Pākuʻu polihale
Kuhi hopeʻole
ʻO kēia mau kumu maʻamau o ka ʻeha hope haʻahaʻa hiki ke ʻeha a kaupalena i nā hana.
He ʻeha ʻeha ʻoi aku ka lōʻihi ma mua o 2 / 3 Weeks
ʻO ka ʻeha subacute ka lōʻihi ma waena o 4 a me 12 mau pule, ʻoiai ʻo ka ʻeha hope mau ʻekolu mahina a ʻoi aku paha. ʻAʻole kēia mau hōʻailona o kahi maʻi iwi kuamoʻo koʻikoʻi.
ʻO ka hōʻemi ma mua o 1% o ka poʻe me ka hōʻeha haʻahaʻa ua ʻike ʻia me ke ʻano e pono ai ke ʻoki ʻana i ka spine:
X-ray a i ʻole MRI no ka ʻike ʻana i ka ʻeha hope haʻahaʻa
DHiki i nā octors ke ʻōlelo aku i kahi x-ray a i ʻole MRI inā loaʻa ka ʻeha haʻahaʻa mai kahi ʻeha ʻeha, e like me a:
Lepeke
haule
ʻO ka ulia kaʻa
ʻO nā kumu ʻē aʻe o ka ʻeha hope haʻahaʻa hiki ke hōʻoia i ke kiʻi lāʻau lapaʻau koke a ma hope paha.
Hoʻomaka ka hana diagnostic me ka loiloi o nā hōʻailona haʻahaʻa haʻahaʻa a pehea e pili ai i nā mea i loaʻa i ka wā o ka:
Kūʻai kino
ʻO ka hoʻokolohua Neurological
Nā moʻolelo pilikino
Hoʻohana ke kauka i kēia mau hopena e hoʻoholo ai inā pono ke kiʻi spinal, me ke ʻano o ka hoʻāʻo kiʻi, x-ray, a i ʻole MRI a me ka manawa e hōʻoia ai i kahi hōʻailona.
A Low Back X-Ray / MRI
ʻIke maikaʻi ka X-ray spinal imaging i nā pilikia o ka iwi aka ʻaʻole maikaʻi loa me nā hōʻeha hōʻeha. Hiki ke hana ʻia nā moʻo X-ray no ka ʻike ʻana i nā haʻihaʻi compression vertebral.
mua
Kūlike
ʻO nā manaʻo lateral
ʻO ka MRI kahi hōʻike hoʻāʻo i ka radiation. Hana ʻia nā MRI ʻO 3-D ka hiʻohiʻona anatomical o nā iwi spinal a me nā lole palu. ^ E Ha yM. Mea like me kahi waihoʻoluʻu gadolinium Hoʻohana ʻia e hoʻoikaika a hoʻomaikaʻi i ka maikaʻi o nā kiʻi. Kuhi ʻia ka hoʻohālikelike ʻia ma kahi lālani intravenous i kou lima a i ʻole lima ma mua o ka wā hoʻāʻo. An Hiki i ka MRI ke loiloi i nā hōʻailona neurological, e like me ka ʻāhae ʻana o ka ʻeha a i ʻole ka ʻeha e ulu ana ma hope o ka ʻike ʻana i ka maʻi kanesa.
Nā ʻmplelo, a me nā Diagnoses Medical Co-e pili ana, a me nā Kaukiʻi e pono ai ke Kauka Pūkini Kālā
Nā hōʻailona neurological
ʻO ka ʻeha hope haʻahaʻa e ʻā ana, pā i waho, a i lalo paha i loko o ka ʻāʻī, nā wāwae, a me nā wāwae
Hiki i nā hōʻemi keʻokeʻo ma lalo o ke kino ke hōʻike i ka huhū o ka nerve
ʻAno, huhū, a i ʻole nā nāwaliwali e ulu
ʻAʻole hiki ke hāpai i kou wāwae, aka hāʻule wāwae
Ana ʻia ka hoʻoheheʻe ʻana i kou kino holoʻokoʻa ma o ka millisievert (mSv), i ʻike ʻia hoʻi ʻo ka maʻa kūpono. ʻO ka nui like ka nui o ka radiation i kēlā me kēia manawa e ʻike ʻoe i kahi x-ray. I ka wā e hana ana i kahi x-ray, ʻo ka radiation ʻaʻole i hoʻopili ʻia e ke kino e hoʻokumu i ke kiʻi.
Hiki ke kōkua ʻia ka hopena e kauka i kahi kauka no ka mau hopena pili o ka huli ana i ka leo:
Hoʻohana ka scans CT i ka radiation
Pilikia nā ʻiʻo kino a me nā ʻāpana o ke kua i lalo i ka ʻike ʻana i ka radiation, e like me nā mea hānau.
ʻO ka MRI Radiation-Free No ke aha e hoʻohana wale ai i kēia ho'āʻo ma nā manawa āpau
ʻAʻole hiki ke hoʻohana ʻia ka MRI i nā maʻi āpau no kāna ʻenehana magnet ikaika. ʻAʻole hiki ke nānā ʻia nā wahine hāpai a i ʻole nā mea metala i loko o ko lākou kino, e like me ka spinal cord stimulator, heart pacemaker, etc., me kahi MRI.
He pipiʻi ka hoʻāʻo MRI; ʻAʻole makemake nā kauka e kuhikuhi i nā hoʻokolohua pono ʻole e hoʻonui ai i nā kumukūʻai. A i ʻole ma muli o nā kikoʻī maikaʻi i hāʻawi ʻia e nā MRI, i kekahi manawa hiki ke nānā aku ka pilikia spinal akā ʻaʻole.
la'ana: Kuhi ʻia i kahi MRI o ka lalo o a herniated disc i ka mea maʻi me ka ʻeha ʻole o ke kua/wāwae a i ʻole nā hōʻailona ʻē aʻe.
ʻO kēia ke kumu e lawe mai ai nā kauka i kā lākou mau ʻike āpau e like me nā hōʻailona, ka hoʻokolokolo kino, a me ka mōʻaukala olakino e hōʻoia i kahi hōʻailona a hana i kahi hoʻolālā lapaʻau maʻamau.
Hāpai Hāpai Hana Imaging
Inā loaʻa ka ʻeha haʻahaʻa, e hoʻolohe i ka ʻōlelo a ke kauka. ʻAʻole paha lākou e kauoha koke i kahi x-ray lumbar a i ʻole MRI akā e hoʻomanaʻo i nā pilikia i ʻōlelo ʻia ma luna, e like me nā hōʻailona neurological a me nā kūlana olakino e noho pū ana. Akā, kōkua kēia mau ho'āʻo e ʻike i ke kumu a i ʻole nā kumu o ka ʻeha. E hoʻomanaʻo ʻo ia ke kōkua i ka loaʻa ʻana o nā maʻi i ko lākou olakino maikaʻi loa a me ka ʻeha ʻole.
Pehea e hoopau ai i ka eha hope ma ke ano | (2020) Nā wāwae pae |El Paso, Tx
Nā pūnaewele NCBI
ʻO nā diagnostics he mea nui i ka loiloi o ka trauma spine. Ua loli nui ka ʻōuli o ka ʻenehana hoʻomohala ʻana i ka loiloi a me ka mālama ʻana i nā hōʻeha pōkole. Hoʻohana i ka hana hoʻohālikelike i ka hoʻohana ʻana iā CT a me ka MRI, i waena o nā mea kōkua, i ka hoʻopāʻeha a me nā noho paʻa. Ua hoʻomaʻamaʻa maikaʻi ʻia nā ʻeha a me nā hōʻeha manuahi ʻia e nā magnetaging resonance imaging, a i ʻole MRI paha, akā ʻO ka scan tomography computed a i ʻole CT scans e loiloi maikaʻi loa i ka ʻeha spinal a i ʻole ka haʻi kuamoʻo.
I kekahi manawa, he mauʻanoʻano likeʻole o ka'ōiwi a hiki ke hoʻonui i keʻano o ka papa hana maoli a iʻole kekahi mau papa. ʻO kēia mauʻano maʻamauʻole o ka'ōiwi keʻano i nāʻano olakinoʻekolu e kapaʻia ka lordosis, ka kyphosis, a me ka scoliosis.
ʻAʻole i manaʻo ʻia e piʻo maoli, wili, a i ʻole ka piko. ʻO ke ʻano kūlohelohe o ka iwi kuamoʻo olakino ʻano pololei me nā pihi liʻiliʻi e holo ana i mua a i hope i ʻike ʻia e ka ʻaoʻao.
Ke nānā nei i ka iwi kuamoo mai ka hope, pono ʻoe e ʻike i kahi mea ʻokoʻa ʻokoʻa - kahi ʻōiwi e holo pololei i lalo, luna a lalo me ka ʻaoʻao ʻole o nā ʻaoʻao ʻaoʻao. ʻAʻole naʻe kēia e hana.
ʻO ka'ilihi ka hōʻeaʻana i ka vertebrae, nā iwi liʻiliʻi i hoʻopiliʻia ma luna o kekahi me kekahi me nā pākuʻi pilikia ma waena o kēlā me kēia. Hana kēia mau iwi i mau hui, e hoʻokuʻu ana i ka'ōniwi e kukuli a uʻi i nāʻano likeʻole.
Kūleʻa iki lākou, hāʻule iki i loko o ka liʻiliʻi o ke kua, a ma keʻano iki i ka'ā'ī. Hiki i ka hukiʻana o ka'umekaumaha, me ka hoʻoikaika i ke kino, hiki ke hoʻokau i ka pilikia ma ke kuihi a e kōkua kēia mau pale liʻiliʻi i ka hopena o ka hopena.
Nā kūlana like ʻole no nā ʻano ʻano curvatures spinal
ʻO kēlā me kēia maʻiʻehaʻehaʻeha e pili ana i kahi wahi o ka'ōiwi ma kahiʻano maʻamau.
ʻO Hyper a Hypo Lordosis ʻO kēia maʻi curvature maʻi ʻōiwi e hoʻopili i ka hope i lalo, e hoʻohuli i ka iwi i loko a i ʻole waho nui.
Hyper a iʻole Hypo Kyphosis ʻO kēia maʻi ʻōiwi curvature e hoʻopili i ka kua i luna, e kulou i ka iwi kuamoʻo, e hopena ai i kēlā wahi a puni a pālahalaha ʻole paha.
ʻO Scoliosis Hiki i kēia maʻi ʻōiwi curvature ke hoʻololi i ka iwi kuamoʻo holoʻokoʻa, e hoʻohuli i nā ʻaoʻao, e hana i kahi ʻano C a i ʻole S.
He aha nā hōʻailona?
ʻO kēlā me kēiaʻano pāʻokoʻa e hōʻike iā ia iho nā hiʻohiʻona. ʻOiai paha e piʻi kekahi mau hōʻailona, nui ka poʻe i ke kūkoko o ka pikapika.
Hakuosis
ʻO kahi hiʻohiʻona ʻeā i kahi e kuʻi ai nā kuhū a i ʻole ʻoi aku ka maikaʻi.
ʻO ka hōʻoluʻolu ma hope, ma kaʻaoʻao lumbar
Ke waiho ma kahiʻiliʻili ma ke kua,ʻaʻole e pā i ka papalina kaʻaoʻao lalo,ʻoiaiʻo ia e ho'āʻo ana e huki i ke pelvis a pololei i lalo.
Pahi a me kekahi mau hana
Paʻi hope
ʻO Kyphosis
ʻO kahi kahuli aiʻole hump a hiki i ke kua i luna
ʻO kaʻeha hope o luna a me ka luhi ma hope o ka noho ʻana a kū paha i mau wā lōʻihi (kyphosis a Scheuermann)
Ka wāwae a iʻole hope paha
Kūleʻa ke poʻo i kahi mamao ma mua o ke kūponoʻole
ʻO Scoliosis
Hikiʻole nā kī a me nā pū'ī
Hoʻoiʻa ka lau hoʻokahi o ka poʻahiwi ma mua o kekahi
Kū ke kanaka i kekahiʻaoʻao
He aha nā kumu?
He nui nā kumu olakino likeʻole e hiki ke lilo i ka huela ma keʻano kuhihewa a iʻole e hana i keʻano o ke kuamo. ʻO kēlā me kēia nā lāʻauʻokoʻa 'ōleloʻia i nāʻano likeʻole a me nā kūlana.
Hakuosis
Osteoporosis
ʻO ka Achondroplasia
Kōpaeʻole
Obesity
Ke Kūlana Kūʻokoʻa
ʻO Kyphosis
ʻO Kyphosis
Arthritis
ʻO nā kumukū ma luna o kaʻula
Ke kūlana o ka nohona kūikawā (ka ulu kūpono o ka vertebrae oiai ke kanaka i loko o ka utero)
ʻO Spina Bifida
ʻO ka maʻi o Scheuermann
ʻO ka maʻi'ākau
Osteoporosis
ʻO ka noho maʻamau a me ka hoʻokaumahaʻole
ʻO Scoliosis He mea pohihihi no nae i na kauka. ʻAʻole maopopo iā lākou ke kumu o ke ʻano maʻamau o ka scoliosis i ʻike pinepine ʻia i nā keiki a me nā ʻōpio. ʻO kekahi o nā kumu a lākou i kuhikuhi ai:
ʻO ka pilikino, he kūlana e holo i nāʻohana
Hoʻoponopono
Ka maʻi hānau
eha
ʻO nā maʻi curvature spinal & Chiropractic
Hoʻopiliʻia ka'ōpū no ka maʻi o kaʻeha ua hōʻike ʻia he maikaʻi loa. Kōkua ʻo Chiropractic i ka hoʻihoʻi ʻana i ke kaulike kūlohelohe ʻoiai ʻo ka mea maʻi kekahi o kēia ʻano ʻano.
Aia nā hōʻike hiki i nā keikikāne a me nā mākua ke hoʻomaopopo i nā'ōkau o ke kuamo i ko lākou hoʻomakaʻana ma o kāu chiropractor. ʻO kaʻike muaʻana o kēia mau pilikia he mea koʻikoʻi i kaʻikeʻana iā lākou ma mua o ka liloʻana i mea koʻikoʻi.
Pilikino Spine & *SCIATICA TREATMENT* | El Paso, TX (2019)
Ua hoʻoholoʻia ka hopena o ka scoliosis ma kahi o ka 2 a hiki i ka 3 pakeneka o nā keiki a me nā mākua maʻAmelika Hui Pūʻia. Heʻeono paha aʻeiwa miliona kānaka. ʻOiai ka mea e ulu ana i ka hapanui o nā papa kuʻuna maʻamau no nā keikikāne a me nā kaikamāhine, hiki iā ia ke ulu i ka wā'ōpiopio. I kēlā me kēia makahiki, kokoke i nā keiki 30,000 i ka paleʻana i ka pale o ka scoliosis i ka manawa o ka poʻe 38,000 e hoʻopili i ka'ōpū o ke ahupuaʻa e hoʻoponopono ai i ka pilikia. Hiki i nā Scoliosis hōʻike ke loaʻa nā pōmaikaʻi nui ma kaʻikeʻana i nā mea pilikia no nā scoliosis a hiki i ka mālamaʻana i ka lāʻau.
ʻIkeʻoe i ka scoliosis,ʻo ka maʻalahi ke mālama.
ʻO ka Scoliosis kahi e hoʻonui mau i ka wā kamaliʻi. No nā kaikamāhine, ke hana nei ia ma waena o 7 a me 14 mau makahiki. Hoʻokumu nā keikikāne i kekahi manawa ma hope aku, ma waena o 6 a me 16 makahiki.
ʻO ka loaʻaʻana o kahi hōʻike scoliosis i kēlā me kēia makahiki i kēia mau wāʻoihana koʻikoʻi e hiki i nā kauka ke hōʻoia i ke kūlana i ka wā mua a hoʻomaka i ka hoʻoponoponoʻana ma mua o ka paʻakikī. Hiki i nāʻenehana sculiosis ke koi i nā hōʻailona maʻamau, ke kākoʻo, a me ke kāʻeiʻana.
Ua hōʻikeʻiaʻo Chiropractic e kōkua i nā scoliosis, e like me ka hoʻoukaʻana, nāʻoihana kūikawā, a me ka hoʻokele kino. Aia kekahi hoʻololi o nā'ōpū i hanaʻia e nā chiropractors e pili ana i ka mālamaʻana i ka scoliosis.
Ke hoʻoponopono mua i keʻano, hiki ke hōʻokiʻia ka angle Cobb mai ka holomuaʻana a hoʻemiʻia hoʻi i mea eʻoi aku kaʻoi aku o kaʻele. Hoʻomaopopo ka lawelaweʻana i nā hōʻailona maʻamauʻole i nā lā mua o ka scoliosis, no laila, he mea koʻikoʻi kaʻike mua a me kaʻike muaʻana.
ʻO ka ʻike mua ʻana i nā hihia koʻikoʻi hiki ke hoʻoponopono i nā pilikia o kēia manawa a pale i nā pilikia e hiki mai ana.
Hiki i nā Chiropractors ke ʻike kekahi mau mea pilikia scoliosis i nā keiki ma mua o ka ulu ʻana o ke ʻano. ʻO ka nānā ʻana i ka scoliosis e ʻae iā lākou e ʻike i ka ʻāʻī ma kahi kaulaʻi iwi kuamoʻo - kahi hōʻailona maʻamau e ulu lākou i ka scoliosis.
I kaʻikeʻana o nā mākua i ke keiki i kahi kūlana kiʻekiʻe loa no ka hoʻolālāʻana i nā scoliosis, hiki iā lākou ke hana i nā hana kūpono me ka mālamaʻana i nā home no nā hōʻailona o ka scoliosis a me ka mālama pūʻana i nā papa hana i manaʻoʻia. Eʻike lākou i ka nānāʻana i nā hōʻailona a hiki ke hoʻoponopono koke iā lākou i mea e hiki ai i ka lawelawe ke hoʻomaka i ka manawa hiki mua.
Kōkua i nā mea noiʻi a me nā kauka iʻoi aku ka maikaʻi i ka hanaʻana i nā scoliosis.
ʻO ka hoʻomakaʻana a me ka uluʻana o nā scoliosis ka mea i hūnāʻia i ka mea pohihihi no nā mea noiʻi a me nā kauka. ʻOiai ua nui nā hana i ka hoʻomaopopoʻana i keʻano, ua koe ka koe i koe e aʻo.
Ua nui nā haʻawina i kōkua i nā kauka i ka ʻike ʻana i nā keiki pilikia nui a me ka hana ʻana i nā maʻi maʻi mua, e like me ke ʻanoua pili ka piko o ka wāwae a me ka wāwae i nā scoliosis. Eia naʻe, he mea nui ka nānāʻana, kaʻike, a me ka mālamaʻana i ka holoʻana o nāʻikepili no ka hoʻonuiʻana i nā noiʻi a me kaʻoi aku o nā noiʻi e hanaʻia.
ʻO ka ʻike ʻana i nā maʻi scoliosis hou aʻe i ka wā mua. He hopena ʻelua kēia ma ka noiʻi. Hāʻawi ia i nā ʻikepili hou aʻe e loiloi a hoʻopaʻa ʻia, a e hoʻonui i ka hoihoi i ke kūlana ʻoiai ʻoi aku ka nui o nā hihia o ka scoliosis pae mua. E hoʻoikaika hou kēia i ka noiʻi.
E hōʻalo i ka 'pāʻani kali' e ʻike inā e holomua ana ka scoliosis.
ʻO kēlā me kēia makua i kali i nā hopena o ka ho'āʻoʻana a iʻole eʻike inā inā e ulu a hoʻonui paha kahi maʻi i ka makemake e pāʻani i kēlā pāʻani hoʻomaha. ʻO kaʻohana,ʻo ia ka mea mua iʻike i ka scoliois i loko o kahi keiki.
ʻOiai manaʻo paha lākou he pilikia, a ʻike paha aia kekahi pilikia, hiki iā lākou ke hana i kahi 'kali a ʻike' i ka mālama ʻana. Inā ʻoi aʻe ka piʻi ʻana, hiki iā lākou ke ʻimi i ka lāʻau lapaʻau, akā ʻo ka hoʻomau mau ʻana o ka ʻike ʻole inā e ʻoi aku ka ʻino o ka piʻi - a me ka hopohopo e hoʻopuka ai - hiki ke hoʻopilikia i ka maluhia o ka noʻonoʻo o nā mākua wale nō akā i ke keiki pū kekahi.
Hāʻawi nā kānana scoliosis i ka maluhia o ka noʻonoʻo a nānā i ka ulu ʻana o ke keiki i mea e holomua ai kā lākou scoliosis a lilo i pilikia e hiki ke kamaʻilio ʻia me ke ala wikiwiki a maikaʻi loa hoʻi.
Ma kahi o 1.5 miliona mau kānaka i loko oʻAmelika Huipūʻia ua loaʻa i ka maʻi'ōhumu. Rheumatoid arthritis, aiʻole RA, he maʻi hoʻomau, maʻi maʻi autoimmune e hōʻike ana i kaʻeha a me ka hūʻana o nā hui. Me RA, ka pūnaewele hoʻopiliʻole, ka mea e palekana ai i ko kākou ola ma ka hoʻoneʻeʻana i nā mea'ē aʻe e like me nā huakī a me nā maʻiʻino, e hōʻehahewa i nā hui. Hoʻopili pinepineʻia ka'ōlohelohe Rheumatoid i nā hono o nā lima, nā wāwae, nā lima lima, nā kuʻe lima, nā kuli a me nā wāwae. He nui nā kauka lapaʻau e'ōlelo mua i ka hōʻailona a me ka mālamaʻana i ka RA.
Hōʻuluʻulu Manaʻo
ʻO Rheumatoid arthritis ka mea i ʻike pinepine ʻia i ka maʻi ʻōpala ʻōnaehana. ʻO nā wahine, nā puhipaka, a me nā poʻe me ka mōʻaukala ʻohana o ka maʻi e loli pinepine ʻia. ʻO nā pae hoʻohālikelike no ke kuhi hōʻailona me ka loaʻa ʻana o hoʻokahi ami me ka pehu definite i wehewehe ʻole ʻia e kekahi maʻi ʻē aʻe. Hoʻonui ka likelihood o kahi rheumatoid arthritis diagnosis me ka helu o nā hono liʻiliʻi i pili. I ka mea hoʻomanawanui me ka maʻi o ke ake, ke kū mai o kahi mea rheumatoid a i ʻole anti-citrullined protein antibody, a i ʻole kiʻekiʻe C-reactive protein level a i ʻole erythrocyte sedimentation rate e hōʻike nei i kahi hōʻailona o ka rheumatoid arthritis. Pono e hoʻopili i ka loiloi mua o ka hale hana pilikino me ka helu piha o ke koko me ka dif- ferential a me ka loiloi o ka hana renal a me ka hepatic. ʻO nā mea maʻi e lawe ana i nā mea ola biologic e pono e hoʻāʻo no ka maʻi hepa B, hepatitis C, a me ka tuberculosis. ʻO ka hōʻoia ma mua o ka rheumatoid arthritis e ʻae no ka mālama mua ʻana me nā mea antirheumatic e hoʻololi ai i ka maʻi. Hoʻohana pinepine ʻia nā hui pū ʻana o nā lāʻau e kaohi i ka maʻi. ʻO ka Methotrexate ka lāʻau lapaʻau mua no ka rheumatoid arthritis. ʻO nā ʻākena biologic, e like me ka tumzros factor factor inhibitors, manaʻo ʻia he ʻelua laina āpau a i ʻole hiki ke hoʻohui ʻia no ka lua pālua. ʻO nā pahuhopu o ka mālama ʻana me ka hoʻohaʻahaʻa ʻana i ka ʻeha hui a me ka pehu ʻana, ka pale ʻana i ka hōʻino radiographic a me ka deformity ʻike ʻia, a me ka hoʻomau ʻana o ka hana a me nā hana pilikino. Hōʻike ʻia ke pani kuapo no nā mea maʻi me ka hōʻino pū ami paʻa nona nā ʻōuli e hoʻomalu maikaʻi ʻole ʻia e ka hoʻokele olakino. (Kauka Lapaʻau Fam. 2011; 84 (11): 1245-1252. Kuleana kope ― 2011 American Academy of Family Physicians.)
ʻO ka Rheumatoid arthritis (RA) ka mea maʻamau āpau o ke kino, me ka lōʻihi o ke ola holoʻokoʻa a hiki i ka 1 ka nui ma ke ao holoʻokoʻa. Hiki ke loaʻa iā 1 Onset i kēlā me kēia mau makahiki, akā he laulā i waena o 30 a me 50 years.2ʻAʻohe pilikia. Ma kekahi hui nui o ka US,ʻo ka nui o ka nui o nā maʻi me ka RA i loaʻa ka pilikia o ka hana ma hope o 35 years.10
Hoʻoponopono āpau a me ka hanaʻana
E like me nā maʻi autoimmune, ʻo ka etiology o RA he multifactorial. ʻIke ʻia ka maʻalahi o ka genetic i ka ʻohana clustering a me nā haʻawina māhoe monozygotic, me ka 50 ka nui o ka pilikia RA e pili ana i nā genetic factors.4 ʻO nā hui genetic no RA e komo pū me ka leukocyte antigen-DR45 a me -DRB1, a me nā ʻano like ʻole i kapa ʻia ʻo ka epitope.6,7. 4 Ua ʻike ʻia nā haʻawina hoʻopaʻa ʻana o Genome-wide i nā hōʻailona genetic hou e hoʻonui ai i ka pilikia o ka RA a me nā maʻi autoimmune ʻē aʻe, e komo pū ana me STAT40 gene a me CD5 locus.8 ʻO ka puhi paka ka mea nui e hoʻoulu ai i ke kaiapuni no RA, ʻoi aku ka nui o ka poʻe me kahi genetic predisposition.9 ʻOiai nā maʻi. hiki ke wehe i kahi pane autoimmune, ʻaʻohe pathogen i hōʻike ʻia e kumu e hōʻike ʻia ai ka RA.6 RA e nā ala inflammatory e alakaʻi ai i ka hoʻonui ʻana o nā pūnaewele synovial i nā hui. Hiki ke alakaʻi i ka hoʻokumu ʻana o ka pannus i lalo i ka luku ʻana i ka cartilage a me nā erosions iwi. ʻO ka hana nui ʻana o nā cytokine pro-inflammatory, me ka tumor necrosis factor (TNF) a me interleukin-10, e hoʻoneʻe i ka hana luku.XNUMX
NāʻAha Nino
ʻO ka makahikiʻelemakule, ka moʻoleloʻohana o ka maʻi, a me ka wahine wahine e pili ana i ka piʻiʻana o ka RA,ʻoiaiʻaʻole iʻike nuiʻia kaʻokoʻa o ke kāne i nā poʻe maʻi kahiko. = 1, a hiki i ka 1.4 no ka poe puhi paka he 2.2 makahiki). ʻAʻole hiki ke ʻike ʻia ka RA i nā wahine parous ma mua o nā wahine nulliparous (RR = 40). = 11 no ka poʻe me ka menarche ma 12 makahiki a ʻoi aʻe paha) a me ka maʻamau ʻole o ka manawa menstrual (RR = 0.61) hoʻonui i ka pilikia.
ʻike,
Hōʻike Kūʻokoʻa
ʻO nā maʻi me ka RA ke hōʻike nei me kaʻeha a me ke koʻikoʻi i nā hui lōʻihi. Hoʻokomo pinepineʻia nā lima, nā lōʻihi e pili ana i nā hui āpau, a me nā huila metapalipelu. ʻO kaʻoʻoleʻa o ka lā iʻoi aku ka lōʻihi o ka hora e hōʻike i kahi moʻo'ōlelo a me ka moʻo'ōlelo. Hiki keʻikeʻia ka'ōpiopio Boggy no ka synovitis (Nānā 1), a iʻole ka paleʻana o ka synovial mahele haʻahaʻa i palpable ma ka hōʻikeʻokoʻa. Hiki i nā maʻi ke hōʻike pū me nāʻano o nāʻano o keʻano o nā maʻi āpau ma mua o ka hoʻomakaʻana o ke kūlana maʻi. ʻO nā hōʻailona pūnaewele o ka luhi, nā lilo o ke kaumaha, a me ka maʻi wela haʻahaʻa e hiki mai me ka maʻi maʻi.
Nā Palapala Poʻomanaʻo
I ka makahiki 2010, ua hui pū ka American College of Rheumatology a me European League Against Rheumatism i ka hana ʻana i nā pae hoʻohālikelike hou no ka RA (Table 1). koʻikoʻi. ʻAʻole i hoʻokomo ʻia nā pae hoʻohālikelike o ka makahiki 16 i ka loaʻa ʻana o nā nodules rheumatoid a i ʻole nā hoʻololi erosive radiographic, ʻoi aku ka liʻiliʻi o ia mau mea ʻelua i ka RA mua. ʻAʻole koi ʻia ka maʻi maʻi symmetric ma nā pae hoʻohālike o ka makahiki 1987, e ʻae ana i ka hōʻike asymmetric mua. Eia kekahi, ua hoʻomohala a hōʻoia ka poʻe noiʻi Dutch i kahi lula wānana lapaʻau no RA (Table 2010) .2010 ʻO ke kumu o kēia lula e kōkua i ka ʻike ʻana i nā maʻi me ka maʻi ʻaʻole i hoʻohālikelike ʻia e holomua ana i ka RA, a e alakaʻi i ka hahai- luna a kuhikuhi.
Nā ho'āʻo diagnost
Hōʻike pinepine ʻia nā maʻi autoimmune e like me RA ma ke ʻano o nā autoanti-body. ʻAʻole kikoʻī ʻo Rheumatoid factor no RA a hiki ke loaʻa i nā maʻi me nā maʻi ʻē aʻe, e like me ka maʻi hepa C, a me nā poʻe ʻelemakule olakino. ʻOi aku ka kikoʻī o ka anti-citrullinated protein antibody no RA a hiki ke pāʻani i ka maʻi pathogenesis.6 Ma kahi o 50 a i ka 80 pakeneka o ka poʻe me RA ka rheumatoid factor, anti-citrullinated protein antibody, a i ʻole nā mea ʻelua.10 Loaʻa paha i nā maʻi me RA. he hopena ho'āʻo antinuclear antibody maikaʻi, a he mea koʻikoʻi ka hoʻāʻo ʻana i nā ʻano ʻōpio o kēia maʻi.19 Hoʻonui pinepine ʻia ka pae o ka protein C-reactive a me ka erythrocyte sedimentation rate me ka RA ikaika, a ʻo kēia mau mea hoʻohālikelike o ka manawa he ʻāpana o ka mea hou. Nā pae hoʻohālikelike RA.16 Hiki ke hoʻohana ʻia nā pae protein C-reactive a me ka erythrocyte sedimentation rate no ka hahai ʻana i ka hana maʻi a me ka pane ʻana i ka lāʻau. He mea kōkua ka helu ʻana o ke koko piha me ka ʻokoʻa a me ka loiloi o ka hana renal a me ka hepatic no ka mea hiki ke hoʻololi i nā hopena i nā koho lapaʻau (e laʻa, ʻaʻole e kuhikuhi ʻia ka mea maʻi me ka lawa ʻole o ka renal a i ʻole ka thrombocytopenia nui i ka lāʻau anti-inflammatory nonsteroidal [NSAID]). Loaʻa ka anemia haʻahaʻa o ka maʻi maʻi i ka 33 a i ka 60 pakeneka o nā maʻi āpau me RA, 20 ʻoiai pono e noʻonoʻo ʻia ke kahe koko o ka ʻōpū i nā poʻe maʻi e lawe ana i nā corticosteroids a i ʻole NSAID. Hoʻopaʻa ʻia ka Methotrexate i nā poʻe maʻi me ka maʻi hepatic, e like me ka maʻi hepa C, a me nā poʻe maʻi me ka hōʻeha nui o ka renal. Hiki ke hana hou i ka ma'i Hepatitis B me ka ho'ohana 'ana i ka TNF inhibitor. 21 Pono e hana 'ia ka lekiō o na lima a me na wawae no ka loiloi 'ana no ke ano o na ho'ololi erosive periarticular, 'o ia paha ka mea e hō'ike ana i ka subtype RA 'oi aku ka ikaika.22
ʻIkeʻikeʻokoʻa
Hōʻike ka ʻili i ka systemic lupus erythematosus, systemic sclerosis, a i ʻole psoriatic arthritis. Pono e noʻonoʻo ʻia ka polymyalgia rheumatica i ka mea maʻi kahiko me nā hōʻailona ma ka poʻohiwi a me ka ʻūhā, a pono e nīnau ʻia ka mea maʻi e pili ana i ka arteritis kino. He mea kōkua ka lekiō umauma i ka loiloi no ka sarcoidosis ma ke ʻano he kumu o ka ʻāʻī. Hiki i nā poʻe me ka liʻiliʻi o ʻeono pule o nā hōʻailona ke loaʻa i kahi kaʻina viral, e like me ka parvovirus. Hōʻike ʻia nā ʻāpana hoʻopaʻa paʻa mau o ka pehu ʻana o ka hui ʻana i ka arthropathy kristal, a pono e hana ʻia ka arthrocentesis no ka loiloi no nā kristal monosodium urate a i ʻole calcium pyrophosphate dihydrate kristal. ʻO ka loaʻa ʻana o nā helu kumu myofascial a me nā hōʻailona somatic hiki ke hōʻike i ka fibromyalgia, hiki ke noho pū me RA. No ke kōkuaʻana i ke alakaʻiʻana i ka hōʻailona a me ka hoʻoholoʻana i ka hoʻolālā lapaʻau, pono e hoʻouna kokeʻia nā poʻe maʻi me ka maʻi o ka maʻi i kahi rheumatology subspecialist.16,17
ʻO ka Rheumatoid arthritis, aiʻole RA paha,ʻo ia keʻano maʻamau o nā maʻi o ka maʻi. ʻO ka RA he maʻi maʻi liʻiliʻi, i hanaʻia i ka manawa e hoʻopiliʻia ai ka pūnaewele olaʻole, ka pūnaewele palekana o ke kanaka, i kona mau iho a me nā mea kino,ʻo ia hoʻi nā hono. Hāʻa pinepineʻia kaʻikeʻana o ka hamo o ka Rheumatoid e nā hōʻailona o kaʻeha a me ka mumū, a pinepine i nā mea liʻiliʻi o nā lima, nā lima a me nā wāwae. Wahi a nā kumu loea, he mea nui ka hōʻoia mua a me ka mālamaʻana i ka RA no ka paleʻana i ka hoʻohapuʻia hou a hoʻemi i nā hōʻailona hōʻino. Dr. Alex Jimenez DC, CCST Insight
lapaʻau
Ma hope o ka loaʻaʻana o ka RA aʻikeʻia ka loiloi muaʻana, e hoʻomaka ke kaukua. Ua kūpono nā kulekele hou i ka hoʻoponoponoʻana i ka RA, 21,22, akā,ʻo ka manaʻo hoʻomanawanui kekahi hapa nui. Aia kekahi mau'ōlelo kūikawā no nā wāhine o ka wā hānau keiki no ka mea he nui nā lāʻau i loaʻa ka hopena i ka hopena. ʻO nā pahuhopu o ke olakino,ʻo ia ka hoʻohaʻahaʻaʻana i kaʻeha a me ke kīpēʻana, e pale ana i nā palupalu (e like me keʻokiʻana o uller) a me ka hōʻinoʻana i ka laula (e like me ka palaka), mālama i ka maikaʻi o ke ola (ke kanaka a me ka hana), a me nā hōʻailona'ē aʻe. ʻO ka maʻi-hoʻololiʻana i nā lāʻau antirheumatic (DMARDs) ka mea nui o ka RArapy.
DMARDs
Hiki i nā DMARD ke olaola a nonbiologic paha (Table 3) Manaʻo ʻia ka Methotrexate ma ke ʻano he lāʻau lapaʻau mua i nā poʻe maʻi me ka RA ikaika, ke ʻole ka contraindicated a ʻaʻole ʻae ʻia. Sulfasalazine (Azulfidine) aiʻole hydroxychloroquine (Plaquenil) pro-inflammatory e like me ka monotherapy i nā maʻi me ka haʻahaʻa o ka maʻi'activity a i ʻole nā hiʻohiʻona prognostic maikaʻi ʻole (eg, seronegative, non-erosive RA). ma mua o ka monotherapy; akā naʻe, ʻoi aku ka nui o nā hopena ʻino.23 Inā ʻaʻole i mālama maikaʻi ʻia ka RA me kahi DMARD nonbiologic, pono e hoʻomaka ʻia kahi DMARD biologic.21 TNF inhibitors ka lāʻau lapaʻau lāʻau mua a ʻo ia ka mea i aʻo nui ʻia o kēia mau mea hana. Inā maikaʻi ʻole ka TNF inhibitors, hiki ke noʻonoʻo ʻia nā lāʻau lapaʻau olaola hou. ʻAʻole ʻōlelo ʻia ka hoʻohana like ʻana o nā lāʻau lapaʻau ʻoi aku ma mua o hoʻokahi (e laʻa, adalimumab [Humira] me ka abatacept [Orencia]) no ka nui o nā hopena ʻino.
Nā NSAID a me nā Corticosteroids
Hiki i nā lāʻau'aloʻolo lāʻau no ka RA ke komo i nā NSAIs a me ka lolo, intramuscular, a iʻole corticosteroids intra-articular no ka mālamaʻana i kaʻeha a me ka mumū. ʻO ke kūpono, hoʻohanaʻia nā NSAID a me nā corticosteroids no ka hoʻoponopono pōkole. ʻO DMARDs ka therapy.21,22 iʻoi aku
Nā Hoʻoponopono Hoʻolaha
Ua aʻo ʻia nā hana ʻai meaʻai, me ka meaʻai meaʻai meaʻai a me ka Mediterranean, i ka mālama ʻana i ka RA me ka ʻole o ka hōʻike ʻana o ka pōmaikaʻi. me RA.25,26 Eia hou, thermotherapy a me ka therapeutic ultrasound no RA 'aʻole i aʻo adequately.27,28 A Cochrane loiloi o nā lāʻau lapaʻau lapaʻau no RA i hoʻoholo i ka gamma-linolenic acid (mai ke ahiahi primrose aiʻeleʻele currant hua aila) a me Tripterygium wilfordii (the thunder god vine) loaʻa nā pōmaikaʻi.29,30 He mea nui e hoʻomaopopo i nā maʻi ua hōʻike ʻia nā hopena koʻikoʻi me ka hoʻohana ʻana i ka lāʻau lapaʻau.31
ʻO ka hoʻomehana a me ke olakino
ʻO nā hualoaʻa o nā ho'āʻo hana i hoʻonohonohoʻia no ka hoʻoikaikaʻana i ka maikaʻi o ke ola a me ka ikaika o ka mīkini i nā maʻi me nā polokalamu hoʻolālā aʻo RA.32,33,ʻaʻole i hōʻikeʻia he mau hopenaʻeha i ka maʻi o ka RA, Ua hōʻikeʻia ka hoʻomaikaʻiʻana o ke akua i ka lōʻihi o ka holoʻana i ka poʻe me ka RA, akā, ua kaupalenaʻia ka hopena o ka hopena .34 Ua hoʻoholoʻia nā ho'āʻoʻana o Iyengar yoga i ka poʻe'ōpio me ka RA e holo nei.35
Ka lōʻihi o ke kauka
Loaʻa ke kala ʻana ma 10 a 50 pakeneka o nā maʻi me RA, ma muli o ke ʻano o ka wehewehe ʻana o ke kala ʻana a me ka ikaika o ka lāʻau lapaʻau. nā poʻe maʻi ma mua o 10 makahiki), me ka lōʻihi o ka maʻi, me ka hana maʻi ʻoi aku ka maʻalahi, me ka ʻole o ka hoʻokiʻekiʻe ʻana o ka manawa acute phase reactants, a me ka loaʻa ʻole o ka rheumatoid factor a i ʻole anti-citrullinated protein antibody loaʻa. i ka huina liʻiliʻi e pono ai. Pono nā poʻe maʻi i ka nānā pinepine ʻana e hōʻoia i nā hōʻailona kūpaʻa, a ʻo ka hoʻonui koke ʻana i ka lāʻau lapaʻau e ʻōlelo ʻia me nā maʻi ʻaʻa.40
Kahi Hoʻohui
Hōʻikeʻia ka pani houʻana i ka wā he nui ka hoʻohaunaʻiaʻana o nā hui a me ka manaʻole o nā hōʻailona me ka mālamaʻana i ka lāʻau. ʻO nā hopena lōʻihi lōʻihi,ʻo ia ke kākoʻo, me 4 wale nō i ka 13 ka nui o nā pani pani lōʻihi e pono ai ka hoʻololi houʻana i loko o nā makahiki 10.38ʻO kaʻokoʻa a me ke kuli keʻano o ka hui.
Mākaʻikaʻi lōʻihi
ʻOiai ua manaʻo ʻia ʻo RA he maʻi o nā ami, he maʻi ʻōnaehana hoʻi ia e hiki ke hoʻopili i nā ʻōnaehana okana lehulehu. Hoʻokomo ʻia nā hōʻike extra-articular o RA ma ka Papa 4.1,2,10 ʻO ka poʻe maʻi me ka RA he pālua ka piʻi ʻana o ka lymphoma, i manaʻo ʻia ma muli o ke kaʻina hana inflammatory lalo, ʻaʻole ia he hopena o ka lāʻau lapaʻau.39 ʻO nā maʻi me ka Aia nō hoʻi ka RA i ka nui o ka pilikia o ka maʻi ʻaʻaʻa coronary, a pono nā kauka e hana pū me nā poʻe maʻi e hoʻololi i nā mea pilikia, e like me ka puhi paka, ke koko kiʻekiʻe, a me ka cholesterol kiʻekiʻe.40,41 Class III or IV congestive heart failure (CHF) is a contraindication no ka hoʻohana 'ana i ka TNF inhibitors, hiki ke hoʻonui i nā hopena CHF.21 I nā maʻi me ka RA a me ka maʻiʻino, pono e makaʻala me ka hoʻohana mauʻana i nā DMARDs,ʻo ia hoʻi ka TNF inhibitors. ʻAʻole pono e hoʻomaka ʻia nā DMARD Biologic, methotrexate, a me leflunomide i nā poʻe maʻi me ka herpes zoster ikaika, ka maʻi fungal nui, a i ʻole ka maʻi bacterial e koi ana i nā lāʻau antibiotic.
Hōʻikeʻike
ʻO nā maʻi me ka RA e ola ana iʻekolu mau makahiki i ka 12 ma lalo o ka heluna kanaka nui .40 Ua hoʻonuiʻia ka make ma loko o kēia mau maʻi ma muli o ka maʻi leʻaleʻa cardiovascular, keʻole ma nā mea maʻi nui a me ka mumū mau. Hiki ke hoʻololi i ka holomua o ke atherosclerosis me ka hoʻopiliʻana i ka ola i loko o ka poʻe me RA.41.
ʻIkepili Sources: Ua hoʻopauʻia ka huli PubMed i loko o Clinical Queries ma ka hoʻohanaʻana i nā hua'ōlelo o ka'ōhumu o ka rumatika, nā hōʻailona'ē aʻe, a me nā hōʻailona antirheumatic hoʻololi. Loaʻa i ka hulina nā kānana-hoʻoponopono, nā ho'āʻoʻana i ke kaulikeʻana, nā hoʻokolohuaʻokoʻa, a me nā loiloi. Uaʻimi pūʻia nō hoʻi ka Agency no ke Keʻena Ola Ola a me kaʻoiaʻiʻo o nā hōʻike hōʻike, Evidence Clinical, ka waihonaʻike Cochrane, Essential Evidence, a me UpToDate. Ka lā maʻamau: September 20, 2010.
Ka wehewehe o ka mea kākau: ʻAʻohe pili kālā pili e hōʻike. I ka hopena, ʻo ka rheumatoid arthritis kahi maʻi maʻi autoimmune e hōʻeha ai i nā hōʻailona ʻeha, e like me ka ʻeha a me ka ʻehaʻeha, ka mumū a me ka pehu ʻana o nā hono, a me nā mea ʻē aʻe. ʻO ka pōʻino hui i hōʻike ʻia ʻo RA he symmetrical, ʻo ia hoʻi ka hopena maʻamau i nā ʻaoʻao ʻelua o ke kino. Pono ka ʻike mua no ka mālama ʻana i ka RA. ʻO ka laulā o kā mākou ʻike i kaupalena ʻia i nā pilikia olakino chiropractic a me spinal. No ke kūkākūkā ʻana i ke kumuhana, e ʻoluʻolu e nīnau iā Kauka Jimenez a i ʻole e kelepona mai iā mākou ma�915-850-0900�. Ua mālama ʻia e Dr. Alex Jimenez
Pākuʻi Hou Kūkākūkā: Hoʻopiʻi i ke Kino Pain me kaʻole o ke kahakaha
ʻO ka ʻeha kuli kahi hōʻailona kaulana i hiki ke hana ʻia ma muli o nā ʻano ʻeha o ke kuli a me / a i ʻole nā kūlana, e like menā pōʻai hoʻolālā. ʻO ke kuli kekahi o nā pūpū nui loa i loko o ke kino o ke kanaka e like me ka hanaʻiaʻana o ka laka o nā iwiʻehā,ʻehā mau ligaments,ʻo keʻano o ke kuamo, ka manisciʻelua, a me ke kāleti. Wahi a ka American Academy o nā Kauka Lapaʻau,ʻo nā kumu maʻamau loa o kaʻeha o ke kuli pēlā i ka patellar subluxation, ka patellar tendinitis a me ke kuli o ka māmā, a me ka maʻi o Osgood-Schlatter. ʻOiai paha e hiki ke kaumaha ka'ūpuku i nā poʻe ma luna o 60 makahiki, hiki ke hanaʻia kaʻeha o ke kuli ma nā keiki a me nā'ōpio. Hiki ke mālamaʻia kaʻehaʻeha i ka home ma hope o nā ala RICE, akā naʻe, hiki i nāʻeha o ke kuli kūpono ke koi koke i nā lāʻau lapaʻau, e like me ka mālamaʻana i ka chiropractic.
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