Cudurka Canqawga & Cagaha Cudurka Arthritis & Trauma II| El Paso, TX.

Lisfranc-Jab-ka-bax

• M/C oo ka go'a cagta ee articulation tarsal-metatarsal articulation (Lisfranc joint). Saamayn toos ah ama degitaan iyo dhirbaaxo ama laablaabasho cagta ah. Lisfranc ligament haysta saldhigga 2aad ee MT iyo 1aad Cu waa dillaacay. Waxay ka muuqataa jab-jabka ama jabka.
• Sawirka: tillaabada 1aad: shucaaca cagta xaaladaha badankooda waa ku filan Dx. MSK US ayaa laga yaabaa inay ku caawiso: tuso Cu1-Cu2 khalkhalka galay. ligament iyo bannaanka la ballaadhiyey> 2.5mm. MRI ayaa laga yaabaa inay ku caawiso laakiin lama huraan. Kaalmada aragtida miisaanka Dx.
• 2-nooc: homolateral (1st MTP wadajir ah oo xiriir ah) iyo kala duwanaansho (2-5 MT barokacay dabadeed iyo 1st MT dhexdhexaad ah)
• Maareynta: hagaajinta qalliinka waa muhiim
• NB Atraumatic Lisfranc kala-baxa waa dhibaato joogto ah oo ku timaada cagta Charcot

Dhaawaca Osteochondral ee Talus (OCD)

• Caadiyan Aan dhaawac ahayn ayaa laga helay qubbad sare-dhexe oo talar ah. Naxdin leh ayaa laga yaabaa inay saamayso qubbad sare-lateral.
• Kiliinik ahaan: xanuun / shuban / quful. Sawirku waa muhiim.
• Talaabada 1aad: radiography waxa laga yaabaa inay daaha ka rogto xuddunta shucaaca/halo, jajab.
• MRI waxtar leh esp. haddii OCD ay tahay carjawda iyo inay muujiso bararka lafaha.
• Maareynta: aan qaliin ahayn: kabka lugaha gaaban/immonbiliation-4-6 wk. qalliin: saarista arthrocsopic.
• Dhibaatooyinka: DJD 2aad dhicis ah

Dhaawacyada Metatarsal

• Jabka ba'an & Cadaadisku waa caadi: m/c 5th MT & 2nd, 3rd MT.
• Jones Fx: dheeraad ah-articular Fx ee metaphysis u dhow ee 5th MT. U nugul urur la'aanta. Inta badan waxay u go'an tahay qaliin.
• Been abuur-Jones: Avulsion intra articular avulsion of 5th MT styloid/saldhig by foosha eccentric ee Peroneus Brevis M. Loo maareeyay muxaafid: kicinta boot-cast. Jones iyo Pseudo-Jones Dx labadaba raadiyaha taxanaha cagta.
• Cadaadiska Fx. Calcaneus, 2nd, 3rd, 5th MTs. Soo-celinta soo noqnoqda (orodeysa) ama "Cagta Maarso" 2nd/3rd MT. Kiliinik ahaan: xanuunka ku dhaca dhaqdhaqaaqa, hoos u dhaca nasashada. Dx: Raajooyinku inta badan abaal-marin hore uma laha. MRI ama MSK US ayaa laga yaabaa inay ku caawiyaan. Maareeyey: Muxaafid ahaan. Dhibaatooyinka; Horumarka oo dhammaystiran Fx
• Suufka cawska: hyperextension caadiga ah ciyaaraha fudud ee 1st MTP-sesamoid/plantar dhismaha saxanku waa jeexjeexayaa. 1st MTP aan degganayn/ dabacsan Si hawlkar ah loo maareeyey.

Arthritis-ka cagta & anqawga

• DJD ee canqowga: aan caadi ahayn OA aasaasiga ah. Caadi ahaan waxay u koraan sida 2nd ilaa trauma/AVN, RA, CPPD, Hemophilic arthropathy, Juvenile Idiopathic Arthritis, iwm
• Arthritis bararka: RA waxaa laga yaabaa inay ku horumarto anqawga ama xubin kasta oo synovial ah. Waxay caadi ahaan soo bandhigaysaa Gacmaha/cagaha smmetrical RA marka hore (2aad, 3aad MCP, curcurka, MTP-yada cagaha) badiyaa leh nabaad guurka, lebbiska JSL, osteopenia juxta-articular, iyo subluxations daahday.
• HLA-B27 spondyloarthropathies: caadi ahaan waxay saameeyaan darafyada hoose: ciribta, canqowga esp ee Reactive (Reiter). Kordhinta lafaha erosive-soosaarka ayaa ah muhiim Dx.
• Gouty Arthritis: caan ku ah cirifka hoose. Anqawga, cag-dhexe-cagta 1st MTPs. Bilawga ugu horreeya: xanuunka gouty arthritis-ka oo ba'an oo leh ST effusion oo aan lahayn nabaad-guur/tophi. Gout-ka sare ee daba-dheeraada: Peri-articular, intra-osseous feer-ka baxay nabaad-guurka oo leh cidhifyo aad u-laad-laadsan, aan lahayn bilowga JSL/osteopenia, ST. Tophi waa la arki karaa.
• Arthropathy kala duwan: PVNS. Aan caadi ahayn. Waxay saamaysaa 3-4aad ee nolosha. Natiijada kororka synovial oo leh Macrophages iyo unugyo badan oo Nuclear ah oo Giant ah oo ay ka buuxaan hemosiderin iyo dufanka dufanka leh waxay u horseedi kartaa barar, burburka carjawda, nabaad-guurka lafaha dibadda. Dx: Raajooyinku waa dareen la'aan, qaabka MRI ee doorashada. Biopsi synovial. Maareynta: qalliin, waxay noqon kartaa mid adag.

Neuropathic Osteoarthropathy

• (Wadajirka Charcot) Caadiyan iyo kor u kaca cudurka d/t ee nooca 2 DM. Waxaa laga yaabaa inuu la kulmo xanuunka marka hore (50% kiisaska) iyo arthropathy aan xanuun lahayn oo burburaya sida muujin soo daahday. Horey Dx: daahday. Sawirku waa muhiim: raajooyin: bilawga abaal-marin, dheecaan SF ah ayaa la arkay. MRI waxay ka caawisaa hore ee Dx iyo xajinta off-loading. Late Dx: Kala-bax aan la soo celin karin, burbur, naafo. Xusuusin: Kala-baxa Lisfrance ee wadajirka Charcot
• M/C lugta dhexe ee lugta (TM) 40% kiisaska, canqowga 15%. Horumarka: Lugaha hoose, boogaha, caabuqyada, cudurrada oo kordha, iyo dhimasho.
• Horey Dx: by MRI waa muhiim. Ka shakiya in bukaanada qaba nooca 2 DM gaar ahaan haddii hore oo aan dhaawac ahayn cagaha / anqaw xanuun la soo sheegay.

Sawirka Anqawga & Cagaha