Ukukhubazeka Kwepensela-Enkomishini

-Delile

• Ukubuka konke
• Izimbangela zokukhubazeka kwepensela-enkomishini
• Izimpawu zokukhubazeka kwepensela-enkomishini
• Ukuhlonza ukukhubazeka kwepensela-enkomishini
• Ukwelapha ukukhubazeka kwepensela-enkomishini
• Umbono

Ukubuka konke

Ukukhubazeka kwepensela-enkomishini kuyisifo esingajwayelekile samathambo esihlotshaniswa nefomu elibi le-psoriatic arthritis (PsA) elibizwa nge-arthritis mutilans. Kungenzeka futhi nge-rheumatoid arthritis (RA) ne-scleroderma. "Ipensela-endebeni" lichaza ukuthi ithambo elithintekile libukeka kanjani ku-X-ray:

• Ukuphela kwethambo kukhubazeke kwaba isimo sepensela esicijile.
• Leli “pensela” ligugile ingaphezulu lethambo elihlanganayo laba inkomishi.

Ukukhubazeka kwepensela-enkomishini akuvamile. Ama-mutilans e-arthritis athinta kuphela amaphesenti ama-5 abantu abane-PsA kanye nabantu abane-arthritis ye-rheumatoid. Sizobheka ikakhulukazi ukukhubazeka kwepensela-enkomishini nge-PsA.

Uma ama-X-ray noma ukuskena kwakho kubonisa noma yiziphi izimpawu zokuwohloka kwepensela-inkomishi, kubalulekile ukuqala ukwelashwa ngokushesha okukhulu ukwehlisa noma ukumisa ukonakala okuqhubekayo. Ngaphandle kokwelashwa, ukubhujiswa okuhlangene kungaqhubeka ngokushesha.

Amalunga okuqala athintekile imvamisa amalunga omunwe wesibili nowesithathu (amalunga e-distal interphalangeal). Isimo singathinta namalunga wakho wezinzwane.

Yize ukukhubazeka ngepensela-enkomishini kuvame ukubonakala kwi-PsA, ezinye izinhlobo zesifo samathambo ezithinta amathambo omgogodla wakho kanye nezitho (spondyloarthropathies) nakho kungadala lokhu kuphazamiseka kweminwe nezinzwane. Futhi, kwenzeka ngokungajwayelekile ku:

• i-systemic sclerosis (i-scleroderma)
• Isifo sikaBehcet
• uhlelo lupus erythematosus

Izimbangela zokukhubazeka kwepensela-enkomishini

Ama-mutilans e-arthritis kanye nokukhubazeka kwawo kwepensela-enkomishini kuyindlela ebucayi kakhulu ye-PsA engalashwa.

Izimbangela ze-PsA aziqondakali ngokuphelele. Kuthathwa njengokuxhumana okuyinkimbinkimbi kofuzo, ukungasebenzi kahle kwamasosha omzimba, nezici zemvelo. Mayelana nabantu abane-psoriasis bathuthukisa i-PsA.

Ukuba nomlando womndeni we-psoriasis kwandisa ubungozi bakho bokuthola i-psoriasis ne-PsA. Kepha kunokwehluka okuhlukile kofuzo phakathi kwe-psoriasis ne-PsA. Unamathuba aphindwe kathathu noma kahlanu okuthola ifa le-PsA kunalokho okufanele ukwenze njengefa le-psoriasis.

Ucwaningo lwezofuzo luthole ukuthi abantu abane-PsA abanezakhi zofuzo ezimbili ezithile (I-HLA-B27 noma I-DQB1 * 02) babe nengozi eyengeziwe yokuthuthukisa ama-mutilans e-arthritis.

Izici zemvelo okucatshangwa ukuthi zinikela ku-PsA zifaka:

• ukucindezeleka
• izifo (njenge-HIV noma izifo ze-streptococcal)
• ukuhlukumezeka kwamalunga (ikakhulukazi nezingane)

Izimpawu zokukhubazeka kwepensela-enkomishini

‘Ukukhubazeka ngepensela endebeni kuyisifo esingajwayelekile samathambo. I-X-ray yalokhu kukhubazeka ikhombisa ithambo elithintekile lapho ukuphela kwethambo kuguqulwe kwaba isimo sepensela ebukhali. Leli “pensela” ligugile ingaphezulu lethambo elihlanganayo laba inkomishi. ‘

Abantu abanokukhubazeka kwepensela-endebe okususelwa ku-PsA bangathola izimpawu zaleli fomu le-arthritis. Izimpawu ze-PsA ziyahlukahluka futhi zingafana nezinye izifo:

• ukuvuvukala kweminwe noma izinzwane (dactylitis); izifundo zithole i-dactylitis ekhona kubantu abane-PsA
• ukuqina okuhlangene, ukuvuvukala, nobuhlungu, imvamisa kuba amalunga amane noma ambalwa kanye ne-asymmetric (hhayi ilunga elifanayo ezinhlangothini zombili zomzimba wakho)
• izinguquko zezipikili, kufaka phakathi ukugoqa nokuhlukaniswa kwezipikili embhedeni wezipikili
• Ubuhlungu bentamo yokuvuvukala
• isifo sokuqaqamba kwamalunga komgogodla namalunga amakhulu (i-spondylitis)
• ukuvuvukala kwelungu elilodwa noma womabili ama-sacroiliac (sacroiliitis); isifundo esisodwa sathola ukuthi kubantu abane-PsA bane-sacroiliitis
• ukuvuvukala kokufakwa, izindawo lapho imisipha noma imisipha ingena khona emathanjeni akho (enthesitis)
• ukuvuvukala kwesendlalelo esiphakathi leso, okubangela ukubomvu nokubona okufiphele (uveitis)

Uma une-pencil-in-cup deformity, ungahle ube nalezi zimpawu:

• ukunyuka okukhuphukile kwezicubu ezingaphezulu kwejoyini
• ukubhujiswa kwamathambo okukhulu (i-osteolysis)
• "Ingilazi ye-opera" noma iminwe "ye-telescopic", lapho izicubu zethambo ziwela khona, kusale isikhumba kuphela

Ukuhlonza ukukhubazeka kwepensela-enkomishini

I-PsA ivame ukungatholakali, ngenxa yezimpawu zayo ezahlukahlukene kanye nokuntuleka kwesivumelwano ngemibandela. Ukusiza ukulinganisa ukuxilongwa, iqembu lamazwe omhlaba le-rheumatologists lenze izindlela ze-PsA ezaziwa nge-CASPAR, izindlela zokuhlukanisa i-psoriatic arthritis.

Obunye bobunzima ukuthi i-arthritis ivela ngaphambi kwezimpawu ze-psoriasis yesikhumba kubantu abane-PsA. Ngakho-ke izimpawu zesikhumba kungenzeka zinganikeli umkhondo. Ngaphezu kwalokho, izimpawu ze-psoriasis ne-PsA azihlali njalo - zingavutha futhi zinciphise.

Udokotela wakho uzothatha umlando wezokwelapha, kufaka phakathi umlando wezokwelapha womndeni wakho. Bazokubuza mayelana nezimpawu zakho:

• Zimbi kangakanani?
• Ube nabo isikhathi esingakanani?
• Ingabe bafika badlule?

Bazophinde bahlole ngokuphelele ngokomzimba.

Ukuqinisekisa ukuxilongwa kwe-arthritis mutilans kanye nokukhubazeka kwepensela-in-cup, udokotela wakho uzosebenzisa izinhlobo ezingaphezu kweyodwa zokuhlola izithombe, kufaka phakathi:

• I-X-ray
• i-sonograph
• Ukuskena kwe-MRI

Udokotela wakho uzobheka ubunzima bokubhujiswa kwamathambo. I-Sonography ne-imaging ye-MRI inganikeza isithombe esihle ngokwenzekayo. I-Sonography, ngokwesibonelo, ingahle ithole ukuvuvukala okwamanje okungakabi nazimpawu. I-MRI inganikeza isithombe esinemininingwane eminingi yezinguquko ezincane esakhiweni samathambo akho nakwizicubu ezizungezile.

Kunezifo ezimbalwa kakhulu ezingabandakanya ukukhubazeka kwepensela-enkomishini. Uma ungenazo izimpawu zesikhumba ze-psoriasis, udokotela wakho kungenzeka ahlole izimpawu zegazi zesifo samathambo nezinye izifo ezingadala lesi sifo.

I-PsA ayitholakali kahle. Kepha ukungaqondakali kahle kokukhubazeka kwepensela-endebe akunakwenzeka, ngenxa yesithombe sayo esihlukile se-X-ray. Ezinye izimpawu zakho zizoqondisa udokotela ekufinyeleleni ekutholeni isifo esingaphansi.

Ukwelapha ukukhubazeka kwepensela-enkomishini

Inhloso yokwelashwa kokukhubazeka ngepensela-endebe ukwenza lokhu:

• ukuvimbela noma yikuphi ukuwohloka kwamathambo okuqhubekayo
• ukuhlinzeka ukukhululeka kobuhlungu
• nikezela ngokwelashwa ngokomzimba nangokomsebenzi ukugcina ukusebenza kwezandla nezinyawo zakho

Ukwelashwa okuqondile kuzoncika ebukhulwini bokukhubazeka kwakho nasembangela ebangelwa yikho.

Ngokukhubazeka kwepensela-enkomishini ehlobene ne-PsA, udokotela wakho angakunikeza izidakamizwa ezingezona ukuvuvukala (ama-NSAID) ezingekho emthethweni ukuze kudambise izimpawu. Kodwa le mithi ngeke iyeke ukubhujiswa kwamathambo.

Ukwehlisa noma ukumisa ukulahleka kwethambo, udokotela angahle anikeze imishanguzo yokuguqula izifo (i-DMARDs) noma ama-molecule amancane omlomo (OSMs) njenge:

• imethotrexate
• i-tofacitinib (Xeljanz)
• i-apremilast (Otezla)

Iqembu lezidakamizwa elibizwa nge-biologics livimbela i-tumor necrosis factor (TNF-alpha), ebamba iqhaza kwi-PsA. Izibonelo zifaka:

• i-etanercept (Enbrel)
• infliximab (i-Remicade, i-Inflectra, i-Renflexis)
• adalimumab
• golimumab
• isitifiketi se-certolizumab

Ama-biologics avimba i-interleukin 17 (IL-17), ekhuthaza ukuvuvukala, afaka:

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

Ezinye izinto eziphilayo udokotela wakho angakuyala zihlanganisa:

• i-ustekinumab (Stelara), evimba ama-molecule wokuvuvukala IL-23 no-IL-12
• i-abatacept (CTLA4-Ig), evimba ukusebenza kwamaseli we-T, uhlobo lweseli olubalulekile ekuphenduleni amasosha omzimba

Ukwelashwa kokuhlanganiswa kungadingeka ezimweni ezinzima kakhulu. Izidakamizwa eziningi kakhulu zisakhiwa noma ezivivinyweni zokwelashwa ezibhekise kumaseli athile noma imikhiqizo yawo ecatshangwa ukuthi ingadala ukuvuvukala nokubhujiswa kwamathambo.

Ukwelashwa ngokomzimba nangokomsebenzi kungasiza ekunciphiseni izimpawu, ukugcina ukuguquguquka, ukunciphisa ukucindezeleka ezandleni nasezinyaweni, nokuvikela amalunga ekulimaleni.

Xoxa nodokotela wakho ukuthi yiziphi izinhlanganisela zokwelashwa ezingaba ngcono kuwe. Phinda ubuze ukuthi ngabe ukuhlolwa komtholampilo kungaba yini inketho. Qiniseka ukuthi uxoxa ngemiphumela emibi yama-DMARD, ama-molecule amancane omlomo (ama-OSM), kanye ne-biologics. Futhi cabanga ngezindleko, ngoba eminye yemithi emisha iyabiza kakhulu.

Kwezinye izimo, ukuhlinzekwa kabusha noma ukubuyiselwa ngokuhlanganyela kungaba yindlela.

Ukuhlinzwa kwe-PsA akuvamile: Olunye ucwaningo luthole ukuthi amaphesenti ayi-7 kuphela abantu abane-PsA abahlinzwa ngamathambo. Ukubuyekezwa kwe-PsA nokuhlinzwa ngo-2008 kwaphawula ukuthi ukuhlinzwa kwezinye izimo kuqeda ngempumelelo izinhlungu nokusebenza okuthuthukile komzimba.

Umbono

Ukukhubazeka ngepensela-enkomishini akukwazi ukwelashwa. Kodwa izindlela eziningi zokwelashwa ezitholakalayo zinganciphisa noma ziyeke ukuwohloka kwamathambo okuqhubekayo. Futhi imishanguzo emisha ethembisayo iyakhiwa.

Ukwelashwa ngokomzimba kungasiza ekuqiniseni imisipha nasekugcineni amalunga akho, izandla nezinyawo ziguquguquka futhi zisebenza. Uchwepheshe osebenza emsebenzini angakwazi ukusiza ngezinto zikagesi ukusiza ekuhambeni nasekusebenzeni imisebenzi yansuku zonke.

Ukudla ukudla okunempilo okulwa nokuvuvukala nokuvivinya umzimba njalo kungasiza impilo yakho yonke.

Ukuqala ukwelulekwa noma ukujoyina iqembu lokusekelwa kungakusiza ukuthi ubhekane nengcindezi nokukhubazeka. I-Arthritis Foundation neNational Psoriasis Foundation bobabili banikeza usizo lwamahhala.