Ukukhubazeka kwePensile-kwiNdebe

Umxholo

• Ushwankathelo
• Oonobangela bokukhubazeka ngepensile-kwindebe
• Iimpawu zokukhubazeka kwepensile-kwindebe
• Ukuchonga ipensile-kwindebe yokukhubazeka
• Ukunyanga ukukhubazeka kwepensile-kwindebe
• Imbonakalo

Ushwankathelo

Ukukhubazeka kwepensile-kwindebe kukuphazamiseka kwethambo okunqabileyo okunxulunyaniswa nefomathi yamandla e-psoriatic arthritis (PsA) ebizwa ngokuba sisifo samathambo. Inokwenzeka kwakhona nge-rheumatoid arthritis (RA) kunye ne-scleroderma. "Ipensile-ekwikomityi" ichaza ukuba ithambo elichaphazelekayo libukeka njani kwi-X-ray:

• Isiphelo sethambo siye sonakaliswa imilo yepensile ebukhali.
• Le "pensile" igugile umphezulu wethambo elihlangeneyo kwimo yekomityi.

Ukukhubazeka kwepensile-kwindebe kunqabile. I-Arthritis mutilans ichaphazela kuphela malunga neepesenti ezintlanu zabantu abane-PsA kunye nabantu abane-rheumatoid arthritis. Siza kujonga ikakhulu ukusilela kwepensile-kwindebe nge-PsA.

Ukuba ii-X-reyi okanye izikeni zakho zibonisa naziphi na iimpawu zokonakala kwepensile-kwindebe, kubalulekile ukuqala unyango ngokukhawuleza ukunciphisa okanye ukuyeka ukonakala ngakumbi. Ngaphandle konyango, ukutshatyalaliswa ngokudibeneyo kunokuqhubeka ngokukhawuleza.

Amalungu okuqala okuchaphazeleka ahlala edityaniswa ngomnwe wesibini nowesithathu (amanqwanqwa e-distal interphalangeal). Le meko inokuchaphazela namalungu akho eenzwane.

Nangona ukusilela kwepensile-kwindebe kusoloko kubonakala kwi-PsA, ezinye iindlela zesifo samathambo ezichaphazela amathambo omqolo wakho kunye namalungu omzimba (spondyloarthropathies) nawo anokubangela ukuphazamiseka kweminwe neenzwane. Kananjalo, kwenzeka kunqabile kwi:

• inkqubo ye-sclerosis (scleroderma)
• Isifo sikaBehcet
• inkqubo lupus erythematosus

Oonobangela bokukhubazeka ngepensile-kwindebe

I-Arthritis mutilans kunye neempawu zayo zokubhala ipensile-kwindebe zezona ndlela zibukhali zePSA enganyangekiyo.

Izizathu ze-PsA aziqondakali ngokupheleleyo. Kucingwa njengonxibelelwano oluntsonkothileyo lwemfuza, ukungasebenzi kwenkqubo yomzimba yokuzikhusela, kunye nemeko yokusingqongileyo. Malunga nabantu abane-psoriasis baphuhlisa i-PsA.

Ukuba nembali yosapho ye-psoriasis yonyusa umngcipheko wokufumana i-psoriasis kunye ne-PsA. Kodwa kukho umahluko okwahlukileyo wofuzo phakathi kwe-psoriasis kunye ne-PsA. Unamathuba amathathu ukuya kwamahlanu osengozini yokuba nelifa le-PsA kunokuba uza kufumana i-psoriasis.

Uphando lwemfuzo lufumanise ukuba abantu abane-PsA abanezakhi zofuzo ezimbini (I-HLA-B27 okanye I-DQB1 02) banomngcipheko okhulayo wokuphucula i-arthritis mutilans.

Izinto zokusingqongileyo ekucingelwa ukuba zinegalelo kwi-PsA zibandakanya:

• uxinzelelo
• usulelo (njenge-HIV okanye usulelo lwe-streptococcal)
• ukukhathazeka kumalungu (ngakumbi kubantwana)

Iimpawu zokukhubazeka kwepensile-kwindebe

'Ukukhubazeka kwepensile kwindebe kukungahambi kakuhle kwethambo. IX-reyi yoku khubazeka ibonisa ithambo elichaphazelekayo kunye nokuphela kwethambo eligudileyo laba yimilo yepensile ebukhali. Le "pensile" igugile umphezulu wethambo elihlangeneyo kwimo emile yekomityi. ‘

Abantu abane-pencil-in-cup deformity evela kwi-PsA banokufumana iimpawu zolu hlobo lwe-arthritis. Iimpawu ze-PsA ziyahluka kwaye zinokufana nezinye izifo:

• ukudumba iminwe okanye iinzwane (dactylitis); Izifundo zifumene i-dactylitis ekhoyo kubantu abane-PsA
• ukuqina ngokudibeneyo, ukudumba, kunye nentlungu, zihlala kumalungu amane okanye ambalwa kumalungu kunye ne-asymmetric (hayi indibaniselwano efanayo kumacala omabini omzimba wakho)
• utshintsho lwezipikili, kubandakanya ukubetha kunye nokwahlulwa kwezikhonkwane ebhedini yesikhonkwane
• intlungu yentamo
• Isifo samathambo esivuthayo somqolo kunye namalungu amakhulu (spondylitis)
• ukudumba kwelinye okanye omabini amalungu e-sacroiliac (sacroiliitis); Olunye uphononongo lufumanise ukuba kubantu abane-PsA bane-sacroiliitis
• Ukudumba kwezinto, indawo apho kungena khona imisipha okanye imithambo (i-enthesitis)
• ukudumba komaleko ophakathi wamehlo, kubangela ubomvu kunye nombono ophuthileyo (uveitis)

Ukuba unesiphene sendebe, unokufumana ezi mpawu:

• ukwanda kokuhamba kwethishu egubungele ngokudibeneyo
• ukutshatyalaliswa kwamathambo (osteolysis)
• "Iglasi ye-opera" okanye iminwe "ye-telescopic", apho izicwili zethambo ziyawa, kushiyeke ulusu kuphela

Ukuchonga ipensile-kwindebe yokukhubazeka

I-PsA ihlala ihamba ingafunyanwa, ngenxa yeempawu zayo ezahlukeneyo kunye nokusilela kwesivumelwano kwiikhrayitheriya. Ukunceda ekumiseni ukufumanisa isifo, iqela lamazwe e-rheumatologists liphuhlise iikhrayitheriya ze-PsA eyaziwa ngokuba yi-CASPAR, iikhrayitheriya zokuhlelwa kwe-psoriatic arthritis.

Obunye bobunzima kukuba isifo samathambo sivela ngaphambi kweempawu zesikhumba se-psoriasis zabantu abane-PsA. Ke iimpawu zolusu azinakho ukunika umkhondo. Ukongeza, iimpawu ze-psoriasis kunye ne-PsA azihlali rhoqo - zinokugqabhuka kwaye zinciphise.

Ugqirha wakho uya kuthatha imbali yezonyango, kubandakanya nembali yosapho lwakho. Baza kukubuza malunga neempawu zakho:

• Bomelele kangakanani?
• Unexesha elingakanani unazo?
• Ngaba bayahamba?

Kananjalo baya kuqhuba uvavanyo lomzimba.

Ukuqinisekisa ukuxilongwa kwe-arthritis mutilans kunye ne-pencil-in-cup deformity, ugqirha wakho uya kusebenzisa ngaphezu kweyodwa uhlobo lovavanyo lokucinga, kuquka:

• X-reyi
• isimboli
• Ukuskena iMRI

Ugqirha wakho uya kujonga ubukhali bentshabalalo yethambo. I-Sonography kunye ne-imaging ye-MRI inokunika umfanekiso ocacileyo wento eyenzekayo. Umzekelo, umzekelo, unokufumana ukudumba okwangoku okwangoku. I-MRI inokunika umfanekiso ocacileyo wotshintsho oluncinci kulwakhiwo lwethambo kunye nezicubu ezijikelezileyo.

Zimbalwa kakhulu izifo ezinokuthi zibandakanye ukungasebenzi kwepensile-kwindebe. Ukuba awunazimpawu zolusu ze-psoriasis, ugqirha wakho uya kujonga amanqaku e-rheumatoid arthritis kunye nezinye izifo ezinokubangela esi sifo.

I-PsA ayiqondwanga kakuhle. Kodwa ukuxilongwa okungalunganga kwepensile-kwindebe yokukhubazeka akunakulindeleka, ngenxa yomfanekiso wayo ohlukileyo weX-ray. Ezinye iimpawu zakho ziya kukukhokela ugqirha ekufikeleleni ekuchongeni isifo esisisiseko.

Ukunyanga ukukhubazeka kwepensile-kwindebe

Injongo yonyango lokukhubazeka kwepensile-kwindebe kuku:

• thintela nakuphi na ukonakala kwamathambo
• ukubonelela ngeentlungu
• ukubonelela ngonyango olusebenzayo kunye nolomsebenzi ukugcina ukusebenza kwezandla neenyawo zakho

Unyango oluthile luya kuxhomekeka kubukhali bokukhubazeka kwakho nakwisizathu esisisiseko.

Ukukhubazeka kwepensile-kwindebe enxulumene ne-PsA, ugqirha wakho unokumisela iziyobisi ezingezizo ezokulwa nokudumba (i-NSAIDs) ukunciphisa iimpawu. Kodwa la machiza awayi kuyeka ukutshatyalaliswa kwamathambo.

Ukunciphisa okanye ukuyeka ukulahleka kwethambo, ugqirha unokumisela izifo eziguqula iziyobisi (i-DMARD) okanye ii-molecule ezincinci zomlomo (ii-OSM) ezinje:

• imethotrexate
• Tofacitinib (Xeljanz)
• I-apremilast (i-Otezla)

Iqela leziyobisi elibizwa ngokuba yi-biologics inhibit tumor necrosis factor (TNF-alpha), edlala indima kwi-PsA. Imizekelo ibandakanya:

• I-etanercept (i-Enbrel)
• infliximab (Remicade, Inflectra, Renflexis)
• adalimumab
• golimumab
• isatifikethi sepgol

I-Biologics evimba i-interleukin 17 (IL-17), ekhuthaza ukudumba, kubandakanya:

• secukinumab (iCosentyx)
• ixekizumab (iTaltz)
• brodalumab (uSiliq)

Ezinye i-biologics ugqirha unokumisela zibandakanya:

• ustekinumab (Stelara), othintela iimolekyuli ezivuthayo IL-23 kunye ne-IL-12
• i-abatacept (i-CTLA4-Ig), ethintela ukwenziwa kweeseli ze-T, uhlobo lweseli olubalulekileyo ekuphenduleni kwamajoni omzimba

Unyango lwendibaniselwano lunokufuneka kwezona meko zinzima. Nokuba amachiza amaninzi aphantsi kophuhliso okanye kuvavanyo lweklinikhi olujolise kwiiseli ezithile okanye kwiimveliso zazo ekucingelwa ukuba zinokubangela ukudumba kunye nokutshatyalaliswa kwethambo.

Unyango lomzimba kunye nolomsebenzi lunokuba luncedo ekupheliseni iimpawu, ukugcina ubhetyebhetye, ukunciphisa uxinzelelo ezandleni nasezinyaweni, kunye nokukhusela amalungu ekulimaleni.

Xoxa nogqirha wakho malunga nokudibanisa unyango kunokuba kulunge kuwe. Buza nokuba ingaba uvavanyo lweklinikhi lunokukhetha na. Qiniseka ukuba uxoxa ngeziphumo ebezingalindelekanga ze-DMARD, ii-molecule ezincinci zomlomo (ii-OSMs), kunye ne-biologics. Kananjalo jonga iindleko, kuba amanye amachiza amatsha abiza kakhulu.

Kwezinye iimeko, ukuhlinzwa ngokutsha okanye ukutshintshwa ngokubambisana kunokukhetha.

Utyando lwe-PsA aluqhelekanga: Olunye uphononongo lufumanise ukuba kuphela iipesenti ezisi-7 zabantu abane-PsA abanokuhlinzwa ngamathambo. Ukuphononongwa ngo-2008 kwe-PsA kunye notyando kuqatshelwe ukuba utyando ngamanye amaxesha luye lwaphelisa iintlungu kunye nokuphucula ukusebenza komzimba.

Imbonakalo

Ipensile-kwindebe yokukhubazeka ayinakunyangeka. Kodwa unyango oluninzi lweziyobisi lunokucothisa okanye luyeke ukonakala kwethambo ngakumbi. Kwaye amayeza amatsha ethembisayo aphantsi kophuhliso.

Unyango lomzimba lunokunceda ekomelezeni izihlunu kunye nokugcina amalungu akho, izandla kunye neenyawo ziguquguqukayo kwaye zisebenza. Umsebenzi wezonyango unokukwazi ukunceda ngezixhobo ezincedisayo ekuhambeni nasekusebenzeni imisebenzi yemihla ngemihla.

Ukutya ukutya okunempilo okuchasayo kunye nokufumana imithambo rhoqo kunokunceda impilo yakho iphela.

Ukuqala ukucebisa okanye ukujoyina iqela lenkxaso kunokukunceda ukumelana noxinzelelo kunye nokukhubazeka. Isiseko seArthritis kunye neNational Psoriasis Foundation zombini zibonelela ngoncedo lwasimahla.