Pencile-i-Cup Deformity

Anter

• Hōʻike Overview
• Kumu o ka penikala-i loko o ke kīʻaha deformity
• Nā ʻōuli o ka deformity pencil-in-cup
• ʻIke i ka deformity penikala-i-kīʻaha
• Ka mālama ʻana i ka deformity pencil-in-cup
• ʻO ka nānā aku

Hōʻike Overview

ʻO ka deformity pencil-in-cup kahi maʻi iwi laha ʻole e pili nui ʻia me kahi ʻano koʻikoʻi o psoriatic arthritis (PsA) i kapa ʻia he mutilans arthritis. Hiki iā ia ke hana me ka rheumatoid arthritis (RA) a me ka scleroderma. "Pencil-in-cup" wehewehe i ke ʻano o ka iwi i hoʻopili ʻia i kahi X-ray:

• Ua huki ka hopena o ka iwi i kahi ʻano penikalaʻoiʻoi.
• Ua hoʻopau kēia "penikala" i ka ʻili o kahi iwi e pili ana i kahi ʻano kīʻaha.

Kākaʻikahi ka pencil-in-cup deformity. Hoʻopili ka poʻe mutilans ma kahi o 5 pākēneka wale nō o ka poʻe me PsA a me nā kānaka me ka rumatika arthritis. E nānā nui mākou i ka deformity penikala-i-kīʻaha me PsA.

Inā hōʻike kāu X-ray a i ʻole scans i nā hōʻailona o ka penikala penikala i loko o ke kīʻaha, he mea nui e hoʻomaka i ka lāʻau i ka wā e hiki ai ke hoʻolohi a kū hoʻi i ka hoʻohaʻahaʻa hou ʻana. Me ka ʻole o ka lapaʻau ʻana, hiki i ka luku pū ʻia ke holo wikiwiki.

ʻO nā hono mua e hoʻopili pinepine ʻia ka lua a me ke kolu o nā hono manamana (distal interphalangeal ami). Hiki i ke kūlana ke hoʻopili i kou hono i nā manamana wāwae.

ʻOiai ʻike pinepine ʻia ka deformity penikala-i loko o ke kīʻaha ma PsA, nā ʻano ʻē aʻe o ka arthritis e hoʻopili i nā iwi o kou iwi kuamoʻo a me nā lālā (spondyloarthropathies) hiki ke hana i kēia maʻi o nā manamana lima a me nā manamana wāwae. Eia kekahi, ʻaʻole loaʻa iki i:

• ʻōnaehana sclerosis (scleroderma)
• Maʻi ʻo Behcet
• ʻōnaehana lupus ʻōnaehana

Kumu o ka penikala-i loko o ke kīʻaha deformity

ʻO ka Arthil mutilans a me kona ʻano penikala-i loko o ke kīʻaha deformity ke ʻano nui loa o ka PsA i mālama ʻole ʻia.

ʻAʻole maopopo maopopo nā kumu o PsA. Manaʻo ʻia he pilina paʻakikī o nā genetics, hana ʻole o ka ʻōnaehana pale, a me nā ʻano kaiapuni. E pili ana i ka poʻe me psoriasis hoʻomōhala PsA.

ʻO ka loaʻa ʻana o ka moʻolelo ʻohana o psoriasis e hoʻonui ai i kou makaʻu i ka loaʻa ʻana o psoriasis a me PsA. Akā he mau ʻokoʻa ʻokoʻa ʻokoʻa ma waena o psoriasis a me PsA. ʻEkolu a ʻelima mau manawa āu e hoʻoilina ai iā PsA ma mua o kou hoʻoilina iā psoriasis.

Ua loaʻa i kahi noiʻi genetic ka poʻe me PsA i loaʻa ʻelua mau ʻāpana kikoʻī (HLA-B27 a i ʻole DQB1 * 02) ua hoʻonui i ka makaʻu o ka hoʻomohala ʻana i nā mutilans arthritis.

ʻO nā kumu kaiapuni i manaʻo e hāʻawi i PsA:

• hoʻoluhi
• nā maʻi (e like me HIV a i ʻole nā ​​maʻi maʻi streptococcal)
• trauma i nā hono (ʻo ia hoʻi me nā keiki)

Nā ʻōuli o ka deformity pencil-in-cup

ʻO ka Pencil-in-cup deformity kahi maʻi iwi laha ʻole. Hōʻike kahi X-ray o kēia deformity i ka iwi i hoʻopili ʻia me ka hopena o ka iwi i huki ʻia i kahi ʻano penikalaʻoi. Ua hoʻopau kēia "penikala" i ka ʻili o kahi iwi e pili ana i kahi ʻano kīʻaha. '

ʻO ka poʻe i loaʻa ka deility penikala i loko o ke kīʻaha e kū mai ana mai PSA e ʻike paha i nā ʻōuli o kēia ʻano o ka arthritis. He ʻano like ʻole nā ​​ʻōuli o PsA a hiki ke like me nā ʻano maʻi ʻē aʻe:

• pehi nā manamana lima a me nā manamana wāwae (dactylitis); Loaʻa nā noiʻi i ka dactylitis i loko o ka poʻe me PsA
• ʻoʻoleʻa o ka ami, huʻi, a me ka ʻeha, maʻamau i ʻehā a ʻoi aku paha o nā hono a me ka asymmetric (ʻaʻole like like ma nā ʻaoʻao ʻelua o kou kino)
• loli ke kui, e like me ka waiho ʻana a me ka hoʻokaʻawale ʻana o nā kui mai ka moena kui
• ʻeha ʻāʻā huhū
• ʻōhū o ka iwi kuamoʻo a me nā ami nui (spondylitis)
• pehu o hoʻokahi a i ʻole ʻelua sacroiliac ami (sacroiliitis); hoʻokahi noiʻi i loaʻa i ka poʻe me PsA i sacroiliitis
• ka hoʻowahāwahā o nā entheses, nā wahi i komo ai nā ʻāʻī a i ʻole nā ​​ligament i kou mau iwi (enthesitis)
• pehu o ka papa waena o ka maka, ke kumu o ka ʻulaʻula a me ka hihi o ka hihi (uveitis)

Inā loaʻa iā ʻoe ka dexity pencil-in-cup, loaʻa paha iā ʻoe kēia mau ʻōuli:

• hoʻonui i ka neʻe o ke kiko ma luna o ka ami
• luku iwi nui (osteolysis)
• ʻO nā aniani "opera" a i ʻole nā ​​"manela" telescopic ", kahi e hāneʻe ai ka iwi iwi, a waiho ka ʻili wale nō

ʻIke i ka deformity penikala-i-kīʻaha

ʻAʻole ʻike pinepine ʻia ʻo PsA, no ka mea o nā ʻōuli ʻokoʻa a me ka ʻole o ka ʻaelike ma nā pae hoʻohālikelike. No ke kōkua ʻana i ke kaulike kaulike, ua hoʻomohala kahi hui honua o rheumatologists i nā pae hoʻohālikelike no PsA i kapa ʻia ʻo CASPAR, nā pae hoʻohālikelike no ka psoriatic arthritis.

ʻO kekahi o nā pilikia ʻo ia ka līlū ma mua o ka maʻi o ka maʻi psoriasis i nā poʻe me PsA. No laila ʻaʻole paha e hāʻawi ʻia nā ʻōuli o ka ʻili i kahi hōʻailona. Hoʻohui, ʻaʻole mau nā ʻōuli o psoriasis a me PsA - hiki iā lākou ke lapalapa a hoʻohaʻahaʻa.

E lawe kāu kauka i ka mōʻaukala olakino, me ka mōʻaukala o ka ʻohana. E nīnau lākou iā ʻoe e pili ana i kāu mau ʻōuli:

• Pehea ko lākou koʻikoʻi?
• Pehea kou lōʻihi?
• Hele mai paha lākou a hele?

E alakaʻi lākou i kahi hoʻokolokolo kino.

E hōʻoia i kahi kuhi o ka mutilans arthritis a me ka dexity pencil-in-cup, e hoʻohana ai kāu kauka i nā ʻano hōʻike kiʻi ʻē aʻe ma mua o hoʻokahi.

• X-ray
• sonograph
• MRI hoʻoili

E nānā kāu kauka no ke koʻikoʻi o ka luku iwi. Hiki i nā kiʻi Sonography a me MRI ke hāʻawi i kahi kiʻi finer o ka mea e hana nei. ʻO ke sonography, ma kahi laʻana, ʻike paha i ka mumū i ka loaʻa ʻole o nā ʻōuli. Hiki iā MRI ke hāʻawi i kahi kiʻi kikoʻī o nā hoʻololi liʻiliʻi i kāu hanana iwi a me nā mea a puni.

He kakaikahi loa nā maʻi e pili ana i ka deformity pencil-in-cup. Inā ʻaʻohe ou ʻōuli o ka maʻi ʻo psoriasis, e nānā paha kāu kauka no nā hōʻailona koko o ka rheumatoid arthritis a me nā maʻi ʻē aʻe i hiki ke kumu i kēia maʻi.

Ua kuhi hewa ʻo PsA. Akā ʻaʻole hiki ke kuhi hewa i ka deformity pencil-in-cup, no ka ʻano o kāna kiʻi X-ray ʻokoʻa. Kou mau ʻōuli ʻē aʻe e alakaʻi i ke kauka i ka hiki ʻana i kahi hōʻailona o ka maʻi maʻi.

Ka mālama ʻana i ka deformity pencil-in-cup

ʻO ka pahuhopu o ka mālama ʻana no ka deformity penikala i loko o ke kīʻaha e:

• pale i ka hōʻino hou ʻana o ka iwi
• hāʻawi i ka ʻehaʻeha
• hāʻawi i ke olakino a me ka hana hana e mālama i ka hana o kou mau lima a me kou mau wāwae

E pili ka mālama ʻana i ka paʻakikī o kou deformity a me ke kumu o ke kumu.

No ka deformity penikala-i-kīʻaha e pili ana iā PsA, hiki i kāu kauka ke kuhikuhi i nā lāʻau anti-inflammatorial nonsteroidal (NSAIDs) e hōʻoluʻolu i nā ʻōuli. Akā ʻaʻole kēia mau lāʻau e hōʻoki i ka luku iwi.

E hoʻolohi a hōʻoki paha i ka nalo ʻana o ka iwi, hiki i ke kauka ke kuhikuhi i nā lāʻau antirheumatic (DMARDs) e hoʻololi i nā maʻi (DMARDs) a i ʻole nā ​​mole liʻiliʻi waha (OSM) e like me:

• methotrexate
• tofacitinib (Xeljanz)
• apremilast (ʻOtezla)

ʻO kahi hui o nā lāʻau i kapa ʻia he biologics e kāohi i ka tumrosis tumrosis factor (TNF-alpha), kahi e hoʻokau nei i PsA. ʻO nā laʻana me:

• etanercept (Enbrel)
• infliximab (Remicade, Inflectra, Renflexis)
• adalimumab
• golimumab
• certolizumab pegol

Nā biologics e ālai ana i ka interleukin 17 (IL-17), kahi e paipai ai i ka palahū, e hoʻopili pū me:

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

Nā biologics ʻē aʻe i kau kauka e kuhikuhi ai:

• ustekinumab (Stelara), nā mea e ālai i nā mole kūpale IL-23 a me IL-12
• abatacept (CTLA4-Ig), kahi e ālai ai i ka hoʻoulu ʻana o nā hunaola T, kahi ʻano o ke koloka nui i ka pane ʻana o ka ʻōnaehana pale

Pono paha e mālama i nā kuʻikahi i nā hihia ʻoi loa. ʻOi aku ka nui o nā lāʻau i lalo o ka hoʻomohala ʻana a i ʻole nā ​​hoʻokolohua hoʻokolohua e pahuhopu nei i nā hunaola kikoʻī a i ʻole nā ​​huahana a lākou i manaʻo ai e hoʻāla i ka mumū a me ka iwi.

Hiki ke kōkua i ke olakino a me ka ʻoihana hana no ke kōkua ʻana i nā ʻōuli, ka mālama ʻana i ka maʻalahi, ka hoʻēmi ʻana i ke koʻikoʻi ma nā lima a me nā wāwae, a me ka pale ʻana i nā hono mai kahi ʻeha.

Kūkākūkā me kāu kauka he aha ka huikau o nā lapaʻau e kūpono iā ʻoe. E nīnau pū inā he hoʻokolokolo paha he koho. E kūkā pono e kūkākūkā i nā hopena o DMARD, nā mole liʻiliʻi liʻiliʻi (OSM), a me nā biologics. E noʻonoʻo pū i ke kumukūʻai, no ka mea, pipiʻi loa kekahi o nā lāʻau hou.

I kekahi mau hihia, he ʻokoʻa ke koho ʻana i ke kūkulu hou ʻana a i ʻole ke pani pani.

ʻAʻole maʻamau ka ʻoki ʻana no PsA: Hoʻokahi o nā noiʻi i ʻike ʻia he 7 wale nō pākēneka o ka poʻe me PsA i loaʻa i kahi ʻoki orthopedic. ʻO ka loiloi 2008 o PsA a me ke kahakaha i hōʻike ʻia ʻo ke ʻoki ʻana i kekahi mau hihia i hoʻomaha maikaʻi i ka ʻeha a hoʻomaikaʻi i ka hana kino.

ʻO ka nānā aku

ʻAʻole hiki ke hoʻōla ʻia ka deformity pencil-in-cup. Akā nui nā lāʻau lapaʻau i loaʻa i hiki ke hoʻolohi a hoʻopau paha i ka hōʻino hou ʻana o ka iwi. A ʻoi aku ka hoʻohiki ʻana o nā lāʻau hou i lalo o ka hoʻomohala.

Hiki i ke olakino kino ke kōkua i ka hoʻoikaika ʻana i nā mākala a me ka mālama ʻana i kou mau ami, nā lima, a me nā wāwae e maʻalahi a hana. Hiki paha i kahi mea hoʻoponopono hana ke kōkua me nā lakohana e kōkua i ka neʻe a hana i nā hana o kēlā me kēia lā.

ʻO ka ʻai ʻana i kahi papaʻai anti-inflammatory olakino a me ka loaʻa ʻana o ka hoʻoikaika kino pinepine hiki ke kōkua i kou olakino holoʻokoʻa.

Ke kōkua nei i ka ʻōlelo aʻo ʻana a i ʻole ke komo ʻana i kahi hui kākoʻo e kōkua iā ʻoe e kūpale i ke koʻikoʻi a me ke kīnā ʻole. Hāʻawi ka Arthritis Foundation a me ka National Psoriasis Foundation i kōkua kōkua manuahi.