Madokotala ochita opaleshoni amagwiritsira ntchito njira zosiyanasiyana zoyezetsa matenda kuti athandize kuzindikira mtundu weniweni wa kuvulala kwa minofu ndi mafupa kapena kusokonezeka ndipo amagwiritsa ntchito zotsatira za mayeserowa kukonzekera njira yoyenera ya chithandizo. Nawa ena mwa mayeso omwe amagwiritsidwa ntchito mobwerezabwereza pakuvulala kwa minofu ndi mafupa.
Kusanthula thupi
Dokotala akhoza kukuuzani zambiri za thanzi lanu mwa kungoyang'ana inu. Zizindikiro ndi zizindikiro zoonekeratu zimaphatikizapo zofooka (atrophied) kapena asymmetrical minofu, kusakanikirana kosayenera, kutupa, kusintha kwa khungu (monga mikwingwirima kapena zofiira zomwe zingasonyeze kutupa) ndi zophuka monga cysts, calluses kapena chimanga.
Mgwirizano
Palpation amatanthauza kukhudza. Pakuwunika kwa thupi, dokotala amatha kumva mafupa a wodwalayo kuti awone ngati akutentha kapena kutupa, zomwe ndi zizindikiro za kutupa. Angathe kukakamiza minofu kapena mfundo kuti adziwe malo achikondi. Palpation itha kugwiritsidwanso ntchito kuzindikira malo omera monga zotupa kapena cysts. Dokotala akhoza kuyika dzanja pa mgwirizano ndikukupemphani kuti musunthire mgwirizanowo, makamaka ngati mukudandaula za "kutuluka" kapena "kugwedeza" kumverera. Izi zimathandiza dokotala kuti amve matope pamene akuyenda pamwamba pa olowa. Ngati wina ali ndi mgwirizano, dokotala akhoza kugwedeza malowo asanayese kukonzanso mafupa.
Kuyesa Kwamayendedwe osiyanasiyana
Kuyesa kosiyanasiyana kumatha kutchedwanso kuyesa kusinthasintha. Amagwiritsidwa ntchito kuyeza momwe mungasunthire olowa. Malumikizidwe ena monga chala chachikulu ndi mapewa amakhala ndi kusuntha kosiyanasiyana, pafupifupi bwalo lathunthu. Zilumikizo zina monga bondo zimakhala ngati mahinji ndipo zimakhala ndi malire oyenda. Kuyesa kosiyanasiyana kumatha kukhala kogwira ntchito kapena kungokhala chete. M'mayesero ogwira ntchito, mumachita mayendedwe onse. Pakuyezetsa kopanda pake, adotolo agwira malekezero ndikusuntha.
Mayesero a Minofu
Minofu kukhala minofu yofewa, sikuwoneka pa X-ray. Choncho kuyesa kwa minofu ndi gawo lofunika kwambiri pakuwunika kwa thupi. Kufooka kwa minofu kungasonyeze kuvulala kwa minyewa yomwe imagwirizanitsa minofu ndi fupa, kuvulala kwa mitsempha yomwe imatulutsa minofu, kapena kufooka kwapadera kwa minofu yomweyi kuti isagwiritsidwe ntchito. Pofuna kuyesa mphamvu ya minofu, dokotala angafunse wodwalayo kuti asamuke m'njira zina pamene akugwiritsa ntchito mphamvu yotsutsa. Mwachitsanzo, adotolo angakufunseni kuti mukhale pampando ndikuyesera kukweza bondo limodzi pamene akukankhira pansi pa mwendo wanu wapamwamba kapena dokotala akhoza kugwira chigongono cha wodwalayo pamtunda wa digiri 90 ndikufunsa kuti apinde dzanja pansi. Kuyeza mphamvu yogwira pofunsa kufinya dzanja la dokotala ndi mtundu wina wa mayeso a minofu.
Ma radiographs (ma X-ray)
Ma X-ray (ma X-ray) ndi njira zodziwika bwino komanso zopezeka kwambiri zowunikira matenda. Ngakhale wodwala akudandaula za kuvulala pachikhatho kapena pachikaso, dokotala mwina ayitanitsa ma X-ray kuti atsimikizire kuti palibe fupa lomwe lasweka. Ma X-ray nthawi zonse amagwiritsidwa ntchito pochiza kusweka ndi kusokonekera kwa mafupa, ndipo angalimbikitsidwenso ngati dokotala wanu akuganiza kuti fupa kapena chiwalo cha mafupa chawonongeka chifukwa cha matenda ena monga nyamakazi kapena osteonecrosis (kufa kwa maselo a mafupa). Mafupa, zotupa ndi zinthu zina zokhuthala zimaoneka zoyera kapena zopepuka chifukwa zimayamwa kuwala. Minofu yofewa ndi kusweka kwa mafupa kumalola kuwala kudutsa, zomwe zimapangitsa kuti ziwalozi ziwoneke zakuda.
Dual-energy X-ray Absorptiometry
Dual-energy X-ray absorptiometry (DEXA) ndiyeso lomwe limagwiritsidwa ntchito kwambiri poyesa kuchuluka kwa mafupa. Imatha kuwunika molondola komanso molondola kusintha kwa kachulukidwe ka mafupa kwa odwala matenda osteoporosis omwe akulandira chithandizo. Makinawa amatenga chithunzi cha mafupa, thupi lonse, msana, chiuno ndi dzanja ndikuwerengera kachulukidwe kawo. Ndiwopanda ululu komanso wosasokoneza, safuna kukonzekera kwapadera.
Pa mayesowa, munthu amayenera kugona patebulo lopindika pomwe makina ojambulira X-ray amayenda pamwamba pa thupi kuti ajambule zithunzi za chiuno, msana kapena thupi lonse. Mayesowa amatenga pafupifupi mphindi 20 kuti amalize, ndipo mlingo wa radiation kuchokera pa x-ray ndi wocheperako poyerekeza ndi womwe umagwiritsidwa ntchito pachifuwa cha X-ray. Kuchulukana kwa mafupa a wodwalayo ndi chiopsezo cha kuthyoka kumafananizidwa ndi "zachibadwa" za anthu a msinkhu womwewo komanso kuwonjezereka kwa mafupa kotheka.
Maphunziro a Laboratory
Maphunziro a labotale a magazi, mkodzo kapena madzi olowa (synovial) amagwiritsidwa ntchito kuzindikira kupezeka ndi kuchuluka kwa mankhwala, mapuloteni ndi zinthu zina. Dokotala akhoza kuyitanitsa maphunziro a labotale osiyanasiyana malinga ndi zomwe apeza pakuyezetsa koyamba. Zinthu zina, monga nyamakazi, zimatha kudziwika ndi kukhalapo kwa chinthu china m'magazi anu. Mwachitsanzo, kafukufuku wa labotale amatha kudziwa kuchuluka kwa uric acid m'magazi, chomwe ndi chizindikiro cha gout. Kuchuluka kwa maselo oyera a magazi m'madzi olowa m'magazi kungasonyeze kutupa kwakukulu kapena matenda. Nthawi zambiri kuyezetsa m'ma labotale kumafunika asanachite maopaleshoni kuti adziwe zovuta zachipatala.
Doppler Ultrasound
Katswiri wa mafupa akamaganiza kuti wodwalayo ali ndi vuto la mitsempha yamagazi ya miyendo kapena manja, akhoza kumuuza kuti ayesedwe ndi ultrasound. Ultrasound imagwiritsa ntchito mafunde amphamvu omwe amamveka m'thupi. Izi zimapanga chithunzi cha mitsempha yamagazi. Dongosolo la mawu la Doppler limatulutsa mawu akuti "swishing" a pansi pa magazi. Iyi ndi mayeso osavulaza omwe alibe zotsatirapo zoyipa.
Bone Scan
Mitundu iwiri yoyezetsa yosiyana kwambiri imatha kutchedwa masikani a mafupa. Mtundu umodzi umayesa kuchuluka kwa fupa ndipo umagwiritsidwa ntchito pozindikira matenda a Osteoporosis. Mtundu woterewu wa fupa umagwiritsa ntchito mizati yopapatiza ya X-ray kapena ultrasound kuti awone momwe fupa lilili lolimba. Palibe kukonzekera kofunikira pa mayesowa, omwe amatenga mphindi zochepa chabe ndipo alibe zotsatirapo.
Mtundu wachiwiri wa fupa la fupa umagwiritsidwa ntchito pozindikira malo omwe mafupa amapangidwa modabwitsa. Amagwiritsidwa ntchito nthawi zambiri kuwonetsa malo omwe amathyoka kupsinjika kapena kukhalapo kwa nyamakazi, matenda, kapena khansa. Pafupifupi maola atatu kuti sikanidwe, wodwalayo amapatsidwa mlingo wochepa wa radioactive mankhwala otchedwa “technetium” kudzera mu mtsempha wa mtsempha (IV). Izi zimachitika mwachibadwa m'thupi ndipo zimagwiritsidwa ntchito popanga mafupa. Kujambula fupa palokha kumachitika patatha maola atatu, zomwe zimapatsa fupa nthawi kuti litenge technetium. Pamene wodwala wagona patebulo, kamera yapadera ya nyukiliya imatenga chithunzi cha thupi lonse. Izi zimatenga mphindi 30 mpaka 90. Magawo a mapangidwe a mafupa achilendo adzawoneka owala kuposa mafupa ena onse.
Computed Tomography (CT Scan)
Kujambula kwa CT (Computed Tomography) kumaphatikiza ma X-ray ndi ukadaulo wa makompyuta kuti apange chithunzi chatsatanetsatane cha thupi. Chingapangidwe ngati dokotala akukayikira kuti pali chotupa kapena kusweka komwe sikuonekera pa ma X-ray (monga m'khosi kapena m'chiuno) kapena ngati pachitika ngozi yaikulu pachifuwa, m'mimba, m'chiuno, kapena msana. Njirayi siipweteka. Wodwalayo amapemphedwa kuti agone osasuntha patebulo pamene akulowa pakati pa CT scanner yofanana ndi silinda. Chubu cha X-ray chimazungulira pang'onopang'ono wodwalayo, ndikujambula zithunzi zambiri kuchokera mbali zonse. Kompyuta imaphatikiza zithunzizo kuti iwonetse bwino, mbali ziwiri pa TV. Munthu angafunike kumwa kapena kubayidwa ndi barium sulfate kapena utoto kuti ziwalo zina za thupi ziwonekere bwino.
Kujambula kwa Magnetic Resonance (MRI)
MRI (chithunzi cha maginito cha resonance) imagwiritsa ntchito mphamvu za maginito ndi kompyuta yamakono kujambula zithunzi zowoneka bwino za mafupa a munthu ndi minyewa yofewa, zomwe zimapangitsa kuti thupi lanu lizijambula. Itha kugwiritsidwa ntchito kuthandizira kuzindikira minofu yong'ambika, ligaments ndi cartilage, ma disc a herniated, mavuto a m'chiuno kapena m'chiuno ndi zina. MRI imapanga mphamvu ya maginito kuzungulira wodwalayo, kenaka imayendetsa mafunde a wailesi kumalo a thupi kuti awonetsedwe. Mafunde a wailesi amachititsa kuti minyewayi imveke. Kompyutayo imalemba mmene ziwalo zosiyanasiyana za thupi (minofu, minyewa, minyewa) zimatulutsa kunjenjemera kumeneku ndipo imamasulira detayo mwatsatanetsatane chithunzi cha mbali ziwiri. Ngati wina ali ndi implants, zitsulo zachitsulo kapena zinthu zina zachitsulo m'thupi izi ziyenera kudziwitsidwa kwa dokotala asanamuyese MRI.
Kudzudzula
Discography ndi mayeso omwe amagwiritsidwa ntchito kuti adziwe ngati ma diski, (mapepala otsekemera omwe amalekanitsa mafupa a msana), ndiye gwero la ululu wammbuyo. Zitha kuchitidwa musanachite opaleshoni kuti muzindikire bwino disk (ma) zowawa.
Njirayi isanayambe, wodwalayo amapatsidwa maantibayotiki ndi mankhwala opumula kudzera mu mzere wa IV. Mankhwala amagwiritsidwa ntchito kuti dzanzi khungu pa malo mayeso. Panthawiyi, dokotala amaumirira singano mu disk imodzi kapena zingapo ndikulowetsa utoto wosiyana. Wodwalayo amamva ululu pamene utoto umalowetsedwa mu diski yavuto. Pambuyo pake, CT scan iwonetsa kusintha kulikonse mu kukula kapena mawonekedwe a disc. Munthu akhoza kukumana ndi kusapeza bwino kwa minofu pambuyo pa ndondomekoyi; dokotala akhoza kupereka mankhwala ochepetsa ululu kuti athetse vutoli.
Arthrography
Arthrography nthawi zambiri imagwiritsidwa ntchito pothandizira kudziwa chomwe chimayambitsa kupweteka kwamagulu osadziwika bwino. Njira yosiyana ya ayodini imalowetsedwa m'malo olowa kuti athandizire kuwonetsa zolumikizana, monga mitsempha, cartilage, tendors ndi kapsule yolumikizana. Ma X-ray angapo a olowa amatengedwa, pogwiritsa ntchito fluoroscope, chida chapadera cha x-ray chomwe chimasonyeza nthawi yomweyo chithunzicho. Wodwalayo angapemphedwe kuti asale kudya asanayesedwe. Pakuwunika, wodwalayo angapemphedwe kuti asunthire mgwirizanowo m'malo osiyanasiyana pamene zithunzi zimatengedwa. Si zachilendo kumva kusapeza bwino kapena kumva kumva kulasalasa panthawi yochita opaleshoni. Ngati wodwalayo ali ndi pakati, kapena akudwala ayodini kapena nkhono, izi ziyenera kudziwitsidwa kwa dokotala chifukwa wodwalayo akhoza kukhala pachiwopsezo chachikulu cha zovuta.
Electromyography
Electromyography (EMG) imalemba ndikusanthula zochitika zamagetsi mu minofu. Amagwiritsidwa ntchito kuti aphunzire zambiri za momwe mitsempha imagwirira ntchito m'manja ndi miyendo. Mwachitsanzo, kuthyoka kwa fupa lapamwamba la mkono (humerus) kumatha kung'amba kapena kutsina mitsempha yozungulira. EMG ikhoza kugwiritsidwa ntchito kuzindikira kuwonongeka ngati mitsempha sibwerera mkati mwa miyezi inayi yavulala. Nthawi zambiri, munthu amatha kupeza zotsatira atangomaliza mayeso.
Maphunziro a Mitsempha (NCS)
Maphunziro oyendetsa mitsempha nthawi zambiri amachitidwa pamodzi ndi electromyogram kuti adziwe ngati mitsempha ikugwira ntchito bwino. Zitha kulimbikitsidwa ngati munthu ali ndi zizindikiro za matenda a carpal tunnel syndrome kapena mitsempha ina ya m'mimba. Dokotala yemwe akuyesa mayeso amajambula mawaya (electrodes) pakhungu m'malo osiyanasiyana m'njira ya mitsempha. Kenako dokotala amalimbikitsa mitsempha ndi magetsi. Pamene zamakono zikuyenda mumsewu wa mitsempha, ma electrode omwe amaikidwa panjira amatenga chizindikiro ndikuyesa liwiro lake. Mu mitsempha yathanzi, zizindikiro zamagetsi zimatha kuyenda pa liwiro la makilomita 120 pa ola. Ngati mitsempha yawonongeka, komabe chizindikirocho chidzakhala chochepa komanso chofooka. Mwa kulimbikitsa mitsempha m'malo osiyanasiyana, dokotala akhoza kudziwa malo enieni a chovulalacho.
Intrathecal Contrast Enhanced CT Scan
Mayesowa amagwiritsa ntchito utoto wosiyanitsa kuti awonetse msana wa msana ndi mizu ya mitsempha mumsana. Itha kugwiritsidwa ntchito kuthandizira kuzindikira zovuta zam'mbuyo monga spinal stenosis, makamaka kwa odwala omwe ali ndi pacemaker kapena ena omwe sangakhale ndi MRI. Dokotala amapaka mankhwala ochititsa dzanzi pakhungu, omwe angalume kwa mphindi zingapo. Dokotala amagwiritsa ntchito chitsogozo cha X-ray kuti abaye mulingo wochepa kwambiri wamadzimadzi (utoto) mumadzi amsana. Kenako CT scan imayendetsedwa. Ngakhale kuti palibe kukonzekera kwapadera komwe kumafunikira, kupumula kolimba kwa bedi ndikofunikira kwa maola osachepera 24 pambuyo pa mayeso kuti mupewe kupweteka kwa msana. Mutuwu ukhoza kuchitika chifukwa madzi ena omwe amazungulira ubongo ndi msana amatha kutuluka kudzera pamalo opangira jakisoni. Kuyezetsa komweko kungatenge maola angapo chifukwa zingatenge nthawi yaitali kuti utoto ufike pamalo okhudzidwa.
Kulakalaka Kophatikizana ndi Kusanthula
Kulakalaka kophatikizana kungakhale kuyesa kwa matenda komanso njira yamankhwala. M'mikhalidwe monga bursitis, pali madzi oundana omwe amachititsa kutupa ndi kupanikizika. Kuchulukana kwamadzimadzi komweko mozungulira mafupa kumatha kuchitika ndi kuvulala ndi nyamakazi.
Kupuma, kapena kuchotsa madzimadzi kudzera mu syringe, kungachepetse kutupa ndi kuchepetsa kupanikizika. Dokotala amatsuka khungu ndi mankhwala a antibacterial asanalowetse singano yofuna. Wodwalayo angamve kupanikizika ndi kupweteka pamene singano ikulowetsedwa, koma izi ziyenera kuchepetsedwa pamene madzi akuchotsedwa.
Pambuyo poyezetsa, dokotala akhoza kutumiza madzimadzi ku labotale kuti akawunike. Muzochitika zovulaza, pangakhale magazi omwe amapezeka mumadzimadzi kapena madontho amafuta ochokera m'mafupa, zomwe zimasonyeza kukhalapo kwa fracture. Kusanthula kungathenso kudziwa ngati madziwa amachokera ku matenda kapena kuyankha kotupa.
Quantitative Computer Tomography
Quantitative computer tomography (QCT) imagwiritsidwa ntchito poyeza kuchuluka kwa mafupa amchere (BMD) kwa osteoporosis. Ndizofanana ndi CT scan wamba, koma amagwiritsa ntchito pulogalamu yapakompyuta yomwe imatsimikizira kuchuluka kwa mafupa m'chiuno kapena msana. Njirayi imapereka chithunzithunzi chenicheni cha mbali zitatu ndikuwonetsa BMD ngati miyeso yeniyeni ya kachulukidwe ka voliyumu. Izi zimathandiza kuti dokotala aziganizira kwambiri za malo enaake.
Minofu Biopsy
Kusanthula kwa minofu ndi njira yomwe imagwiritsidwa ntchito pozindikira matenda okhudzana ndi minofu. Minofu ndi maselo ochokera ku minofu inayake amachotsedwa ndikuwonedwa mwachisawawa. Njirayi imafuna kachidutswa kakang'ono kokha kamene kamachotsedwa ku minofu yosankhidwa.
Chitsanzo cha minofu chimapezeka polowetsa singano ya biopsy mu minofu. Pamene imachotsedwa ku minofu, kachidutswa kakang'ono ka minofu kamakhalabe mu singano. Dokotala akhoza kuyika singano ya biopsy kangapo m'madera osiyanasiyana a minofu kuti apeze chitsanzo chokwanira choyesa.
Biopsy ya minofu imachitika kuti iwunikire dongosolo la musculoskeletal pazovuta. Njira zosiyanasiyana za matenda zingayambitse kufooka kwa minofu kapena kupweteka. Izi zitha kukhala zokhudzana ndi zovuta zamanjenje, minofu yolumikizana, mitsempha yamagazi, kapena minofu ndi mafupa.
Venografia
Venography amagwiritsidwa ntchito kuti adziwe ngati muli ndi magazi m'mwendo wanu, matenda otchedwa deep vein thrombosis. Uwu ndi vuto lalikulu chifukwa ngati magaziwo atuluka, amatha kupita kumapapu anu, zomwe zimapangitsa kuti pakhale vuto lakupha lotchedwa pulmonary embolism.
Mu mayesowa, njira yosiyanitsa (kapena utoto) imabayidwa pang'onopang'ono m'miyendo yanu pamene mukugona patebulo la X-ray. Utoto umapangitsa kuti mwendo ukhale wofunda, wonyezimira. Ma X-ray amatengedwa kuti adziwe komwe kuli magazi. Pambuyo pa mayeso, madzi omveka bwino amabayidwa pamalo omwewo kuti achotse utoto m'mitsempha yanu. Kuyezetsa kumatenga nthawi yosakwana ola limodzi ndipo kungathe kuchitidwa pachipatala.
Nkhani yolembedwa ndi:
Dr. Mani Ramesh
Wothandizira Opaleshoni Yamafupa
Apollo Hospitals, Chennai
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