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Sawirka & Cilad-sheegista

Kooxda Sawirka & Baadhitaanka ee Rugta dambe. Dr. Alex Jimenez waxa uu la shaqeeyaa dhakhaatiirta qiimaynta sare leh iyo khabiiro sawir-qaadista. Ururkayaga, khabiirada sawir-qaadista waxay bixiyaan natiijooyin degdeg ah, xushmad leh, iyo natiijooyin tayo sare leh. Anagoo la kaashanayna xafisyadayada, waxaan bixinaa tayada adeega waajibaadka bukaankeena oo ay mudan yihiin. Cilad-sheegidda Bukaan-socodka Bukaan-socodka (DOI) waa xarun-Radiology-ga casriga ah ee El Paso, TX. Waa xarunta kaliya ee nooceeda ah ee ku taal El Paso, oo uu leeyahay oo uu maamulo khabiirka Raadiyaha.

Tani waxay ka dhigan tahay marka aad u timaaddo DOI si aad u hesho imtixaan shucaac ah, faahfaahin kasta, laga bilaabo naqshadeynta qolalka, xulashada qalabka, farsamada gacanta lagu doortay, iyo software ka shaqeeya xafiiska, waxaa si taxadar leh u doortay ama naqshadeeyay Raajo-yaqaanka mana aha xisaabiye. Suuqayadu waa hal xarun oo heer sare ah. Qiimahayada la xidhiidha daryeelka bukaanka waa: Waxaan aaminsanahay in loola dhaqmo bukaanada sida aan ula dhaqmi lahayn qoyskayaga, waxaanan ku dadaali doonaa inaan hubinno inaad khibrad fiican u leedahay rugtayada.

Sayniska Aasaasiga ah ee Qaab-dhismeedka Menisci Jilibka Jilibka, Halabuurka, iyo Shaqada

Sayniska Aasaasiga ah ee Qaab-dhismeedka Menisci Jilibka Jilibka, Halabuurka, iyo Shaqada

by | Cirrhaafka, Baaritaanka Daaweynta Duumada, Xanuun Chronic, Caafimaadka, Sawirka & Cilad-sheegista, Daryeelka Dhaawaca, Daraasaadka Cilmi-baarista, Tijaabada Baaritaanka, Dhaawacyada Isboortiga, Daaweyn, Wellness

The jilibka waa mid ka mid ah kala-goysyada ugu adag ee jidhka bini'aadamka, oo ka kooban lafta bowdada, ama femur, lafta shin, ama tibia, iyo jilibka, ama patella, oo ka mid ah unugyo kale oo jilicsan. Tendons waxay ku xiraan lafaha murqaha halka seedaha ay isku xiraan lafaha wadajirka jilibka. Laba qaybood oo u eg carjawda, oo loo yaqaan meniscus, ayaa siinaya xasilloonida wadajirka jilibka. Ujeedada maqaalka hoose waa in la muujiyo iyo sidoo kale ka doodista anatomy ee wadajirka jilibka iyo unugyada jilicsan ee ku hareeraysan.

 

aan la taaban karin

 

  • Macnaha guud: Macluumaadka ku saabsan qaabka, ka kooban, iyo shaqada menisci jilibka ayaa ku kala firirsan ilo iyo goobo badan. Dib-u-eegiddu waxay ka kooban tahay sharraxaad kooban, faahfaahsan oo ku saabsan menisci jilibka oo ay ku jiraan anatomy, etymology, phylogeny, ultrastructure iyo biochemistry, vascular anatomy iyo neuroanatomy, shaqada biomechanical, korriinka iyo gabowga, iyo qaababka sawirka.
  • Helitaanka caddaynta: Raadinta suugaanta ayaa lagu sameeyay dib u eegis lagu sameeyay PubMed iyo OVID maqaallada oo la daabacay 1858 ilaa 2011.
  • Natiijooyinka: Daraasadani waxay muujinaysaa qaab-dhismeedka, isku-dhafka, iyo sifooyinka shaqada ee menisci, kuwaas oo laga yaabo inay khuseeyaan bandhigyada kiliinikada, ogaanshaha, iyo hagaajinta qalliinka.
  • Gabagabo: Fahamka anatomy caadiga ah iyo biomechanics ee menisci waa shardi lagama maarmaan ah si loo fahmo cudur-sidaha jirrooyinka ku lug leh jilibka.
  • Keywords: jilibka, meniscus, anatomy, function

 

Hordhac

 

Marka lagu tilmaamo hadhaaga uurjiifka ee aan shaqaynayn,162 menisci ayaa hadda la og yahay inay muhiim u yihiin shaqada caadiga ah iyo caafimaadka muddada dheer ee wadajirka jilibka. iyo nafaqaynta lafaha jilibka.4,91,152,153

 

Dhaawacyada menisci waxaa loo aqoonsan yahay inay sabab u tahay xanuunada murqaha ee muhiimka ah. Qaab dhismeedka gaarka ah ee kakan ee menisci wuxuu ka dhigayaa daaweynta iyo dayactirka caqabad ku ah bukaanka, dhakhtarka qalliinka, iyo daaweeyaha jireed. Intaa waxaa dheer, dhaawaca muddada dheer wuxuu keeni karaa isbeddellada wadajirka ah ee is-beddelka ah sida samaynta osteophyte, carjawda articular articular, cidhiidhiga booska wadajirka ah, iyo osteoarthritis calaamad.

 

Anatomy ee Menisci

 

Meniscal Etymology

 

Erayga meniscus wuxuu ka yimid ereyga Giriigga m?niskos, oo macneheedu yahay �bisha,

 

Meniscal Phylogeny iyo Anatomy Isbarbardhigga

 

Hominids waxay soo bandhigaan sifooyin isku mid ah anatomic iyo functional, oo ay ku jiraan femur distal distal ah, intra-articular cruciate ligaments, menisci, iyo asymmetrical . ,40,66

 

In lineage primate ee u horseedaya bini'aadamka, hominids waxay u kobceen mawqifka laba-geesoodka ah qiyaastii 3 ilaa 4 milyan oo sano ka hor, iyo 1.3 milyan sano ka hor, isku-dhafka casriga ah ee patellofemoral ayaa la aasaasay (oo leh weji dheer oo patellar ah oo u dhigma trochlea femoral lateral).164 Tardieu baaris ku sameeyay kala-guurka laga soo bilaabo bipedalism-ka marmar ilaa laba-cirifoodka joogtada ah waxaana la arkay in primates ay ku jiraan meniscus dhexdhexaad ah iyo lateral fibrocartilaginous meniscus, iyada oo meniscus dhexdhexaad ah uu la mid yahay morphologically dhammaan primates (bilaha loo qaabeeyey 2 tibial galinta).163 Taas bedelkeeda, meniscus lateral ayaa la arkay qaab ahaan u doorsooma. Gaarka ah ee Homo sapiens waa joogitaanka 2 gelinta tibial�1 hore iyo 1 danbe� taas oo muujinaysa dhaqanka caadiga ah ee dhaqdhaqaaqa fidinta buuxda ee wadajirka jilibka inta lagu jiro marxaladaha taagan iyo lulida ee socodka laba-geesoodka ah.20,134,142,163,168

 

Embryology iyo Kobcinta

 

Qaabka dabeecadda ah ee menisci lateral iyo medial menisci waxaa lagu gaaraa inta u dhaxaysa usbuuca 8th iyo 10th ee uurka.53,60 Waxay ka soo jeedaan lakabka dhexe ee unugyada mesenchymal si ay u sameeyaan lifaaqyo ku wareegsan kaabsoosha wadajirka ah.31,87,110 Menisci soo koraya waa unugyo unugyo iyo xididdo sare leh, iyadoo sahayda dhiiggu ka soo galayo xayndaabka oo ku fidsan dhammaan ballaca menisci-ga. 31 Dhaqdhaqaaqa wadajirka ah iyo walbahaarka dhalmada ka dib ee miisaan-qaadista ayaa ah arrimo muhiim ah oo lagu go'aaminayo jihada fiilooyinka kolajka. Marka la gaaro qaangaarnimada, kaliya 30,31% ilaa 10% hareeraha ayaa helaya dhiig.30

 

Inkasta oo isbeddelladan taariikhiga ah ay jiraan, saamiga tibial plateau ee uu daboolay meniscus u dhigma waa mid joogto ah inta lagu jiro koritaanka uurjiifka, iyada oo menisci dhexdhexaad ah iyo lateral uu daboolayo qiyaastii 60% iyo 80% meelaha dusha sare, siday u kala horreeyaan.31

 

Wadajirka Dhexe

 

Baadhitaanka guud ee menisci jilibka ayaa muujinaya unug siman, dufan leh (Jaantus 1). Waxay yihiin xayndaab-qaabeeya fibrocartilage oo ku yaal dhinacyada dhexe iyo kuwa dambe ee wadajirka jilibka (Jaantuska 2A). Xuddunta, xudduudaha xididdada dhiigga (sidoo kale loo yaqaan aagga cas) ee meniscus kasta waa dhumuc weyn, qallafsan, oo ku dheggan kaabsoosha wadajirka ah. Soohdinta ugu hooseysa (sidoo kale loo yaqaan aagga cad) waxay ku dhufanaysaa gees dhuuban oo xor ah. Sagxadaha sare ee menisci waa concag, oo awood u siinaya artication wax ku ool ah oo leh kondylesyada femoral convex . Sagxadaha hoose waa fidsan si ay u dajiyaan dhulalka tibial (Jaantuska 1).28,175

 

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Meniscus dhexdhexaad ah. Meniscus-ka dhexdhexaadka ah ee dhexdhexaadka ah wuxuu cabbiraa qiyaastii 35 mm dhexroorka (hore ilaa dambe) wuxuuna si weyn uga sii ballaadhan yahay xagga dambe marka loo eego xagga hore. Waxaa jira kala duwanaansho la taaban karo oo ku saabsan meesha ku lifaaqan ee geeska hore ee meniscus medial. Geeska dambe wuxuu ku xiran yahay fossa intercondylar dambe ee tibia ee u dhexeeya meniscus lateral iyo ligament cruciate (PCL; Sawirada 175 iyo iyo1B) .2B). Johnson et al ayaa dib u eegay goobaha galinta tibial ee menisci iyo cilaaqaadkooda muuqaalka ah ee ku hareeraysan calaamadaha anatomic ee jilibka.2 Waxay ogaadeen in meelaha hore iyo kuwa dambe ee geesaha galinta ee meniscus medial ay ka weyn yihiin kuwa meniscus lateral. Aagga galinta geeska hore ee meniscus medial wuxuu ahaa midka ugu weyn, oo cabbiraya 82 mm61.4, halka geeska dambe ee meniscus lateral uu ahaa kan ugu yar, 2 mm28.5

 

Qaybta tibial ee ku-xidhka kaabsoosha waa seedaha halbowlaha. Barta dhexe, meniscus medial wuxuu si adag ugu dheggan yahay femur iyada oo loo marayo uumi ku jira kaabsulka wadajirka ah ee loo yaqaan ligament dhexdhexaad ah oo qoto dheer. ee meniscus-ka dhexdhexaadka ah ee geeska hore ee meniscus lateral (Jaantusyada 175 iyo 1A2A).

 

meniscus lateral. Meniscus-ka dambe wuxuu ku dhow yahay wareeg, oo leh qiyaas lebis ballac ah oo hore ilaa dambe (Jaantus 1 iyo 2A).2A). Waxay ku jirtaa qayb weyn (~ 80%) ee dusha sare ee articular marka loo eego meniscus medial (~ 60%) waana mobile badan.10,31,165 Labada gees ee meniscus lateral waxay ku xiran yihiin tibia. Gelida geesaha hore ee meniscus lateral waxay ku taalaa hore ee cirifka intercondylar iyo ku dheggan goobta ballaaran ee lifaaqa ee ACL (Jaantus 2B) xagga hore ee gelinta geeska dambe ee meniscus medial (Jaantus 9,83B) .2 Meniscus lateral ayaa si dabacsan ugu xiran seedaha kaabsal; si kastaba ha ahaatee, fiilooyinkani kuma xirna seedaha dammaanadda dambe. Geeska dambe ee meniscus lateral wuxuu ku xiran yahay dhinaca gudaha ee kondyle femoral dhexdhexaad ah iyada oo loo marayo xudunta hore iyo dambe ee meniscofemoral ee Humphrey iyo Wrisberg, siday u kala horreeyaan, kuwaas oo asal ahaan ka soo jeeda asalka PCL (Jaantus 83 iyo 1).22

 

seedaha meniscofemoral. Suugaanta ayaa ka warbixisa is-maandhaafka weyn ee joogitaanka iyo xajmiga seedaha meniscofemoral ee meniscus lateral. Waxaa laga yaabaa inaysan jirin, 1, 2, ama 4.? Marka la joogo, seedahan dheeriga ah waxay ka soo wareegaan geeska dambe ee meniscus lateral ilaa dhinaca dambe ee kondhile femoral dhexdhexaad ah. Waxay isla markiiba geliyaan ku dheggan xubinta taranka ee PCL (Jaantus 1 iyo iyo 22).

 

Daraasado taxane ah, Harner et al waxay qiyaaseen aagga isugeynta ee seedaha waxayna ogaadeen in ligament meniscofemoral celcelis ahaan 20% cabbirka PCL (qiyaas ahaan, 7% -35%) .69,70 Si kastaba ha ahaatee, cabbirka aagga la geliyo oo keliya iyada oo aan la aqoon xagasha la geliyo ama cufnaanta kolajku ma muujinayso xooggooda.115 Shaqada seedahani waa mid aan la garanayn; waxaa laga yaabaa inay u soo jiidaan geeska dambe ee meniscus-ka dambe ee jihada hore si ay u kordhiyaan isku-dhafka fossa meniscotibial iyo kondyle femoral lateral.75

 

Ultrastructure iyo Biochemistry

 

Matrix ka baxsan unugga

 

Meniscus waa matrix ka baxsan unugyada cufan (ECM) oo ka kooban ugu horrayn biyaha (72%) iyo kolajka (22%), oo dhexda u ah unugyada.9,55,56,77 Proteoglycans, borotiinno aan collagenous ahayn, iyo glycoproteins ayaa xisaabiya miisaanka qallalan ee soo hadhay. Unugyada Meniscal waxay farsameeyaan oo ay ilaaliyaan ECM, taas oo go'aamisa sifooyinka walxaha unugyada.

 

Unugyada menisci waxaa loo yaqaan fibrochondrocytes sababtoo ah waxay u muuqdaan inay yihiin isku-dhafka fibroblasts iyo chondrocytes.111,177 Unugyada ku jira lakabka sare ee menisci waa fusiform ama spindle qaabeeya (fibroblastic ka badan), halka unugyadu ay ku yaalaan qoto dheer meniscus waa ovoid ama geeso badan (chondrocytic ka badan)

 

Labada nooc ee unuggu waxay ka kooban yihiin reticulum endoplasmic oo aad u badan iyo iskudhafka Golgi. Mitochondria ayaa mararka qaarkood la arkaa, taas oo soo jeedinaysa in dariiqa ugu weyn ee wax soo saarka tamarta fibrochondrocytes ee milieu xididada xididada ay u badan tahay anaerobic glycolysis.112

 

Biyaha

 

Caadi ahaan, menisci caafimaad qaba, dareeraha unuggu wuxuu u taagan yahay 65% ​​ilaa 70% miisaanka guud. Inta badan biyaha waxa lagu hayaa unugyada dareeraha ee proteoglycans. Maaddada biyaha ee unugyada meniscal waxay ka sarreeyaan aagagga dambe marka loo eego meelaha dhexe ama hore; Tijaabooyin unugyo laga soo qaaday oogada iyo lakabyada qoto-dheer waxay lahaayeen waxyaabo isku mid ah.135

 

Cadaadiska haydarooliga weyn ayaa loo baahan yahay si looga gudbo jiidashada iska caabbinta jahwareerka ee ku qasbeysa qulqulka dareeraha iyada oo loo marayo unugyada meniscal. Sidaa darteed, isdhexgalka ka dhexeeya biyaha iyo qaabka macromolecular matrix waxay si weyn u saameeyaan sifooyinka viskoelastic ee unugyada.

 

Collagens

 

Collagens ayaa ugu horreyn mas'uul ka ah xoogga xajinta ee menisci; Waxay ka qaybqaataan ilaa 75% miisaanka qallalan ee ECM.77 ECM wuxuu ka kooban yahay ugu horrayn nooca I kolajka (90% miisaanka qalalan) oo leh qiyaaso kala duwan oo ah noocyada II, III, V, iyo VI.43,44,80,112,181 Inta badan nooca I kolajka ayaa kala sooca fibrocartilage ee menisci iyo carjawda articular (hyaline). Collagens-yadu waxay si aad ah isugu gudbeen hydroxylpyridinium aldehydes.44

 

Habaynta fiber-ka kolajku waxa ay ku habboon tahay in culayska cadaadiska toosan loo wareejiyo culayska wareegga wareegga (Jaantuska 3) . Fiilooyinkani waxay isku daraan xidhiidhada ligamentous ee geesaha meniscal ee dusha sare ee tibial articular (Jaantus 57) Fiilooyinka shucaaca u janjeera ayaa sidoo kale ku jira aagga qoto dheer waxaana la isku dhex daray ama lagu toleeyey inta u dhaxaysa fiilooyinka wareegyada si ay u bixiyaan qaabdhismeed ahaan (Jaantus 3). waxaa ku jira crystals dheer, caato ah oo fosfooraska, calcium, iyo magnesium on electron-probe roentgenographic analysis.

 

 

Borotiinnada matrixka aan collagenous ahayn, sida fibronectin, waxay gacan ka geystaan ​​8% ilaa 13% miisaanka engegan ee dabiiciga ah. Fibronectin wuxuu ku lug leeyahay habab badan oo gacanta ah, oo ay ku jiraan hagaajinta unugyada, embryogenesis, xinjirowga dhiigga, iyo guuritaanka/adhejinta unugga. Elastin wuxuu sameeyaa wax ka yar 0.6% miisaanka meniscus ee qallalan; meelayntiisa ultrastructural ma cadda. Waxay u badan tahay inay si toos ah ula falgasho kolajka si ay u bixiso adkeysiga nudaha.**

 

Proteoglycans

 

Waxay ku yaalaan gudaha meshwork wanaagsan ee fibrillada kolajka, proteoglycans waa waaweyn, molecules hydrophilic si xun u dallacay, oo gacan ka geysanaya 1% ilaa 2% miisaanka qalalan.58 Waxay ku sameysteen borotiinka asaasiga ah oo leh 1 ama in ka badan oo si isku mid ah ugu xiran silsiladaha glycosaminoglycan (Jaantus 4).122 Baaxadda molecules-ka waxaa sii kordhaya isdhexgalka gaarka ah ee hyaluronic acid.67,72 Qadarka proteoglycans ee meniscus waa siddeed-meelood meel ka mid ah carjawda articular,2,3 waxaana laga yaabaa inay jiraan kala duwanaansho badan oo ku xiran goobta saamiga. iyo da'da bukaanka.49

 

 

Iyada oo loo eegayo qaab-dhismeedkooda gaarka ah, cufnaanta xad-dhaafka ah ee sarreeya, iyo xoogagga dib-u-celinta, proteoglycans ee ECM ayaa mas'uul ka ah fuuq-celinta waxayna siiyan nudaha awood sare oo ay iskaga caabiyaan culeysyada cadaadiska ah. meniscus wuxuu ka kooban yahay chondroitin-6-sulfate (40%), chondroitin-4-sulfate (10% ilaa 20%), dermatan sulfate (20% ilaa 30%), iyo keratin sulfate (15%; Jaantus 4).65,77,99,159 ,58,77 Heerarka ugu sarreeya ee glycosaminoglycan waxaa laga helaa geesaha meniscal iyo qeybta hoose ee menisci ee meelaha miisaanka aasaasiga ah.XNUMX

 

Aggrecan waa proteoglycan-ka weyn ee laga helo menisci bini'aadamka wuxuuna inta badan mas'uul ka yahay sifooyinkooda isku-buuqa ee viscoelastic (Jaantuska 5). Proteoglycans yaryar, sida decorin, biglycan, iyo fibromodulin, ayaa laga helaa qadar yar.124,151 Hexosamine waxay ku biirtaa 1% miisaanka qalalan ee ECM.57,74 Shaqooyinka saxda ah ee mid kasta oo ka mid ah proteoglycans yar yar ee meniscus ayaa weli si buuxda u noqon. la caddeeyey.

 

 

Matrix Glycoproteins

 

Carjawda Meniscal waxay ka kooban tahay noocyo kala duwan oo ah glycoproteins matrix, aqoonsiyada iyo hawlahooda aan weli la go'aamin. Electrophoresis iyo midabaynta xiga ee jel polyacrylamide waxay muujinaysaa xadhig leh miisaan kelli ah oo ku kala duwan dhowr kilodaltons ilaa in ka badan 200 kDa.112 Unugyada matrixkan waxaa ka mid ah borotiinnada isku xirka ee xasiliya isku-darka proteoglycan hyaluronic acid iyo borotiinka aan la garanayn ee 116-k. Barootiinkani waxa uu ku dhex jiraa matrixka qaab ka kooban isku xidhan oo isku xidhan oo miisaankiisu sarreeyo.46 Cilmi-baadhista difaaca jirka waxa ay soo jeedinaysaa in ay inta badan ku taal agagaarka xidhmooyinka kolajka ee matrix interterritorial.46

 

Glycoproteins-ku-dheejisku wuxuu ka kooban yahay koox-hoosaadyada glycoproteins-ka matrixka. Makromolecules-yadan ayaa qayb ahaan mas'uul ka ah ku-xidhka molecules kale ee matrixka iyo/ama unugyada. Unugyada isku dhejinta intermolecular ee noocan oo kale ah ayaa sidaas darteed qaybo muhiim ah ka ah ururka supramolecular ee unugyada unugyada ka baxsan ee meniscus.

 

Anatomy Vascular

 

Meniscus-ku waa qaab-dhismeed xididdada dhiigga ah oo leh qayb xaddidan oo dhiigga ah. Xididdada dhexdhexaadka ah, lateral, iyo dhexe ee geniculate (oo laan ka ah halbowlaha popliteal) ayaa bixiya xididdada ugu weyn ee dhinacyada hoose iyo kuwa sare ee meniscus kasta (Jaantus 5) laanta ka daloosha ligamenti popliteal oblique ee geesta dambe ee isgoysyada tibiofemoral. Shabakad xidid premeniscal ah oo ka soo baxa laamaha halbowlayaashan waxay ka soo jeedaan unugyada synovial iyo capsular ee jilibka oo ku teedsan durugsan ee menisci. 9,12,33% ilaa 35,148% ee xudduudaha meniscus ee dhexdhexaadka ah iyo 10% ilaa 30% ee meniscus lateral ayaa si fiican u wanaajiya, taas oo saameyn muhiim ah u leh bogsashada meniscus (Jaantus 10) .25 Endoligamentous maraakiibta hore iyo geesaha danbe ayaa masaafo gaaban u socdaa walaxda menisci waxayna sameeyaan siddooyinkooda terminal, iyagoo siinaya dariiq toos ah oo nafaqo ah. , mooshin wadajir ah).6

 

 

Shimbiraha iyo macaanku waxay baareen menisci ee xayawaanka iyo bini-aadmiga iyagoo isticmaalaya sawir-qaadista elektarooniga iyo microscopy-ka iftiinka.23,24 Waxay arkeen dhismayaal u eg kanaalka oo si qoto dheer u furaya dusha sare ee menisci. Kanaalkani waxaa laga yaabaa inay door ka ciyaaraan qaadista dareeraha gudaha meniscus waxayna qaadi karaan nafaqooyinka dheecaanka synovial iyo xididdada dhiigga ee qaybaha avascular ee meniscus.23,24 Si kastaba ha ahaatee, daraasad dheeraad ah ayaa loo baahan yahay si loo caddeeyo habka saxda ah ee farsamada Dhaqdhaqaaqa ayaa nafaqo siiya qaybta xididdada dhiigga ee menisci.

 

Neuroanatomy

 

Isku-dhafka jilibka waxaa soo jiitay laanta articular ee dambe ee dareemaha tibial-ka dambe iyo laamaha dhamaadka ee dareemayaasha obturator iyo femoral. Qaybta dambe ee kaabsoosha waxaa gelisa laanta peroneal ee soo noqnoqda ee dareemaha peroneal-ka caadiga ah. Xiidmooyinkan dareemayaasha waxay galaan kaabsalka waxayna raacaan sahayda xididada qaybta durugsan ee menisci iyo geesaha hore iyo kan dambe, halkaas oo inta badan fiilooyinka dareemayaasha ay ku urursan yihiin. marka loo eego sadexda dhexe ee dhexe.52,90 Inta lagu jiro darafyada dabacsanaan iyo fidinta jilibka, geesaha meniscal waa cadaadis, gelinta afferent waxay u badan tahay inay ugu weyn tahay meelahan xad dhaafka ah.183,184

 

Mechanoreceptors ee ku dhex jira menisci waxay u shaqeeyaan sidii kuwa wax beddela, iyagoo u beddelaya kicinta jireed ee kacsanaanta iyo isku-buufinta dareen dareen koronto oo gaar ah. Daraasadaha menisci bini'aadamka ayaa aqoonsaday 3 morphologically mechanoreceptors kala duwan: Ruffini endings, Pacinian corpuscles, iyo Golgi tendon xubnaha. Mechanoreceptors Nooca II (Pacinian) waa heer hoose oo si degdeg ah ula qabsanaya isbeddelada xiisadda. Cunsuradan neerfaha ayaa laga helay xooga weyn ee geesaha meniscal, gaar ahaan geesaha dambe.

 

Qaybaha asymmetrical ee jilibka waxay u dhaqmaan si wada jir ah sida nooc ka mid ah gudbinta bayooloji ee aqbala, wareejiya, oo kala daadiya culeysyada femur, tibia, patella, iyo femur. Daraasado dhowr ah ayaa soo sheegay in qaybaha kala duwan ee intra-articular ee jilibka ay yihiin dareen, awood u leh inay soo saaraan calaamadaha neurosensory ee gaadha laf-dhabarka, cerebellar, iyo heerarka sare ee habka dhexe ee dareenka. Waxaa la rumeysan yahay in calaamadahan dareemayaasha dareemayaasha ay keenaan aragtida miyir-qabka ah waxayna muhiim u yihiin shaqada wadajirka ah ee jilibka iyo dayactirka homeostasis nudaha.41

Dr Jimenez White Coat

Meniscus waa carjawda kaas oo siinaya qaabdhismeed iyo daacadnimo shaqaynaysa jilibka. Menisci waa laba suuf oo ah unugyo fibrocartilaginous ah kuwaas oo ku kala fidiya kala-goysyada jilibka marka ay ku dhacdo xiisad iyo jeexjeexa u dhexeeya lafaha shin, ama tibia, iyo lafta bowdada, ama femur. Fahamka anatomy iyo biomechanics ee wadajirka jilibka ayaa lagama maarmaan u ah fahamka dhaawacyada jilibka iyo/ama xaaladaha. Dr. Alex Jimenez DC, CCST Insight

Shaqada biomechanical

 

Shaqada biomechanical ee meniscus waa mid ka tarjumaysa anatomy-ga guud iyo ultrastructural iyo xiriirka ay la leedahay dhismayaasha ku hareeraysan intra-articular iyo ka baxsan-articular. Menisci-gu wuxuu u adeegaa hawlo badan oo biomechanical muhiim ah. Waxay gacan ka geystaan ​​gudbinta culeyska, nuugista naxdinta leh, 10,49,94,96,170 xasilloonida,51,100,101,109,155 nafaqada,23,24,84,141 saliid wadajir ah,102-104,141 iyo proprioception.5,15,81,88,115,147 culayska iyo korodhka goobta xidhiidhka iyo congruity ee jilibka.91,172

 

Meniscal Kinematics

 

Daraasad ku saabsan shaqada ligamentous, Brantigan iyo Voshell ayaa sheegay in meniscus-ka dhexdhexaadka ah uu u guuro celcelis ahaan 2 mm, halka meniscus lateral uu ahaa mid aad u badan oo mobile ah oo leh qiyaastii 10 mm ee barokaca hore ee gadaal inta lagu jiro dabacsanaanta .25 Sidoo kale, DePalma ayaa sheegay in meniscus dhexdhexaad ah. wuxuu maraa 3 mm ee barokaca hore-daba-dambe, halka meniscus lateral uu dhaqaaqo 9 mm inta lagu jiro dabacsanaanta.37 Daraasad la adeegsanayo 5 jilbaha cad, Thompson et al ayaa sheegay in celceliska dalxiiska dhexdhexaadka ah uu yahay 5.1 mm (celcelis ahaan geesaha hore iyo gadaal) iyo celceliska dalxiiska lateral, 11.2 mm, oo ay weheliyaan dusha sare ee tibial articular (Jaantus 7) .165 Natiijooyinka daraasaddan ayaa xaqiijinaya farqi weyn oo u dhexeeya dhaqdhaqaaqa qaybta u dhexeeya menisci dhexdhexaad ah iyo lateral. Saamiga hore iyo kan dambe ee geesaha geesaha ee meniscus waa ka yar yahay wuxuuna tilmaamayaa in meniscus uu u dhaqaaqo in ka badan hal unug. Thompson et al waxay ogaatay in aagga ugu yar ee dhaqdhaqaaqa meniscal uu yahay geeska dambe ee dhexdhexaadka ah, halkaasoo meniscus uu ku xaddidan yahay ku dhejinta taagga tibial ee qaybta meniscotibial ee lafdhabarta dhabarka, kaas oo lagu soo warramey inuu aad ugu nugul yahay dhaawaca. 165 Hoos u dhigista dhaqdhaqaaqa geeska dambe ee meniscus medial waa habab suurtagal ah oo loogu talagalay ilmada meniscal, oo leh natiijada � dabinka fibrocartilage ee u dhexeeya condyle femoral iyo taagga tibial inta lagu jiro dabacsanaan buuxda. Farqiga weyn ee u dhexeeya dalxiiska geesaha hore iyo kan dambe wuxuu gelin karaa meniscus dhexdhexaad ah khatar weyn oo dhaawac ah.143,165

 

 

Kala duwanaanta geesaha hore iyo dhaqdhaqaaqa geesaha dambe waxay u ogolaataa menisci in ay u qaataan raajo hoos u dhacaya oo leh dabacsanaan, taas oo u dhiganta hoos u dhaca qalooca ee kondyles femoral ee dambe. labadda femur iyo tibia inta lagu jiro laablaabashada.

 

Soo gudbinta culeyska

 

Shaqada menisci waxaa lagu qiimeeyay kiliinikada isbeddelada xumaaday ee la socda ka saariddeeda. Fairbank waxay ku qeexday korodhka korodhka iyo isbeddelada hoos u dhaca ee la saadaalin karo ee sagxadaha articular ee jilbaha gebi ahaanba meniscectomized.45 Tan iyo shaqadan hore, daraasado badan ayaa xaqiijiyay natiijooyinkan waxayna sii kordhiyeen doorka muhiimka ah ee meniscus sida ilaalinta, qaabdhismeedka culeyska.

 

Miisaanka ayaa soo saara xoogag axial ah oo dhan jilibka, kuwaas oo cadaadiya menisci, taasoo keentay cadaadis �hoop� (wareeg ah) stress. Lifaaqa adag ee seedaha la geliyo ee hore iyo kan dambe ayaa ka hortagaya meniscus inuu ka soo baxo hareeraha inta lagu jiro culeyska. menisci.170 Menisci-ku wuxuu u gudbiyaa 8% culeyska culeyska iyada oo loo marayo geesaha dambe ee kordhinta, iyadoo 94% gudbinta 70� flexion.50 Radin et al ay muujiyeen in culeysyadan si fiican loo qaybiyey marka menisci ay wada jiraan.153 Si kastaba ha ahaatee, ka saarida meniscus medial meniscus wuxuu keenayaa 50% ilaa 85% hoos u dhaca aagga xidhiidhka kondyle ee femoral iyo 90% korodhka cadaadiska xidhiidhka. qaybta dambe ee 172% ilaa 137% ee caadiga ah.50 Tani waxay si weyn u kordhinaysaa culeyska halkii unug waxayna ka qayb qaadan kartaa dardargelinta burburka carjawda articular iyo hoos u dhaca.70

 

 

Abuuritaanka Shoogga

 

Menisci wuxuu door muhiim ah ka ciyaaraa hoos u dhigista mowjadaha shoogga ee isdaba-joogga ah ee ka yimaada culeyska jilibka ee socodka caadiga ah. .94,96,153 Sida awood la'aanta nidaamka wadajirka ah si uu u nuugo shoogga ayaa lagu lug yeeshay horumarinta osteoarthritis, meniscus wuxuu u muuqan doonaa inuu door muhiim ah ka ciyaaro ilaalinta caafimaadka wadajirka jilibka.20

 

Xasilloonida Wadajirka ah

 

Qaab dhismeedka joomatari ee menisci wuxuu bixiyaa door muhiim ah si loo ilaaliyo wadajirka wadajirka ah iyo xasilloonida. Marka meniscus uu yahay mid sugan, culeyska axial ee jilibka wuxuu leeyahay hawl dejin jiho badan, xaddidaysa dhaqdhaqaaqa xad-dhaafka ah ee dhammaan jihooyinka.9

 

Markolf iyo asxaabtiisuba waxay wax ka qabteen saamaynta meniscectomy ee jilibka hore iyo gadaal-wareegga. Meniscectomy dhexdhexaad ah oo ku jira jilibka ACL-jilibka ah ayaa saameyn yar ku leh dhaqdhaqaaqa hore ee dambe, laakiin jilibka ACL-yarida, waxay keentaa kororka tarjumaadda hore ee tibial-ka dambe ilaa 58% at 90o of flexion.109 Shoemaker iyo Markolf waxay muujisay in geeska dambe ee meniscus medial uu yahay qaabka ugu muhiimsan ee ka hortagaya xoogga tibial ee hore ee jilibka ACL-yar. Kordhinta buuxda iyo 155% at 52 � ee dabacsanaanta ka hooseeya culeyska hore ee tibial 197-N.60 Isbeddelka weyn ee kinematics sababtoo ah meniscectomy dhexdhexaad ah ee jilibka-yaraanta ACL waxay xaqiijineysaa doorka muhiimka ah ee meniscus dhexdhexaadka ah ee xasiloonida jilibka. Dhowaan, Musahl et al ayaa sheegay in meniscus lateral uu door ka ciyaaro tarjumaada tibial hore inta lagu jiro dhaqdhaqaaqa pivot-shift.134

 

Nafaqada iyo Saliidda Wadajirka ah

 

Menisci ayaa sidoo kale laga yaabaa inuu door ka ciyaaro nafaqada iyo saliidda wadajirka jilibka. Farsamoyaqaanka saliiddan ayaan weli la garanayn; menisci waxaa laga yaabaa inuu ku cadaadiyo dareeraha synovial ee carjawda articular, kaas oo yareynaya xoogaga is jiid-jiidka inta lagu jiro culeyska.13

 

Waxaa jira nidaam microcanals gudaha meniscus oo ku yaal meel u dhow xididdada dhiigga, kaas oo la xidhiidha godka synovial; kuwaani waxa laga yaabaa inay bixiyaan gaadiidka dareeraha ah ee nafaqada iyo saliidda wadajirka ah.23,24

 

Lahaanshaha gaarka ah

 

Aragtida dhaqdhaqaaqa wadajirka ah iyo booska (proprioception) waxaa dhexdhexaadiya mechanoreceptors kuwaas oo beddela cillad farsamo oo u beddela calaamadaha neerfaha korantada. Mechanoreceptors ayaa lagu aqoonsaday geesaha hore iyo kan dambe ee menisci.*** Mechanoreceptors-dhakhso leh, sida Pacinian corpuscles, ayaa loo maleynayaa inay dhexdhexaadiyaan dareenka dhaqdhaqaaqa wadajirka ah, iyo soo-dhoweynta tartiib-tartiib ah, sida Ruffini endings iyo Golgi tendon xubnaha, ayaa la aaminsan yahay in ay dhexdhexaadiyaan dareenka booska wadajirka ah.140 Aqoonsiga walxahan neerfaha (oo inta badan ku yaal saddex meelood meel dhexe iyo dibadda ee meniscus) waxay muujinaysaa in menisci ay awood u leeyihiin inay ogaadaan macluumaadka la-qabsiga ee wadajirka jilibka, sidaas darteedna ciyaaro doorka afferent ee muhiimka ah ee habka falcelinta dareenka ee jilibka.61,88,90,158,169

 

Qaangaarka iyo gabowga ee Meniscus

 

Microanatomy ee meniscus waa mid adag waxaana hubaal ah inay muujiso isbeddellada dareenka. Marka da'da kor u kacdo, meniscus wuxuu noqdaa mid qallafsan, luminaya barti, wuxuuna noqdaa huruud.78,95 Microscopically, waxaa si tartiib tartiib ah u luminaya xubno unugyo ah oo leh meelo madhan iyo kororka unugyada fibre ee marka la barbardhigo unugyada laastikada.74 Meelahan cystic waxay bilaabi karaan jeex, oo leh xoog torsional by kondyle femoral, lakabyada kore ee meniscus ayaa laga yaabaa inay ka xiiraan lakabka qoto dheer ee isdhexgalka isbeddelka cystic, oo soo saara jeexjeex toosan. Goynta lakabyadan dhexdooda waxay keeni kartaa xanuun. Meniscus-ka dillaacay waxa laga yaabaa inuu si toos ah u dhaawaco carjawda articular ee kor-dhaafka ah.74,95

 

Ghosh iyo Taylor waxay ogaadeen in xoojinta kolajku ay kor u kacday dhalashada ilaa 30 sano oo ay joogto ilaa 80 sano jir, ka dib hoos u dhac ayaa dhacay. Dhallaanka cusub ilaa 58% � 21.9% inta u dhaxaysa da'da 1.0 ilaa 8.1 sano.0.8 Kadib 30 sano jir, heerarka borotiinka matrix-ka ee aan collagenous kor u kacay ilaa 70% - 80%. Peters iyo Smillie waxay arkeen kororka hexosamine iyo uronic acid da'da.70

 

McNicol iyo Roughley waxay barteen kala duwanaanshaha proteoglycans meniscal ee gabowga113; kala duwanaansho yar oo saarista iyo cabbirka hydrodynamic ayaa la arkay. Heerarka keratin sulfate marka loo eego chondroitin-6-sulfate ayaa kordhay da'da.146

 

Petersen iyo Tillmann immunohistochemically waxay baareen menisci bini'aadamka (laga bilaabo 22 toddobaad ee uurka ilaa 80 sano), iyagoo eegaya kala duwanaanta xididdada dhiigga iyo lymphatics ee 20 ka mid ah dadka. Waqtiga dhalmada, ku dhawaad ​​dhammaan meniscus-ka ayaa xididdada dhiigga loo geliyay. Sannadka labaad ee nolosha, aagga xididada ayaa ka soo baxay wareegga gudaha. Tobankii sano ee labaad, xididdada dhiigga ayaa ku jiray saddex geesoodka. Ka dib 50 sano jir, kaliya rubuci durugsan ee saldhigga meniscal ayaa la sameeyay. Unugyada isku xiran ee cufan ee gelinta ayaa la sameeyay laakiin maaha fibrocartilage ee gelinta. Xididdada dhiigga waxaa weheliyay lymfatics dhammaan aagagga.��

 

Arnoczky wuxuu soo jeediyay in miisaanka jidhka iyo dhaqdhaqaaqa wadajirka jilibka ay baabi'in karaan xididdada dhiigga ee gudaha iyo dhexe ee menisci.9 Nafaqada nudaha meniscal waxay ku dhacdaa iyada oo loo marayo dhiig-karka xididdada dhiigga iyo iyada oo loo marayo faafinta dheecaanka synovial. Baahida loo qabo nafaqeynta iyadoo la adeegsanayo faafintu waa rarista iyo sii daynta joogtada ah ee sagxadaha articular, culayska jidhka iyo xoogga muruqa.130 Habkani wuxuu la mid yahay nafaqada carjawda articular

 

Sawirka Resonance Magnetic ee Meniscus

 

Sawir-qaadista resonance magnetic (MRI) waa qalab ogaanshaha oo aan fiicneyn oo loo isticmaalo qiimeynta, ogaanshaha, iyo la socodka menisci. MRI si ballaaran ayaa loo aqbalaa qaabka sawirka ugu fiican sababtoo ah kala duwanaanshaha jilicsan ee jilicsan.

 

Dhinaca MRI-da isgoysyada ah, meniscus-ka caadiga ah wuxuu u muuqdaa qaab-dhismeed hoose oo calaamad hoose ah (madow) (Jaantus 9). Jeexitaanka meniscal waxaa lagu gartaa joogitaanka calaamadda intrameniscal oo kordhaysa oo ku fidsan oogada dhismahan.

 

 

Daraasado dhowr ah ayaa qiimeeyay isticmaalka kiliinikada ee MRI ee ilmada meniscal. Guud ahaan, MRI waa mid aad xasaasi u ah oo gaar u ah ilmada meniscus. Dareenka MRI ee lagu ogaanayo ilmada meniscal waxay u dhexeysaa 70% ilaa 98%, iyo gaar ahaan, laga bilaabo 74% ilaa 98%. meniscus iyo 48,62,105,107,117% ee meniscus lateral.1014 Falanqaynta maadada ee bukaanada 89 ee MRI iyo baaritaanka arthroscopic ayaa helay 88% dareenka iyo 48% saxnaanta ilmada meniscal.2000

 

Waxaa jiray farqi u dhexeeya baaritaanka MRI iyo pathology-ga lagu aqoonsaday inta lagu jiro baaritaanka arthroscopic. . . Baaritaannada arthroscopic ayaa lagu xusay 66 ka mid ah 561 (12%). -86% siday u kala horreeyaan). Shepard et al waxay qiimeeyeen saxnaanta MRI ee lagu ogaanayo nabarrada kiliinikada ee muhiimka ah ee geeska hore ee meniscus ee 92 jilibka MRI22 oo isku xigta waxayna heleen 349% heerka been-abuurka ah. Kordhinta xoogga isha hore ee geeska hore maahan inay tilmaamayso nabar caafimaad ahaan muhiim ah.6

 

Gabagabada

 

Menisci ee wadajirka jilibka ayaa ah xayndaab-qaabaysan oo ah fibrocartilage kuwaas oo siinaya xasilloonida sii kordheysa ee articulation femorotibial, qaybinta culeyska axial, nuugaya shoogga, oo siiya saliidda wadajirka jilibka. Dhaawacyada menisci waxaa loo aqoonsan yahay inay sabab u tahay xanuunada murqaha ee muhiimka ah. Ilaalinta menisci waxay si aad ah ugu tiirsan tahay ilaalinta hal-abuurkeeda gaarka ah iyo abaabulkeeda.

 

Mahadnaq

 

Ncbi.nlm.nih.gov/pmc/articles/PMC3435920/

 

Qoraalada

 

Ncbi.nlm.nih.gov/pmc/articles/PMC3435920/

 

Gabagabadii, jilibku waa isku-xidhka ugu wayn uguna adag ee jidhka bini'aadamka. Si kastaba ha ahaatee, sababtoo ah jilibka ayaa si caadi ah u dhaawacmi kara dhaawac iyo/ama xaalad awgeed, waxaa lagama maarmaan ah in la fahmo anatomy ee wadajirka jilibka si bukaanku u helo daaweyn habboon. arrimaha caafimaadka laf dhabarta. Si aad ugala hadasho mawduuca, fadlan xor u noqo inaad waydiiso Dr. Jimenez ama nagala soo xidhiidh at�915-850-0900 .

 

Waxaa soo saaray Dr. Alex Jimenez

 

Badhanka Wicista Cagaaran H .png

 

Mawduuc Dheeraad ah oo Wadahadal ah: Nasinta Jilibka Xanuunka Qalliin la'aan

 

Xanuunka jilibka waa calaamad caan ah oo ku dhici karta dhaawacyo jilibka ah iyo/ama xaalado kala duwan, oo ay ku jiraandhaawacyada isboortiga. Jilibku waa mid ka mid ah kala-goysyada ugu adag ee jidhka bini'aadamka maadaama uu ka kooban yahay isgoysyada afar lafo, afar seediyo, seedooyin kala duwan, laba menisci, iyo carjawda. Sida laga soo xigtay Akademiyada Maraykanka ee Dhakhaatiirta Qoyska, sababaha ugu badan ee xanuunka jilibka waxaa ka mid ah subluxation patellar, patellar tendinitis ama jilibka jumper, iyo cudurka Osgood-Schlatter. Inkasta oo xanuunka jilibka ay u badan tahay inuu ku dhaco dadka ka weyn 60 sano, xanuunka jilibka wuxuu sidoo kale ku dhici karaa carruurta iyo dhalinyarada. Xanuunka jilibka waxaa lagu daweyn karaa guriga iyadoo la raacayo hababka RICE, si kastaba ha ahaatee, dhaawacyada daran ee jilibka ayaa laga yaabaa inay u baahdaan daryeel caafimaad oo degdeg ah, oo ay ku jiraan daryeelka xanuunka loo yaqaan 'chiropractic care'.

 

sawirka blog ee wiil warqad kartoon ah

 

DHEERAAD AH | Mawduuca MUHIIMKA AH: El Paso, TX Chiropractor ayaa lagu taliyay

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tixraacyada
1. Adams ME, Hukins DWL. Matrixka ka baxsan unugyada meniscus. Gudaha: Mow VC, Arnoczky SP, Jackson DW, tafatirayaasha. ed. Jilibka Meniscus: Aasaaska aasaasiga ah iyo Caafimaadka. New York, NY: Raven Press; 1992:15-282016
2. Adams ME, McDevitt CA, Ho A, Muir H. Go'doominta iyo sifada boroteoglycans-cufnaanta-sare ee ka soo jeeda menisci semilunar. J Lafaha Wadajirka Sug Am. 1986;68: 55-64 [PubMed]
3. Adams ME, Muir H. Glycosaminoglycans ee menisci canine. Biochem J. 1981;197: 385-389 [Maqaallo bilaash ah PMC] [PubMed]
4. Axmed AM, Burke DL. Qiyaasta in-vitro ee qaybinta cadaadiska joogtada ah ee kala-goysyada synovial: qaybta I. Dusha tibial ee jilibka. J Biomech Eng. 1983;185: 290-294 [PubMed]
5. Akgun U, Kogaoglu B, Orhan EK, Baslo MB, Karahan M. Dariiqa reflex ee suurtogalka ah ee u dhexeeya meniscus medial iyo muruqa-xub-xun: daraasad tijaabo ah oo ku saabsan bakaylaha. Jilibka Surg Sports Traumatol Arthrosc. 2008;16(9): 809-814 [PubMed]
6. Alberts B, Johnson A, Lewis J, Raff M, Roberts K, Walter P. Biology-ga Molecular ee Unugga. Qormada 4aad. Bethesda, MD: Xarunta Qaranka ee Macluumaadka Bayoloji; 2002
7. Allen CR, Wong EK, Livesay GA, Sakane M, Fu FH, Woo SL. Muhiimadda meniscus-ka dhexdhexaadka ah ee jilibka hore ee jilibka-la'aanta. J Orthop Res. 2000;18(1): 109-115 [PubMed]
8. Arnoczky SP. Dhisida meniscus: tixgalinta bayoolojiga. Clin Orthop Relat Res. 1999;367S: 244-253[PubMed]
9. Arnoczky SP. Guud ahaan iyo anatomy vascular ee meniscus iyo doorkeeda bogsashada meniscal, dib u soo kabashada iyo dib u habeynta. Gudaha: Mow VC, Arnoczky SP, Jackson DW, tafatirayaasha. , ed. Jilibka Meniscus: Aasaaska aasaasiga ah iyo Caafimaadka. New York, NY: Raven Press; 1992:1-14
10. Arnoczky SP, Adams ME, DeHaven KE, Eyre DR, Mow VC. Meniscus-ka. Gudaha: Woo SL-Y, Buckwalter J, tafatirayaasha. , ed. Dhaawaca iyo Dayactirka Unugyada Jilicsan ee Musculoskeletal. Park Ridge, IL: Akademiyada Maraykanka ee Dhakhaatiirta Lafaha; 1987:487-537
11. Arnoczky SP, Warren RF. Anatomy of the cruciate ligaments. Gudaha: Feagin JA, tafatiraha. , ed. Xirmooyinka Muhiimka ah. New York, NY: Churchill Livingstone; 1988:179-195
12. Arnoczky SP, Warren RF. Microvasculature of meniscus aadanaha. Am J Sports Med. 1982;10: 90-95[PubMed]
13. Arnoczky SP, Warren RF, Spivak JM. Dayactirka Meniscal iyadoo la adeegsanayo xinjirowga fibrin ee exogenous: daraasad tijaabo ah ee eeyaha. J Lafaha Wadajirka Sug Am. 1988;70: 1209-1217 [PubMed]
14. Aspden RM, Yarker YE, Hukins DWL. Jihaynta collagen ee meniscus ee wadajirka jilibka. J. Anat. 1985;140: 371. [Maqaallo bilaash ah PMC] [PubMed]
15. Assimakopulos AP, Katonis PG, Agapitos MV, Exarchou EI. Innervations ee meniscus aadanaha. Clin Orthop Relat Res. 1992;275: 232-236 [PubMed]
16. Atencia LJ, McDevitt CA, Nile WB, Sokoloff L. Waxyaabaha carjawda ee eyga aan qaan-gaarin. Isku xidhka Tissue Res. 1989;18: 235-242 [PubMed]
17. Athanasiou KA, Sanchez-Adams J. Injineerinka jilibka Meniscus. San Rafael, CA: Morgan & Claypool Publishers; 2009
18. Baratz ME, Fu FH, Mengato R. Ilmada Meniscal: Saamaynta meniscectomy iyo hagaajinta aagagga xiriirinta xididada xididada iyo walbahaarka jilibka bini'aadamka. Warbixin horudhac ah. Am J Sports Med. 1986;14: 270-275 [PubMed]
19. Barrack RL, Skinner HB, Buckley SL. Lahaanshaha jilibka hore ee jilibka. Am J Sports Med. 1989;17: 1-6 [PubMed]
20. Beaufils P, Verdonk R, tafatirayaasha. , ed. Meniscus. Heidelberg, Jarmalka: Springer-Verlag; 2010
21. Beaupre A, Choukroun R, Guidouin R, Carneau R, Gerardin H. Jilibka menisci: isku xidhka ka dhexeeya qaab-dhismeedka yar yar iyo biomechanics. Clin Orthop Relat Res. 1986;208: 72-75 [PubMed]
22. Benninghoff A. Form und Bau der Gelenkknorpel in ihren Beziehungen zur Funktion. Erste Mitteilung: Die modellierenden iyo pastehaltenden Faktoren des Knorpelreliefs. Anat Entwickl Gesch. 1925;76: 4263
23. Shimbir MDT, MBE macaan. Kanaalka meniscus semilunar: warbixin kooban. J Lafaha Wadajirka Surg Br. 1988;70: 839. [PubMed]
24. Shimbir MDT, MBE macaan. Nidaamka kanaalka ee menisci semilunar. Ann Rheum Dis. 1987;46: 670-673 [Maqaallo bilaash ah PMC] [PubMed]
25. Brantigan OC, Voshell AF. Makaanikada seedaha iyo menisci ee wadajirka jilibka. J Lafaha Wadajirka Sug Am. 1941;23: 44-66
26. Brindle T, Nyland J, Johnson DL. Meniscus: dib u eegista mabaadi'da aasaasiga ah ee codsiga qalliinka iyo baxnaaninta. J Athlein tareenka. 2001;32(2): 160-169 [Maqaallo bilaash ah PMC] [PubMed]
27. Bullough PG, Munuera L, Murphy J, iyo al. Xoogga menisci ee jilibka sida ay ula xiriirto qaab dhismeedka wanaagsan. J Lafaha Wadajirka Surg Br. 1979;52: 564-570 [PubMed]
28. Bullough PG, Vosburgh F, Arnoczky SP, iyo al. Menisci ee jilibka. Gudaha: Insall JN, tafatiraha. , ed. Qaliinka Jilibka. New York, NY: Churchill Livingstone; 1984:135-149
29. Burr DB, Radin EL. Shaqada meniscal iyo muhiimada dib u soo kabashada meniscal si looga hortago osteoarthrosis qaybta dhexe ee dambe. Clin Orthop Relat Res. 1982;171: 121-126 [PubMed]
30. Carney SL, Muir H. Qaab dhismeedka iyo shaqada proteoglycans carjawda. Physiol Rev. 1988;68: 858-910 [PubMed]
31. Clark CR, Ogden JA. Horumarinta menisci ee wadajirka jilibka bini'aadamka. J Lafaha Wadajirka Sug Am. 1983;65: 530 [PubMed]
32. Clark FJ, Horsh KW, Bach SM, Larson GF. Wax ku biirinta daaweeyayaasha maqaarka iyo wadajirka ee dareenka mawqifka jilibka ee ninka. J Neurophysiol. 1979;42: 877-888 [PubMed]
33. Danzig L, Resnik D, Gonsalves M, Akeson WH. Sahayda dhiigga ee meniscus caadiga ah iyo kuwa aan caadiga ahayn ee jilibka bini'aadamka. Clin Orthop Relat Res. 1983;172: 271-276 [PubMed]
34. Davies D, Edwards D. Sahayda xididada iyo neerfaha ee meniscus-ka bini'aadamka. Am R Coll Surg Engl. 1948;2: 142-156
35. Maalinta B, Mackenzie WG, Shim SS, Leung G. Sahayda xididada iyo neerfaha ee meniscus-ka bini'aadamka. Arthroscopy. 1985;1: 58-62 [PubMed]
36. DeHaven KE. Meniscectomy iyo hagaajinta: waayo-aragnimada bukaan-socodka. Gudaha: Mow VC, Arnoczky SP, Jackson DW, tafatirayaasha. , ed. Jilibka Meniscus: Aasaaska aasaasiga ah iyo Caafimaadka. New York, NY: Raven Press; 1992:131-139
37. DePalma AF. Cudurada Jilibka. Philadelphia, PA: JB Lippincott Co; 1954kii
38. De Smet AA, Graf BK. Ilmada Meniscal waxay seegtay sawirka MR: xidhiidhka qaababka ilmada meniscal iyo ilmada seediga hore ee cruciate. AJR Am J Roentgenol. 1994;162: 905-911 [PubMed]
39. De Smet AA, Norris MA, Yandow DR, iyo al. Baaritaanka MR ee ilmada meniscal ee jilibka: muhiimadda calaamadda sare ee meniscus ee ku fidsan dusha sare. AJR Am J Roentgenol. 1993;161: 101-107[PubMed]
40. Dhee SF. Tilmaamaha qaab-dhismeedka shaqada ee jilibka bini'aadamka: aragtida korriinka. Clin Orthop Relat Res. 2003;410: 19-24 [PubMed]
41. Dhee SF. Jilibka sida gudbinta noolaha oo leh baqshad shaqo: aragti. Clin Orthop Relat Res. 1996;325: 10-18 [PubMed]
42. Dye SF, Vaupel GL, Dye CC. Khariidaynta dareenka neerfaha ee miyir-qabka ah ee dhismayaasha gudaha ee jilibka bini'aadamka iyada oo aan lahayn suuxdin gudaha ah. Am J Sports Med. 1998;26(6): 773-777 [PubMed]
43. Eyre DR, Koob TJ, Chun LE. Biochemistry ee meniscus: astaanta gaarka ah ee noocyada kolajka iyo kala duwanaanshaha goobta ku tiirsan ee halabuurka. Orthop Trans. 1983;8: 56
44. Eyre DR, Wu JJ. Collagen of fibrocartilage: phenotype molecular gaar ah oo ku jira meniscus bovine. FEBS Lett. 1983;158: 265. [PubMed]
45. Fairbank TJ. Kala-goysyada jilibka ayaa isbeddela ka dib meniscectomy. J Lafaha Wadajirka Surg Br. 1948;30: 664-670[PubMed]
46. Fife RS. Aqoonsiga borotiinnada isku xirka iyo borotiinka 116,000-dalton matrix ee ku jira meniscus canine. Arch Biochem Biophys. 1985;240: 682. [PubMed]
47. Fife RS, Hook GL, Brandt KD. Meelaynta guud ee borotiinka dalton ee 116,000 ee carjawda. J Histochem Cytochem. 1985;33: 127. [PubMed]
48. Fischer SP, Fox JM, Del Pizzo W, iyo al. Xaqiijinta ogaanshaha laga helay sawir-qaadista magnetic resonance ee jilibka: falanqaynta xarun-badan oo kun iyo afar iyo toban bukaan ah. J Lafaha Wadajirka Sug Am. 1991;73: 2-10[PubMed]
49. Fitian DC, Kelly MA, Mow VC. Qalabka walxaha iyo xiriirka shaqada qaab-dhismeedka ee menisci. Clin Orthop Relat Res. 1990;252: 19-31 [PubMed]
50. Fukubayashi T, Kurosawa H. Goobta xiriirka iyo qaabka qaybinta cadaadiska ee jilibka: daraasad ku saabsan kala-goysyada jilibka ee caadiga ah iyo osteoarthritic. Acta Orthop Scand. 1980;51: 871-879 [PubMed]
51. Fukubayashi T, Torzilli PA, Sherman MF, Warren RF. Falanqaynta biomechanical in vivo ee dhaqdhaqaaqa hore iyo gadaal ee jilibka, wareegtada barakicinta tibial iyo qulqulka. J Lafaha Wadajirka Sug Am. 1982;64: 258-264 [PubMed]
52. Gardner E. Innervations ee wadajirka jilibka. Anat Rec. 1948;101: 109-130 [PubMed]
53. Gardner E, O�Rahilly R. Horumarka hore ee wadajirka jilibka ee embriyaha bini'aadamka. J. Anat. 1968;102: 289-299 [Maqaallo bilaash ah PMC] [PubMed]
54. Ghadially FN, LaLonde JMA. Burburka lipidic ee intramaterials iyo bode calcified ee carjawooyinka semilunar aadanaha. J. Anat. 1981;132: 481. [Maqaallo bilaash ah PMC] [PubMed]
55. Ghadially FN, LaLonde JMA, Wedge JH. Ultrastructure ee menisci caadiga ah iyo jeexan ee wadajirka jilibka ee bini'aadamka. J. Anat. 1983;136: 773-791 [Maqaallo bilaash ah PMC] [PubMed]
56. Ghadially FN, Thomas I, Yong N, LaLonde JMA. Ultrastructure of carjawda semilunar bakayle. J. Anat. 1978;125: 499. [Maqaallo bilaash ah PMC] [PubMed]
57. Ghosh P, Ingman AM, Taylor TK. Kala duwanaanshaha kolajka, borotiinnada aan kolajiyeyaasha ahayn, iyo hexosamine ee menisci oo ka yimid lafaha jilibka arthritic iyo rheumatoid. J Rheumatol. 1975;2: 100-107[PubMed]
58. Ghosh P, Taylor TKF. Meniscus-ka wadajirka ah ee jilibka: fibrocartilage oo kala duwanaansho ah. Clin Orthop Relat Res. 1987;224: 52-63 [PubMed]
59. Ghosh P, Taylor TKF, Pettit GD, Horsburgh BA, Bellenger CR. Saamaynta dhaqdhaqaaq-la'aanta qalliinka kadib ee dib-u-soo-noqoshada carjawda wadajirka ah ee jilibka: daraasad tijaabo ah. J Orthop Res. 1983;1: 153.[PubMed]
60. Gray DJ, Gardner E. Horumarka dhalmada ka hor ee jilibka bini'aadamka iyo kala-goysyada tibial fibula ee sare. Waxaan ahay J Anat. 1950;86: 235-288 [PubMed]
61. Grey JC. Neural iyo vascular anatomy ee menisci ee jilibka aadanaha. J Orthop Sports Phys Ther. 1999;29(1): 23-30 [PubMed]
62. Grey SD, Kaplan PA, Dussault RG. Sawirka jilibka: heerka hadda jira. Orthop Clin North Am. 1997;28: 643-658 [PubMed]
63. Greis PE, Bardana DD, Holmstrom MC, Burks RT. Dhaawaca Meniscal: I. Sayniska aasaasiga ah iyo qiimaynta. J Am Acad Orthop Surg. 2002;10: 168-176 [PubMed]
64. Gronblad M, Korkala O, Liesi P, Karaharju E. Innervation ee xuub synovial iyo meniscus. Acta Orthop Scand. 1985;56: 484-486 [PubMed]
65. Habuchi H, Yamagata T, Iwata H, Suzuki S. Dhacdooyinka kala duwan ee derman sulfate-chondroitin sulfate copolymers ee carjawda fibrous.. J Biol Chem. 1973;248: 6019-6028 [PubMed]
66. Haines RW. Jilibka tetrapod. J. Anat. 1942;76: 270-301 [Maqaallo bilaash ah PMC] [PubMed]
67. Hardingham TE, Muir H. Ku xidhitaanka oligosaccharides ee hyaluronic acid ee proteoglycans. Biochem J. 1973;135 (4): 905-908 [Maqaallo bilaash ah PMC] [PubMed]
68. Harner CD, Janaushek MA, Kanamori A, Yagi AKM, Vogrin TM, Woo SL. Falanqaynta biomechanical ee dib-u-dhiska lafdhabarta dhabarka ee laba-laaban. Am J Sports Med. 2000;28: 144-151 [PubMed]
69. Harner CD, Kusayama T, Carlin G, iyo al. Qalabka dhismaha iyo farsamada ee ligamentiga dambe ee bini'aadamka iyo seedaha meniscofemoral. Ku: Wax-is-weydaarsiga Shirka Sannadlaha ah ee 40-aad ee Ururka Cilmi-baarista Lafaha; 1992kii
70. Harner CD, Livesgay GA, Choi NY, iyo al. Qiimaynta cabbirrada iyo qaababka bini'aadamka ee jilbaha hore iyo kuwa dambe: daraasad isbarbardhig ah. Trans Orthop Res Soc. 1992;17: 123
71. Hascall VC. Is dhexgalka proteoglycans carjawda leh hyaluronic acid. J Supramol Struct. 1977;7: 101-120 [PubMed]
72. Hascall VC, Heinegrd D. Isku-darka proteoglycans carjawda: I. Doorka hyaluronic acid. J Biol Chem. 1974;249(13): 4205-4256 [PubMed]
73. Heinegard D, Oldberg A. Qaab dhismeedka iyo bayoolaji ee carjawda iyo matrixka lafaha makromolecules aan kollajin. FASEB J. 1989;3: 2042-2051 [PubMed]
74. Helfet AJ. Osteoarthritis ee jilibka iyo qabashadiisa hore. Casharka Instr Course. 1971;20: 219-230
75. Heller L, Langman J. Jilibka meniscofemoral ee jilibka bini'aadamka. J Lafo Joing Surg Br. 1964;46: 307-313 [PubMed]
76. Henning CE, Lynch MA, Clark JR. Vascularity ee bogsashada dayactirka meniscal. Arthroscopy. 1987;3: 13-18 [PubMed]
77. Herwig J, Egner E, Buddecke E. Isbedelada kiimikaad ee menisci wadajirka jilibka ee heerarka kala duwan ee xumaanshaha. Ann Rheum Dis. 1984;43: 635-640 [Maqaallo bilaash ah PMC] [PubMed]
78. H�pker WW, Angres G, Klingel K, Komitowksi D, Schuchardt E. Isbeddellada qaybta elastin ee meniscus-ka aadanaha. Virchows Arch A Pathol Anat Histopathol. 1986;408: 575-592 [PubMed]
79. Humphry GM. Daweyn Ku Saabsan Qalfoofka Aadanaha Oo Ay Ku Jiraan Kala-goysyada. Cambridge, UK: Macmillan; 1858:545-546
80. Ingman AM, Ghosh P, Taylor TKF. Kala duwanaanshaha borotiinnada kolajka iyo kuwa aan-kolajka ahayn ee menisci wadajirka jilibka bini'aadamka oo leh da' iyo hoos u dhac. Gerontology. 1974;20: 212-233 [PubMed]
81. Jerosch J, Prymka M, Castro WH. Ka-hortagga kala-goysyada jilibka oo leh dhaawac ka mid ah meniscus medial. Acta Orthop Belg. 1996;62(1): 41-45 [PubMed]
82. Johnson DL, Swenson TD, Harner CD. Ku-tallaalidda meniscal arthroscopic: anatomic iyo tixgelin farsamo. Lagu soo bandhigay: Shirka Sagaal iyo Tobnaad ee Sannadlaha ah ee Ururka Lafaha Maraykanka ee Daawada Isboortiga; Julaay 12-14, 1993; Dooxada Sun, ID
83. Johnson DL, Swenson TM, Livesay GA, Aizawa H, Fu FH, Harner CD. Gelitaanka-site anatomy ee menisci bini'aadamka: guud ahaan, arthroscopic, iyo anatomy muuqaal ah oo saldhig u ah tallaalka meniscal. Arthroscopy. 1995;11: 386-394 [PubMed]
84. Johnson RJ, Pope MH. Anatomy functional of meniscus. In: Dood-cilmiyeedka Dib-u-dhiska Jilibka ee Akademiyada Maraykanka ee Dhakhaatiirta Lafaha. St Louis, MO: Mosby; 1978:3
85. Jones RE, Smith EC, Reisch JS. Saamaynta meniscectomy medial ee bukaanka ka weyn afartan sano. J Lafaha Wadajirka Sug Am. 1978;60: 783-786 [PubMed]
86. Justice WW, Quinn SF. Qaababka khaldan ee qiimaynta sawirka MR ee menisci jilibka. raajada. 1995;196: 617-621 [PubMed]
87. Kaplan EB. Embryology ee menisci ee wadajirka jilibka. Bull Hosp Joint Dis. 1955;6: 111-124[PubMed]
88. Karahan M, Kocaoglu B, Cabukoglu C, Akgun U, Nuran R. Saamaynta qayb ka mid ah meniscectomy dhexdhexaad ah oo ku saabsan shaqada gaarka ah ee jilibka. Arch Orthop Trauma Surg. 2010;130: 427-431 [PubMed]
89. Kempson GE, Tuke MA, Dingle JT, Barrett AJ, Horsfield PH. Saamaynta enzymes-ka borotiinka ee sifooyinka farsamada ee carjawda articular ee dadka waaweyn. Biochim Biophys Acta. 1976;428(3): 741-760[PubMed]
90. Kennedy JC, Alexander IJ, Hayes KC. Heerarka neerfaha ee jilibka bini'aadamka iyo muhiimaddeeda shaqo. Am J Sports Med. 1982;10: 329-335 [PubMed]
91. Ketlkamp DB, Jacobs AW. Aagga xiriirka Tibiofemoral: go'aaminta iyo saameynta. J Lafaha Wadajirka Sug Am. 1972;54: 349-356 [PubMed]
92. King D. Shaqada carjawooyinka semilunar. J Lafaha Wadajirka Surg Br. 1936;18: 1069-1076
93. Kohn D, Moreno B. Gelitaanka Meniscus anatomy oo saldhig u ah beddelka meniscus: daraasad cadaveric morphological. Arthroscopy. 1995;11: 96-103 [PubMed]
94. Krause WR, Pope MH, Johnson RJ, Wilder DG. Isbeddelka farsamada ee jilibka ka dib meniscectomy. J Lafaha Wadajirka Sug Am. 1976;58: 599-604 [PubMed]
95. Kulkarni VV, Chand K. Anatomy pathological ee meniscus gabow. Acta Orthop Scand. 1975;46: 135-140 [PubMed]
96. Kurosawa H, Fukubayashi T, Nakajima H. Habka culeyska ee wadajirka jilibka: dabeecadda jireed ee wadajirka jilibka oo leh ama aan lahayn menisci. Clin Orthop Relat Res. 1980;149: 283-290 [PubMed]
97. LaPrade RF, Burnett QM, II, Veenstra MA, iyo al. Baahitaanka natiijooyinka sawir-qaadista resonance-ka ee aan caadiga ahayn ee jilbaha asymptomatic: oo leh isku-xirnaanta sawirka magnetic resonance imaging iyo helitaanka arthroscopic ee jilbaha calaamadaha.. Am J Sports Med. 1994;22: 739-745 [PubMed]
98. RJ ugu dambeeyay. Qaar ka mid ah faahfaahinta anatomical ee wadajirka jilibka. J Lafaha Wadajirka Surg Br. 1948;30: 368-688 [PubMed]
99. Lehtonen A, Viljanto J. Mucopolysaccharides ee saxannada intervertebral aadanaha ee herniated iyo carjawda semilunar. Acta Chir Scand. 1967;133(4): 303-306 [PubMed]
100. Levy IM, Torzilli PA, Warren RF. Saamaynta meniscectomy lateral ee dhaqdhaqaaqa jilibka. J Lafaha Wadajirka Sug Am. 1989;71: 401-406 [PubMed]
101. Levy IM, Torzilli PA, Warren RF. Saamaynta meniscectomy medial ee dhaqdhaqaaqa hore iyo gadaal ee jilibka. J Lafaha Wadajirka Sug Am. 1982;64: 883-888 [PubMed]
102. MacConaill MA. Shaqada fibrocarticular ee gudaha articular oo leh tixraac gaar ah oo ku saabsan jilibka iyo xubnaha radio-ulnar hoose. J. Anat. 1932;6: 210-227 [Maqaallo bilaash ah PMC] [PubMed]
103. MacConaill MA. Dhaqdhaqaaqa lafaha iyo kala-goysyada: III. Dheecaanka synovial iyo kaaliyayaasha. J Lafaha Wadajirka Surg Br. 1950;32: 244. [PubMed]
104. MacConaill MA. Daraasadaha farsamada gacanta ee kala-goysyada synovial: II. Barokaca sagxadaha articular iyo muhiimada kala-goysyada kooraha. Ir J Med Sci. 1946;6: 223-235 [PubMed]
105. Mackenzie R, Dixon AK, Keene GS, iyo al. Sawirka dhawaaqa magnetic ee jilibka: qiimeynta waxtarka. Clin Radiol. 1996;41: 245-250 [PubMed]
106. Mackenzie R, Keene GS, Lomas DJ, Dixon AK. Khaladaadka xagga sawirka magnetka ee jilibka: run mise been? Br J Radiol. 1995;68: 1045-1051 [PubMed]
107. Mackenzie R, Palmer CR, Lomas DJ, iyo al. Sawir-qaadista resonance magnetic ee jilibka: daraasadaha waxqabadka ogaanshaha. Clin Radiol. 1996;51: 251-257 [PubMed]
108. Markolf KL, Bargar WL, Shoemaker SC, Amstutz HC. Doorka culeyska wadajirka ah ee xasiloonida jilibka. J Lafaha Wadajirka Sug Am. 1981;63: 570-585 [PubMed]
109. Markolf KL, Mensch JS, Amstutz HC. Qallafsanaanta iyo caajisnimada jilibka: wax ku biirinta qaababka taageerada. J Lafaha Wadajirka Sug Am. 1976;58: 583-597 [PubMed]
110. McDermott LJ. Horumarinta wadajirka jilibka aadanaha. Arch Surg. 1943;46: 705-719
111. McDevitt CA, Miller RR, Sprindler KP. Unugyada iyo matrixka unugga isdhexgalka ee meniscus. Gudaha: Mow VC, Arnoczky SP, Jackson DW, tafatirayaasha. , ed. Jilibka Meniscus: Aasaaska aasaasiga ah iyo Caafimaadka. New York, NY: Raven Press; 1992:29-36
112. McDevitt CA, Webber RJ. Ultrastructure iyo biochemistry ee carjawda meniscal. Clin Orthop Relat Res. 1990;252: 8-18 [PubMed]
113. McNicol D, Roughley PJ. Soo saarista iyo sifada proteoglycan ee meniscus aadanaha. Biochem J. 1980;185: 705. [Maqaallo bilaash ah PMC] [PubMed]
114. Merkel KH. Dusha sare ee menisci bini'aadamka iyo isbeddelladeeda gabowga inta lagu jiro da'da: iskaanka isku dhafan iyo gudbinta baaritaanka microscopic elektarooniga ah (SEM, TEM). Arch Orthop Trauma Surg. 1980;97: 185-191 [PubMed]
115. Messner K, Gao J. Menisci ee wadajirka jilibka: sifooyinka anatomical iyo functional, iyo sababaha daaweynta bukaan-socodka. J. Anat. 1998;193: 161-178 [Maqaallo bilaash ah PMC] [PubMed]
116. Meyers E, Zhu W, Mow V. Qalabka Viscoelastic ee carjawda articular iyo meniscus. Gudaha: Nimni M, tafatire. , ed. Collagen: Chemistry, Biology iyo Biotechnology. Boca Raton, FL: CRC; 1988kii
117. Miller GK. Daraasad mustaqbalka ah oo isbarbardhigga saxda ah ee ogaanshaha ogaanshaha bukaan-socodka ee jeexjeexa meniscal ee leh sawir-qaadista magnet-ka iyo saameynta ay ku leedahay natiijada bukaan-socodka. Arthroscopy. 1996;12: 406-413 [PubMed]
118. Miller GK, McDevitt CA. Joogitaanka trombospondin ee seedaha, meniscus iyo saxanka intervertebral. Glycoconjugate J. 1988;5: 312
119. Mossman DJ, Sarreeye WAS. Raadka xoolaha dabar go’ay. Sci Am. 1983;250: 78-79
120. Mow V, Fitian D, Kelly M. Aasaaska carjawda articular iyo meniscus biomechanics. Gudaha: Ewing JW, tafatiraha. , ed. Carjawda Articular iyo Shaqada Wadajirka ah ee Jilibka: Sayniska Aasaasiga ah iyo Arthroscopy. New York, NY: Raven Press; 1989:1-18
121. Mow VC, Holmes MH, Lai WM. Gaadiidka dareeraha ah iyo qalabka farsamada ama carjawda articular: dib u eegis. J Biomech. 1984;17: 377. [PubMed]
122. Muir H. Qaab dhismeedka iyo dheef-shiid kiimikaadka mucopolysaccharides (glycosaminoglycans) iyo dhibaatada mucopolysaccharides. Am J Med. 1969;47 (5): 673-690 [PubMed]
123. Musahl V, Citak M, O�Loughlin PF, Choi D, Bedi A, Pearle AD. Saamaynta meniscectomy ee dhexdhexaadka ah iyo lateral meniscectomy ee xasiloonida jilibka hore ee jilibka.. Am J Sports Med. 2010;38(8): 1591-1597 [PubMed]
124. Nakano T, Dodd CM, Scott PG. Glycosaminoglycans iyo proteoglycans oo ka kala yimid aagag kala duwan ee meniscus jilibka porcine. J Orthop Res. 1997;15: 213-222 [PubMed]
125. Newton RA. Wax ku biirinta soo-dhowaynta wadajirka ah ee jawaabaha milicsiga iyo kinaesthetic. Phys Ther. 1982;62: 22-29 [PubMed]
126. O�Connor BL. Qaab dhismeedka histological ee menisci jilibka eyga oo leh faallooyin ku saabsan muhiimada ay leedahay. Waxaan ahay J Anat. 1976;147: 407-417 [PubMed]
127. O�Connor BL, McConnaughey JS. Qaab dhismeedka iyo isdhexgalka bisadaha menisci jilibka, iyo xiriirka ay la leeyihiin mala-awaalka dareenka ee shaqada meniscal. Waxaan ahay J Anat. 1978;153: 431-442 [PubMed]
128. Oretorp N, Gilquist J, Liljedahl SO. Natiijooyinka muddada-dheer ee qalliinka ee xasillooni darrada wareegga wareegga anteromedial ee aan degdega ahayn ee jilibka. Acta Orthop Scand. 1979;50: 329-336 [PubMed]
129. Pagnani MJ, Warren RF, Arnoczky SP, Wickiewicz TL. Anatomy ee jilibka. Gudaha: Nicholas JA, Hershman EB, tafatirayaasha. , ed. Cirifka Hoose iyo Laf-dhabarta ee Daawada Ciyaaraha. Qormada 2aad. St Louis, MO: Mosby; 1995:581-614
130. Paulels F. [Saamaynta horumarka ee la qabsiga shaqada ee lafaha]. Anat Anz. 1976;139: 213-220[PubMed]
131. Peters TJ, Smilie IS. Daraasado ku saabsan ka kooban kiimikaad ee menisci ee wadajirka jilibka oo leh tixraac gaar ah oo ku saabsan dhaawaca dillaacsan ee jiifka ah. Clin Orthop Relat Res. 1972;86: 245-252 [PubMed]
132. Petersen W, Tillmann B. Maaddada fibriil ee collagenous ee menisci wadajirka jilibka ee bini'aadamka. Anat Embryol (Berl). 1998;197: 317-324 [PubMed]
133. Poynton AR, Javadpour SM, Finegan PJ, O�Brien M. Jilibka meniscofemoral ee jilibka. J Lafaha Wadajirka Surg Br. 1997;79: 327-330 [PubMed]
134. Preuschoft H, Tardieu C. Sababaha bayomechanical ee kala duwanaanshaha qaab-dhismeedka jilibka iyo suture epiphyseal fog ee hominoids. Folia Primatol (Basel). 1996;66: 82-92 [PubMed]
135. Proctor CS, Schmidt MB, Whipple RR, Kelly MA, Mow VC. Qalabka walxaha ee meniscus-ka caadiga ah ee dhexdhexaadka ah. J Orthop Res. 1989;7: 771-782 [PubMed]
136. Proske U, Schaible H, Schmidt RF. Receptors wadajirka ah iyo kinanesthesia. Exp Brain Res. 1988;72: 219-224 [PubMed]
137. Radin EL, de Lamotte F, Maquet P. Doorka menisci ee qaybinta walbahaarka jilibka. Clin Orthop Relat Res. 1984;185: 290-294 [PubMed]
138. Radin EL, Rose RM. Doorka lafta-hoosaadka ee bilawga iyo horumarka dhaawaca carjawda. Clin Orthop Relat Res. 1986;213: 34-40 [PubMed]
139. Raaszeja F. Untersuchungen Bber Entstehung und feinen Bau des Kniegelenkmeniskus. Bruns Beitr klin Chir. 1938;167: 371-387
140. Reider B, Arcand MA, Diehl LH, iyo al. Lahaanshaha jilibka ka hor iyo ka dib dib u dhiska jilibka hore ee jilibka. Arthroscopy. 2003;19(1): 2-12 [PubMed]
141. Renstrom P, Johnson RJ. Anatomy iyo biomechanics ee menisci. Clin Sports Med. 1990;9: 523-538 [PubMed]
142. Retterer E. De la forme et des connexions que presentment les fibro-cartilages du genou chez quelques singes d�Afrique. Cr Soc Biol. 1907;63: 20-25
143. Ricklin P, Ruttimann A, Del Bouno MS. Ogaanshaha, Baadhista Kala Duwan iyo Daawaynta. Qormada 2aad. Stuttgart, Jarmalka: Verlag Georg Thieme; 1983kii
144. Rodkey WG. Bayoloji aasaasiga ah ee meniscus iyo jawaabta dhaawaca. Gudaha: Qiimaha CT, tifaftiraha. , ed. Casharrada Koorsada Waxbarasho 2000. Rosemont, IL: Akademiyada Maraykanka ee Dhakhaatiirta Lafaha; 2000:189-193 [PubMed]
145. Rosenberg LC, Buckwalter JA, Coutts R, Hunziker E, Mow VC. Carjawda articular. Gudaha: Woo SLY, Buckwalter JA, tafatirayaasha. , ed. Dhaawaca iyo Dayactirka Unugyada Jilicsan ee Musculoskeletal. Park Ridge, IL: Akademiyada Maraykanka ee Dhakhaatiirta Lafaha; 1988:401
146. Roughley PJ. Isbeddellada qaab-dhismeedka proteoglycan ee carjawda xilliga gabowga: asalka iyo saamaynta: dib u eegis. Tallaabooyinka Wakiilada. 1986;518: 19 [PubMed]
147. Saygi B, Yildirim Y, Berker N, Ofluoglu D, Karadag-Saygi E, Karahan M. Qiimaynta shaqada dareemayaasha ee meniscus medial ee bini'aadamka. Arthroscopy. 2005;21(12): 1468-1472 [PubMed]
148. Scapinelli R. Daraasado ku saabsan vasculature ee wadajirka jilibka aadanaha. Acta Anat. 1968;70: 305-331[PubMed]
149. Schutte MJ, Dabezius EJ, Zimny ​​ML, Happe LT. Anatomy neural ee seedaha hore ee bini'aadamka. J Lafaha Wadajirka Sug Am. 1987;69: 243-247 [PubMed]
150. Scott JE. Ururka Supramolecular ee matrixka ka baxsan unugyada glycosaminoglycans, in vitro iyo unugyada. FASEB J. 1992;6: 2639-2645 [PubMed]
151. Scott PG, Nakano T, Dodd CM. Go'doominta iyo sifaynta borotiikooska yaryar ee aagagga kala duwan ee meniscus jilibka porcine. Biochim Biophys Acta. 1997;1336: 254-262 [PubMed]
152. Seedhom BB. Shaqada culeyska ee menisci. Jir-dhiska jirka. 1976;62(7):223. [PubMed]
153. Seedhom BB, Hargreaves DJ. Gudbinta culeyska ee wadajirka jilibka oo leh tixraac gaar ah oo ku saabsan doorka menisci: qaybta II. Natiijooyin tijaabo ah, dood iyo gunaanad. Eng Med. 1979;8: 220-228
154. Shepard MF, Hunter DM, Davies MR, Shapiro MS, Seeger LL. Muhiimada caafimaad ee geesaha hore ee ilmada meniscal ee lagu ogaaday sawirada resonance magnetic. Am J Sports Med. 2002;30(2): 189-192[PubMed]
155. Shoemaker SC, Markolf KL. Doorka meniscus ee xasiloonida hore- danbe ee jilibka hore ee cruciate-yaraanta: saamaynta qayb ahaan ka soo horjeeda wadarta guud. J Lafaha Wadajirka Sug Am. 1986;68(1): 71-79 [PubMed]
156. Skaags DL, Mow VC. Shaqada fiilooyinka tie radial ee meniscus. Trans Orthop Res Soc. 1990;15: 248
157. Skinner HB, Barrack RL. Dareenka booska wadajirka ah ee wadajirka caadiga ah iyo jilibka pathologic. J Electromyogr Kinesiol. 1991;1(3): 180-190 [PubMed]
158. Skinner HB, Barrack RL, Kari SD. Hoos-u-dhaca da'da ee la xidhiidha lahaanshaha. Clin Orthop Relat Res. 1984;184: 208-211 [PubMed]
159. Solheim K. Glycosaminoglycans, hydroxyproline, calcium, iyo fosfooraska ee bogsashada jabka. Acta Univ Lund. 1965;28: 1-22
160. Spilker RL, Donzelli PS. Qaabka cunsurka dhamaadka laba-cirifoodka ah ee meniscus ee falanqaynta cadaadiska- cadaadiska. Gudaha: Mow VC, Arnoczky SP, Jackson DW, tafatirayaasha. , ed. Jilibka Meniscus: Aasaaska aasaasiga ah iyo Caafimaadka. New York, NY: Raven Press; 1992:91-106
161. Spilker RL, Donzelli PS, Mow VC. Qaabka unug-soo-tropic biphasic-ka kooban ee unugga meniscus-ka. J Biomechanics. 1992;25: 1027-1045 [PubMed]
162. Sutton JB. Xirmooyinka: Dabeecaddooda iyo Morfology. Qormada 2aad. London: HK Lewis; 1897kii
163. Tardieu C. Ontogeny iyo phylogeny ee jilayaasha femoral-tibial ee bini'aadamka iyo fossils hominid: saameynta shaqeynta iyo go'aaminta hiddaha. Waxaan ahay J Phys Anthropol. 1999;110: 365-377 [PubMed]
164. Tardieu C, Dupont JY. Asalka dysplasia trochlear femoral: anatomy isbarbardhigga, korriinka, iyo koritaanka wadajirka patellofemoral. Rev Chir Orthop Reparatrice Appar Mot. 2001;87: 373-383 [PubMed]
165. Thompson WO, Thaete FL, Fu FH, Dye SF. Dhaqdhaqaaqa meniscal tibial iyadoo la adeegsanayo dib-u-dhiska saddex-geesoodka ah ee sawir-qaadista magnetic. Am J Sports Med. 1991;19: 210-216 [PubMed]
166. Tissakht M, Axmed AM. Sifooyinka culeyska culeyska ee maadada meniscal ee bini'aadamka. J Biomech. 1995;28: 411-422 [PubMed]
167. Tobler T. Zur normalen und pathologischen Histologie des Kniegelenkmeniscus. Arch Klin Chir. 1933;177: 483-495
168. Vallois H. Etude anatomique de l�articulation du genou chez les primates. Montpelier, France: L�Abeille; 1914kii
169. Verdonk R, Aagaard H. Shaqada meniscus-ka caadiga ah iyo cawaaqibka dib-u-celinta meniscal. Scand J Med Sci Sports. 1999;9(3): 134-140 [PubMed]
170. Voloshin AS, Wosk J. Neefsashada naxdinta leh ee meniscectomized iyo jilbaha xanuunka leh: isbarbardhigga daraasadda vivo. J Biomed Eng. 1983;5: 157-161 [PubMed]
171. Wagner HJ. Die kollagenfaserarchitecktur der menisken des menschlichen kniegelenkes. Z Mikrosk Anat Forsch. 1976;90: 302. [PubMed]
172. Walker PS, Erkman MJ. Doorka meniscus ee gudbinta xoogga ah ee jilibka. Clin Orthop Relat Res. 1975;109: 184-192 [PubMed]
173. Wan ACT, Felle P. Xididdada menisco-femoral. Clin Anat. 1995;8: 323-326 [PubMed]
174. Warren PJ, Olanlokun TK, Cobb AG, Bentley G. Proprioception ka dib arthroplasty jilibka: saamaynta naqshadaynta prosthetic. Clin Orthop Relat Res. 1993;297: 182-187 [PubMed]
175. Warren RF, Arnoczky SP, Wickiewiez TL. Anatomy ee jilibka. Gudaha: Nicholas JA, Hershman EB, tafatirayaasha. , ed. Cirifka Hoose iyo Laf-dhabarta ee Daawada Ciyaaraha. St Louis: Mosby; 1986:657-694
176. Watanabe AT, Carter BC, Teitelbaum GP, iyo al. Dambiyada caadiga ah ee sawir-qaadaha magnetic ee jilibka. J Lafaha Wadajirka Sug Am. 1989;71: 857-862 [PubMed]
177. Webber RJ, Norby DP, Malemud CJ, Goldberg VM, Moskowitz RW. Astaamaha proteoglycans-ka cusub ee la sameeyay ee ka yimid menisci bakayle ee dhaqanka xubnaha. Biochem J. 1984;221(3): 875-884 [Maqaallo bilaash ah PMC] [PubMed]
178. Webber RJ, York JL, Vanderschildren JL, Hough AJ. Qaab dhaqameedka xubinta taranka ee lagu qiimeeyo hagaajinta dhaawaca ee jilibka fibrocartilaginous meniscus. Am J Sports Med. 1989;17: 393-400 [PubMed]
179. Wilson AS, Legg PG, McNeu JC. Daraasado ku saabsan isdhexgalka meniscus medial ee wadajirka jilibka ee bini'aadamka. Anat Rec. 1969;165: 485-492 [PubMed]
180. Xigasho CJ. Meniscus: qaab-dhismeedka, qaab-dhismeedka iyo shaqada. jilibka. 1996;3: 57-58
181. Wu JJ, Eyre DR, Slayter HS. Nooca VI collagen ee saxanka intervertebral: biochemical iyo elektarooniga sifada microscopic ee borotiinka asalka ah. Biochem J. 1987;248: 373. [Maqaallo bilaash ah PMC] [PubMed]
182. Yuusuf K. Qaab dhismeedka saddex-geesoodka ah ee menisci caadiga ah ee aadanaha. J Jpn Ortho Assoc. 1978;52: 391
183. Zimny ​​ML. Mechanoreceptors ee unugyada articular. Waxaan ahay J Anat. 1988;64: 883-888
184. Zimny ​​ML, Albright DJ, Dabezies E. Mechanoreceptors ee meniscus medial aadanaha. Acta Anat. 1988;133: 35-40 [PubMed]
185. Zivanovic S. Menisco-meniscal seedaha wadajirka jilibka aadanaha. Anat Anz. 1974;145: 35-42[PubMed]
Xir Accordion
Cudurka Canqawga & Cagaha Cudurka Arthritis-ka & Dhaawaca I | El Paso, TX.

Cudurka Canqawga & Cagaha Cudurka Arthritis-ka & Dhaawaca I | El Paso, TX.

by | Sawirka & Cilad-sheegista

Jabka anqawga

  • 10% dhammaan jabka. 2nd m/c daba socota qoorta femoral Fx. Tirakoobka dadka: ragga da'da yar ee firfircoon iyo dheddigga lafaha ka weyn
  • Stable Fx: saadaasha guud waa wanaagsan tahay
  • Fx aan degganayn: waxay u baahan tahay ORIF. 15%-20% fursadaha 2nd OA.
  • Doorka sawir-qaadista waa in la go'aamiyo kakanaanta, xasilloonida iyo qorsheynta daryeelka (ie, operative vs. muxaafidka)
  • Kala soocida weberku waxay tixgelisaa jeexjeexa tibial-fibular syndesmosis ee fog iyo xasillooni-darrada iman karta
  • Weber A - ka hooseeya syndesmosis. Deggan, sida caadiga ah avulsion of malleolus fibular fog
  • Weber B - heerka syndesmosis: waxa laga yaabaa inuu ka baxsan yahay syndesmosis oo xasilloon ama dillaacsan syndesmosis oo aan degganayn
  • Weber C - oo ka sarreeya syndesmosis. Had iyo jeer degenaansho la'aan d/t jeexjeexa syndesmosis
  • Kala duwanaanshaha jabka ayaa laga yaabaa inay ku lug yeeshaan booska/doorka lafta talus inta lagu jiro Fx (tusaale, afduub, dhejin, wareeg, iwm.) tan waxaa loo yaqaan kala soocida Lauge-Hanson

Tibiofibular Syndesmosis & Xasiloonida Anqawga

Arthritis cagta canqowga iyo dhaawaca el paso tx.

Saxnaanta Dx Clinical

Arthritis cagta canqowga iyo dhaawaca el paso tx.

Mortise & Aragtida AP

Arthritis cagta canqowga iyo dhaawaca el paso tx.

AP, Medial Oblique & Aragtida Dabadeed

Arthritis cagta canqowga iyo dhaawaca el paso tx.
  • Muuji infrasyndesmotic Fx ee fibular malleolus (Weber A)
  • Dhaawac xasiloon
  • Daryeelka muxaafidka ah ee qaabka kabaha lugaha gaaban ee kabaha / kabaha ayaa la isticmaali karaa. Soo kabasho wacan Haddii aysan jirin caddaynta dhaawaca osteochondral, fursadaha yar ee dhaawaca OA ka dambeeya
  • Sawir kale looma baahna. MRI ayaa laga yaabaa inay ku caawiso inay muujiso xanuunka lafaha iyo dhaawaca lafaha lafaha

Weber B ee Heerka Syndesmosis

Arthritis cagta canqowga iyo dhaawaca el paso tx.
  • Waxay noqon kartaa mid deggan ama aan degganayn. Mararka qaarkood, go'aanka waxaa la sameeyaa xilliga sahaminta qalliinka.
  • Baaritaanka CT-ga ayaa laga yaabaa inuu ku caawiyo qiimeyn dheeraad ah
  • Maareynta: waxay ku xiran tahay xasilloonida. Xasillooni dheeraad ah ayaa loo baahan yahay haddii syndesmosis uu dillaaco

Weber C

Arthritis cagta canqowga iyo dhaawaca el paso tx.
  • AP, aragtiyaha dhexdhexaadka ah iyo kuwa dambe waxay muujinayaan Weber C - dhaawaca suprasyndesmotic oo ay weheliso kala-goysyada aan caadiga ahayn ee ballaarinta d/t khalkhalka tib-fib syndesmosis. Dhaawac aad u deggan.
  • Mararka qaarkood, marka Weber C Fx uu 6-cm ka dhigo cidhifka malleolus lateral, waxaa loo yaqaan Pott's anqaw Fx (magaca ka dib Percival Pott's kaas oo soo jeediyay soocidda asalka ah ee jabka canqowga iyada oo ku saleysan xasilloonida iyo heerka wareega). Eraygu xoogaa waa duugoobay.
  • Maareynta: hawlwadeen leh xasilin dheeri ah oo syndesmosis ah

Jabka Maisonneuve

Arthritis cagta canqowga iyo dhaawaca el paso tx.
  • Inta badan jabka laf dhabarta ee fibula u dhow oo ay weheliso dhaawac canqowga ah oo aan degganayn
  • Ma jiro jab canqowga ah oo degdeg ah oo lagu xusay shucaac ahaan, sidaas awgeed waa la waayi karaa aragtida canqowga waxayna u baahan tahay tibia iyo aragtiyo fibula
  • Tilmaamaha Rad: balaarinta canqowga d/t syndesmosis jeexjeexa iyo marmarka qaarkood khalkhal ku yimaada seedaha deltoid. Xuubka interosseous waxa lagu jeexjeexay fibular u dhow Fx oo ay sababtay u soo jiidasho leh xoog wareeg dibadda ah
  • Maareynta: hawlwadeen

Bimalleolar & Trimalleolar Fx

Arthritis cagta canqowga iyo dhaawaca el paso tx.
  • Sawirrada sare Bimalleolar Fx v. aan degganayn, natiijada u janjeersiga iyo afduubka/wareejinta dibadda. Rx: ORIF.
  • Trimalleolar Fx: 3-qaybood oo canqowga ah Fx. Malleolus dhexdhexaad ah iyo lateral iyo avulsion ee dhinaca dambe ee plafond tibial. Degenaansho la'aan badan. Rx: hawl gal

Tillaux Fx

Arthritis cagta canqowga iyo dhaawaca el paso tx.
  • Fx ee carruurta ee saameeya ilmaha ka weyn marka dhinaca dhexe ee jidhku xiran yahay ama ay ku dhowdahay in la xiro dhinaca dambe ilaa uu ka furmo. Kacsi ay sameeyaan seediga hore ee tibi-fibular. Dhibaatooyinka: 2aad qalalan/OA dhicis ah. Rx: waxay noqon kartaa muxaafid haddii ay xasiloon tahay kabka bootinta.

Dhaawacyada Saxanka Kobaca Carruurta

Arthritis cagta canqowga iyo dhaawaca el paso tx.
  • Kala soocidda Salter-Harris waxay caawisaa in la baaro oo la saadaaliyo dhaawacyada jirka.
  • Xanuunka maskaxda ee waxtarka leh: SALTR
  • S: nooca 1-sibix iyada oo saxanka koritaanka
  • A: nooca 2-korka, Fx waxay ku fidsan tahay metaphysis
  • L: nooca 3-hoosee, intra articular Fx wuxuu ku fidaa epiphysis-ka
  • T: nooca4, "iyada" Fx waxay ku fidsan tahay dhammaan: physis, metaphysis, iyo epiphysis.
  • R: nooca 5, "burburtay." Burburka dhaawac jirka ah oo u horseedaya dhimasho dhammaystiran ee saxanka koritaanka
  • Nooca 1 iyo 5: jooga oo aan lahayn jab
  • Nooca 2: wuxuu leeyahay saadaasha ugu fiican waxaana loo arkaa midka ugu caansan.
  • Maareynta: u gudbinta dhakhtarka lafaha ee carruurta
  • Dhibaatooyinka: Xiritaanka fiisigiska hore, gaabin addimada, OA dhicis ah iyo kuwa kale.

Jabka Calcaneal

Arthritis cagta canqowga iyo dhaawaca el paso tx.
  • Inta badan tarsal Fx. 17% furan Fx
  • Mechanisms: loading axial (intra-articular Fx ee kala-goysyada hoose-talar iyo calcaneal-cuboid ee kiisaska 75%). Avulsion by achilles tendon (m/c ee lafaha lafaha). Cadaadiska (daalka) Fx.
  • Intra articular Fx waxa ay xanbaarsan tahay saadaal liidata. Caadi ahaan waa la joojiyay Rx: hawl gal.
  • B/I calcaneal intra-articular fx oo leh isku xidhka laf dhabarta Fx oo leh isku xidhka vertebral Fx (T10-L2) oo inta badan loo yaqaan Casanova aka Don Juan (Lover's) fx.
  • Sawirka: raajo raajo oo ay weheliso "muuqaal cidhib" tallaabada 1aad. Iskaanka CT ayaa u fiican Dx iyo qorshaynta kahor-op.
  • Radiography: Xagasha Bohler (<20-degrees) xagasha Gissane>130-degrees. Tilmaan Calcan, Fx.

Lafaha Tarsal

Arthritis cagta canqowga iyo dhaawaca el paso tx.
  • M/C lafta daamur ee jaban waa Talus. Gobolka M/C: qoorta dheer (30-50%). Mechanism: Culayska axial ee dorsiflexion. Dhibaatooyinka: Ischemic osteonecrosis (AVN) ee talus. dhicis (2nd OA). Sawirka: Tallaabada 1aad: Sawir-qaadista, CT waxay ku caawin kartaa qeexid dheeraad ah
  • Kala soocidda Hawkins waxay ka caawisaa Dx, saadaalinta & daaweynta. "Calaamadaha Hawkins" ee filimka cad/ CT scan ayaa laga yaabaa inay ku caawiyaan AVN Dx. (Sare fallaadhaha buluuga ah waxay muujinayaan saadaasha wanaagsan d/t xariiqda radiolucent oo tilmaamaysa AVN ma jiro sababtoo ah lafta ayaa xididaysan oo markaa dib u soo baxay)
  • Rx: Nooca 1: muxaafid leh kabka lugaha gaaban ama kabaha (khatarta AVN-0-15%), Nooca 2-4-ORIF (khatarta AVN 50%-100%)

Sawirka Anqawga & Cagaha

 

Arthritis Jilibka: Qaababka Sawirka Cilad-sheegidda II | El Paso, TX.

Arthritis Jilibka: Qaababka Sawirka Cilad-sheegidda II | El Paso, TX.

by | Arthritis, Sawirka & Cilad-sheegista

Dareenka Dheecaanka Sagittal

daryeelka xanuunka loo yaqaan 'chiropractic care' el paso tx.
  • Dheecaannada Sagittal ee xasaasiga ah ee MR jeex ah oo muujinaya cyst weyn oo popliteal (Baker's) cyst (sawirka sare) iyo dheecaanka synovial ee la qiyaasi karo (sawirka hoose ka sarreeya)
  • U fiirso meelo badan oo calaamad madow ah oo labada sawir ah, oo ka dhigan kaydka bararka fibrinoid aka "jidhka bariiska" sifo MRI ah oo RA ah.

Gudbinta Rheumatological Maareynta & DRM

  • Maareynta muxaafidka ah oo ay ku xigto daryeelka qalliinka ee xaaladaha adag ee dillaaca seedaha iyo kala-baxa kala-goysyada
  • Akhriska dheeriga ah:
  • Ogaanshaha iyo Maareynta Rheumatoid Arthritis – AAFP
  • www.aafp.org/afp/2011/1201/p1245.html

Septic Arthritis (SA)

  • Septic arthritis – d/t wasakhowga bakteeriyada ama fungal ee wadajirka. SA waxay sababi kartaa burbur wadajir ah oo degdeg ah waxayna u baahan tahay Dx degdeg ah iyo maamulka antibiyootiga
  • Kala-goysyada ayaa saameeya: kala-goysyada waaweyn oo leh dhiig hodan ah (jilibka 50%>miskaha>garbaha).
  • Wadooyinka caabuqa:
  • 1) Hematogenous waa m/c
  • 2) Ku faafi meel ku dhow
  • 3) Gelitaanka tooska ah (tusaale, trauma, itrogenically)
  • Bukaannada halista ugu jira: carruurta, macaanka, difaaca jirka, dhaawaca wadajirka/barar horay u jiray, tusaale, RA, iwm.
  • Isticmaalayaasha maandooriyaha faleebbaha ayaa si gaar ah khatar ugu jira waxayna sidoo kale wasakhayn karaan kala-goysyada aan caadiga ahayn ee "kala-goysyada S" SIJ, SCJ, Symphysis pubis, ACJ, iwm.

 

  • Caafimaad ahaan: way kala duwanaan kartaa waxayna ku xidhan tahay jawaabta difaaca ee martida loo yahay iyo fayraska bakteeriyada. Waxaa laga yaabaa inuu la yimaado bilaw degdeg ah ama ka sii dara xanuunka wadajirka ah ee hore u jiray, barar, xaddidnaanta ROM. Calaamadaha guud ee xumayn, qandho, daal iyo kor u kaca ESR, CRP, Leukocytosis ayaa laga yaabaa.
  • NB Diabetes and immunocompromised waxaa laga yaabaa inay la yimaadaan astaamo yar iyo xummad la'aan d/t jawaabcelinta difaaca oo hoos u dhacda.
  • Dx: bukaan-socod, shucaac iyo shaybaar. Arthrocentesis waxay lagama maarmaan u noqon kartaa dhaqanka, tirada unugyada iyo baaritaanka synovial ee purulent
  • Maareynta: antibiyootiga IV
  • Sawirka Dx: Waxay ku bilaabataa shucaaca laakiin marxaladda hore waxay u badan tahay inay noqon doonto mid aan la arki karin. MRI waxay noqon kartaa mid xasaasi ah oo kaa caawin karta in goor hore la ogaado dheecaanka wadajirka ah, bararka lafaha, iwm. Waxaa laga yaabaa in Maraykanku uu ku caawiyo kala-goysyada kore iyo carruurta. Maraykanku wuxuu ku caawiyaa hagidda irbadda. Scintigraphy lafaha ayaa laga yaabaa in loo isticmaalo marmar haddii MRI la diidayo

Wadooyinka Wasakhda Wadajirka ah

daryeelka xanuunka loo yaqaan 'chiropractic care' el paso tx.

 

  • 1. Hematogenous (M/C)
  • 2. Ka faafi goobta ku xigta
  • 3. Tallaalka tooska ah
  • M/C noolaha-Staph aureus
  • NB Infakshanka Gonococcal wuxuu noqon karaa kala duwanaansho sare xaaladaha qaarkood
  • Isticmaalayaasha daroogada IV: Pseudomonas, candida
  • Unugga sickle: Salmonella
  • Qaniinyada xayawaanka (bisadaha/eyyada): Pasteurella
  • Mararka qaarkood wasakhowga fungal ayaa dhici karta
daryeelka xanuunka loo yaqaan 'chiropractic care' el paso tx.

raajada

daryeelka xanuunka loo yaqaan 'chiropractic care' el paso tx.

 

  • Markii hore ST/ shuban wadajir ah oo aan gaar ahayn, madmadow/ qalloocin diyaaradaha dufanka leh. Sababtoo ah waxay qaadataa 30% isafgaradka iyo 50-75% lafaha trabecular in la burburiyo ka hor inta aan lagu arkin raajada, shucaaca waa dareen la'aan qaar ka mid ah isbeddelada hore. MR imaging waa habka la door bidayo
  • Haddii MRI aan la heli karin ama la diiday. Scintigraphy lafaha oo leh Tc-99 MDT ayaa ku caawin kara
  • Carruurta, Maraykanku wuxuu doorbiday inuu iska ilaaliyo shucaaca ionizing. Carruurta, Maraykanku aad ayuu uga nugul yahay dadka waaweyn sababtoo ah korriinka lafaha

Radiographic Dx

daryeelka xanuunka loo yaqaan 'chiropractic care' el paso tx.

 

  • Natiijooyinkii hore waa kuwo aan faa'iido lahayn. Astaamaha hore waxa ka mid noqon kara fidinta wadajirka ah ee d/t. Bararka jilicsan ee jilicsan iyo mugdiga / barokaca diyaaradaha baruurta
  • 1-2 toddobaad: isbeddellada periarticular iyo kuwa ku xiga ee lafaha ayaa muujinaya sida demineralization pachy, aboor-cunida, burburka lafaha, luminta, iyo kala-baxa epiphyseal "line cortical line" oo leh korodhka bararka unugyada jilicsan. MRI waxay ku caawin kartaa hore Dx.
  • Astaamaha dambe: burbur wadajir ah oo dhammaystiran iyo ankyloses
  • NB Septic arthritis-ku wuxuu si degdeg ah u horumari karaa maalmo gudahood wuxuuna u baahan yahay antibiyootik IV hore si looga hortago burbur weyn oo wadajir ah

T1 & T2 MRI jilibka

daryeelka xanuunka loo yaqaan 'chiropractic care' el paso tx.

 

  • T1 (korka bidix) iyo T2 dufan-sat sagittal jilibka MRI jeexjeexyada ayaa muujinaya luminta calaamadda dhuuxa caadiga ah ee T1 waxayna kordhisaa T2 sababtoo ah bararka septic. sequestrum lafaha d/t osteomyelitis oo u gudbaya septic arthritis-ka ayaa la xusay. Dhiigbax wadajir ah oo calaamadeysan oo leh bararka nudaha jilicsan ee ku xiga ayaa la arkaa. Dx: OSM iyo arthritis-ka septic
  • Sawirku wuxuu caawin karaa Dx ee wadajirka septic. Si kastaba ha ahaatee, Dx kama dambaysta ahi waxay ku salaysan tahay Hx, baadhis jidheed, baadhitaano dhiig iyo tan ugu muhiimsan ee hamiga synovial (arthrocentesis)
  • Dheecaannada synovial waa in loo diraa midabaynta Gram, dhaqanka, baaritaanka gulukooska, tirada leukocytes, iyo go'aaminta kala duwan
  • ESR/CRP waa la kordhin karaa
  • Dheecaannada synovial: WBC waxay noqon kartaa 50,000-60,000/ul, oo leh 80% neutrophils oo leh heerar gulukoos oo daciifay: 75% gram-positive cocci. Wasaaqaynta garaamku aad ayay ugu nugul tahay infekshanka gonococcal oo leh 25% oo keliya dhaqamada +
  • 9% kiisaska, dhaqamada dhiiga ayaa ah isha kaliya ee aqoonsiga cudur-sidaha waana in la helaa kahor daawaynta antibiyootiga
  • Articles: www.aafp.org/afp/2011/0915/p653.html
  • www.aafp.org/afp/2016/1115/p810.html

Arthritis jilibka oo ay keentay Crystal

  • Crystalline Arthritis: koox ka mid ah arthropathies oo ka dhashay dhigaalka crystal ee gudaha iyo hareeraha wadajirka.
  • 2-m/c: Monosodium urate crystals (MSU) � iyo Calcium Pyrofosfate kiristaalo (CPPD) arthropathy
  • Gout: Dhigista MSU gudaha iyo hareeraha kala-goysyada iyo unugyada jilicsan. Heerarka sare ee serum uric acid (UA) (>7mg/dL) oo ay sababto wax soo saarka xad-dhaafka ah ama dheecaanka uric acid
  • Marka UA gaadho/ dhaafto 7mg/dL, waxay ku shubi doontaa unugyada durugsan. Gout aasaasiga ah: dheef-shiid kiimikaad khalkhalka leh ee acids nucleic iyo purines ayaa burbura. Gout-ka sare: korodhka wareegga unugyada: Psoriasis, leukemia, multiple myeloma, hemolysis, chemotherapy, iwm.
  • Xididdada waxay soo bandhigtaa 5-dabeecadood:
  • 1) hyperuricemia asymptomatic (sanado/toban sano)
  • weerarrada ba'an ee gouty arthritis-ka (waxes iyo dhumucyada oo socda dhowr sano)
  • Wejiga u dhexeeya weerarrada
  • Gout korka daba-dheeraada
  • Gouty nephropathy
daryeelka xanuunka loo yaqaan 'chiropractic care' el paso tx.

 

Soo Bandhigida Caafimaadka

  • Waxay ku xiran tahay marxaladaha
  • Weeraro ba'an: xanuun kalagoysyo ah oo ba'an "marka hore iyo kan ugu xun" xitaa xanuun yar oo taabasho ah
  • DDx: kala-goysyada septic-ga (labadaba way wada jiri karaan) bursitis iwm.
  • Gouty arthritis-ku wuxuu caadi ahaan u soo bandhigaa sida monoarthropathy
  • Marxaladda sare ee daba-dheeraatay: kaydka kala goysyada, pinna dhegta, qaababka indhaha, iyo gobollada kale. Nephrolithiasis iwm. Ragga>haweenka. Cayilka, cuntada, iyo da'da> 50-60.
  • Shucaaca: Weerarrada hore waa kuwo aan la arki karin waxaana laga yaabaa inay soo baxaan sida dheecaan wadajir ah oo aan gaar ahayn
  • Raadyogaraafka kore ee kore ee raaga: la feeray nabaad-guurka wareega-articular, goo-goysyada iyo gudaha gudaha Cirifka sifada ah ee sclerosis iyo caleenta gudaha, tophi unug jilicsan. Goobaha bartilmaameedka ah: cirifka hoose m/c
  • Rx: allopurinol, colchicine (tus. ka hortagga xaaladaha degdega ah iyo dayactirka)

Hamiga Synovial

daryeelka xanuunka loo yaqaan 'chiropractic care' el paso tx.

 

  • Hamiga Synovial oo leh mikroskoob kala-sooc leh ayaa muujinaya kiristaalo Irbad u qaabaysan oo si xun u liidata oo leh PMN barar weyn. DDx: kiristaalo CPPD u qaabaysan oo si togan u birefringent (korka hoose ee midig) oo lagu arkay Pseudogout iyo CPPD
daryeelka xanuunka loo yaqaan 'chiropractic care' el paso tx.

 

ST

daryeelka xanuunka loo yaqaan 'chiropractic care' el paso tx.

 

  • Cufnaanta iyo dheecaanka wadajirka ah ayaa feeray nabaad-guurka laf-dhabarta leh oo leh xad-dhaaf xad-dhaaf ah, ilaalinta guud ee cufnaanta lafaha, Calcifications gudaha Dx: gout dusha sare ee dabadheeraad ah

Tilmaamaha Rooda MRI

daryeelka xanuunka loo yaqaan 'chiropractic care' el paso tx.

 

  • Nabaad-guurka oo leh xad-dhaaf xad-dhaaf ah, calaamad hoose oo T1 ah oo sarreeya T2 iyo sawirro dufan-xakamaysan. Kordhinta isbarbardhigga durugsan ee kaydadka dushooda d/t unugga granulation
  • Dx: final Dx; hamiga synovial iyo microscopy polarized

Maqaallo Dheeraad ah

Arthritis jilibka

 

Qiimaynta Bukaannada Soo Bandhigaya Xanuunka Jilibka: Qaybta II. Ogaanshaha Kala Duwanaanshaha

Qiimaynta Bukaannada Soo Bandhigaya Xanuunka Jilibka: Qaybta II. Ogaanshaha Kala Duwanaanshaha

by | Arthritis, Xanuunka lafaha, Cirrhaafka, Baaritaanka Daaweynta Duumada, Xanuun Chronic, Caafimaadka, Sawirka & Cilad-sheegista, Daryeelka Dhaawaca, Daraasaadka Cilmi-baarista, Tijaabada Baaritaanka, Dhaawacyada Isboortiga, Daaweyn, Wellness

Jilibku waa laf-dhabarta ugu weyn ee jidhka bini'aadamka, halkaasoo qaababka adag ee lugaha hoose iyo sare ay isu yimaadaan. Ka kooban saddex lafo, femur, tibia, iyo patella kuwaas oo ay ku hareeraysan yihiin unugyo jilicsan oo kala duwan, oo ay ku jiraan carjawda, seedaha iyo seedaha, jilibku wuxuu u shaqeeyaa sida jilbis, oo kuu ogolaanaya inaad socoto, boodboodo, fadhiiso ama fadhiiso. Natiijo ahaan, si kastaba ha ahaatee, jilibka ayaa loo tixgeliyaa inuu yahay mid ka mid ah kala-goysyada kuwaas oo u nugul inay soo gaaraan dhaawac. Dhaawaca jilibka ayaa ah sababta ugu badan xanuunka jilibka.

Dhaawaca jilibka wuxuu ku dhici karaa natiijada tooska ah ee ka timaadda shil-ku-dhac-iyo-dhac ama shil baabuur, dhaawac xad-dhaaf ah oo ka yimaada dhaawacyada isboortiga, ama xitaa xaaladaha hoose, sida arthritis-ka. Xanuunka jilibka waa calaamad caadi ah oo saamaysa dadka da 'kasta leh. Waxa kale oo laga yaabaa inay si lama filaan ah u bilaabato ama ay si tartiib tartiib ah u korodho wakhti ka dib, oo ka bilaabma raaxo fudud ama dhexdhexaad ah ka dibna si tartiib ah u sii xumaanaysa marka wakhtigu sii socdo. Waxaa intaa dheer, miisaankaaga xad dhaafka ah wuxuu kordhin karaa halista dhibaatooyinka jilibka. Ujeedada maqaalkan soo socda waa in laga doodo qiimeynta bukaanada soo bandhigaya xanuunka jilibka oo ay muujiyaan kala duwanaanshahooda.

aan la taaban karin

Xanuunka jilibka waa cabasho soo bandhigid caadi ah oo leh sababo badan oo suurtagal ah. Ka warqabka qaababka qaarkood ayaa ka caawin kara dhakhtarka qoyska inuu si hufan u garto sababta hoose. Gabdhaha da'da yar iyo haweenka da'da yar waxay u badan tahay inay yeeshaan dhibaatooyin dabagal ah sida patellar subluxation iyo patellofemoral pain syndrome, halka wiilasha da'da yar iyo ragga da'da yar ay u badan tahay inay yeeshaan dhibaatooyinka habka jilibka sida apophysitis tibial (Osgood-Schlatter lesion) iyo tendonitis patellar . Xanuunka loo soo jeediyo ee ka dhashay pathology-ga wadajirka sinta, sida raasumaalka femoral epiphysis oo simbiriirixsan, ayaa sidoo kale keeni kara xanuun jilibka ah. Bukaannada firfircoon waxay aad ugu dhow yihiin inay yeeshaan murgacashada laf-dhabarta ee degdega ah iyo dhaawacyada xad-dhaafka ah sida pes anserine bursitis iyo medial plica syndrome. Dhaawaca ayaa laga yaabaa inuu keeno dilaac ba'an ee ligamentous ama jab, taasoo keenta barar ba'an oo wadajir ah jilibka iyo hemarthrosis. Septic arthritis-ku waxa laga yaabaa inuu ku soo baxo bukaanada da' kasta, laakiin arthropathy bararka bararka ee crystal-ku wuxuu u badan yahay dadka waaweyn. Osteoarthritis ee wadajirka jilibka ayaa ku badan dadka waaweyn. (Am Fam Physician 2003; 68:917-22. Xuquuqda daabacaadda 2003 Akademiyada Maraykanka ee Dhakhaatiirta Qoyska.)

Hordhac

Go'aaminta sababta asaasiga ah ee xanuunka jilibka ayaa noqon karta mid adag, qayb ahaan sababtoo ah ogaanshaha kala duwanaansho ballaaran. Sida looga wada hadlay qaybta I ee maqaalkan labada qaybood ka kooban, 1 dhakhtarka qoysku waa inuu yaqaanaa anatomy jilibka iyo hababka caadiga ah ee dhaawaca, iyo taariikh faahfaahsan iyo baadhitaan jireed oo diirada lagu saaro waxay soo koobin kartaa sababaha suurtagalka ah. Da'da bukaanka iyo goobta anatomic ee xanuunka waa laba arrimood oo muhiim u noqon kara helitaanka ogaanshaha saxda ah (Shaxda 1 iyo 2). �

Shaxda 1. Sababaha Caadiga ah ee Xanuunka Jilibka

Caruurta iyo Dhallinta

Carruurta iyo dhalinyarada leh xanuunka jilibka waxay u badan tahay inay yeeshaan mid ka mid ah saddexda xaaladood ee caadiga ah: subluxation patellar, apophysitis tibial, ama tendonitis patellar. Cudurada dheeraadka ah ee lagu tixgeliyo carruurta waxaa ka mid ah epiphysis femoral femoral epiphysis oo simbiriirixan iyo septic arthritis-ka.

Subluxation Patellar

Patellar subluxation waa cilad-sheegidda ugu badan ee gabadh da'yar ah oo soo bandhigta qaybaha jilibka.

Cabsida patellar waxa ay keentaa in patella la hoos galiyo, iyo dheecaan khafiif ah ayaa inta badan jira. Dhexdhexaad ama barar daran oo jilibka ah ayaa laga yaabaa inuu muujiyo hemarthrosis, kaas oo soo jeedinaya kala-baxa patellar ee jabka lafaha iyo dhiig-baxa.

Tibial Apophysitis

Wiilka da'da yar ee soo bandhiga xanuunka jilibka hore ee ku yaal tuberosity tibial waxay u badan tahay inuu qabo tibial apophysitis ama Osgood-Schlatter lesion3,4 (Jaantus 1).5 Bukaan-socodka caadiga ah waa wiil 13- ama 14 jir ah (ama a 10- ama 11 jir) oo dhawaan soo martay korriin korriin ah.

Bukaan-socodka qaba tibial apophysitis guud ahaan wuxuu soo sheegaa dhumucyada iyo hoos u dhaca jilibka xanuunka muddo bilo ah. Xanuunku waxa uu ka sii daraa:-jilicsanaan, kor ama hoos jaranjarada, ama foosha xoogga ah ee muruqa quadriceps. Isticmaalka xad dhaafka ah ee apophysitis waxa uu ka sii darayaa boodboodka iyo carqaladaynta sababtoo ah soo noqnoqoshada adag ee soo noqnoqda waxay saaraysaa cadaadis xad dhaaf ah gelinta xuubka patellar.

Baaritaanka jireed, tuberosity tibial waa jilicsan yahay oo bararsan yahay waxaana laga yaabaa inay dareemaan diirimaad. Xanuunka jilibka waxaa lagu soo saaraa fidinta firfircoon ee la iska caabiyey ama jilibka dabacsanaan. Wax dheecaan ah ma jiro. Raadyagaraafka inta badan waa taban; dhif ah, waxay muujiyaan avulsion of apophysis at tuberosity tibial. Si kastaba ha ahaatee, dhakhtarku waa inuusan ku khaldin muuqaalka caadiga ah ee apophysis tibial ee jabka avulsion. �

Shaxda 2 Calaamadaha Kala Duwan ee Xanuunka Jilibka

Jaantuska 1 Aragtida Hore ee Qaab-dhismeedka Jilibka

Tendonitis Patellar

Jilibka boodboodka (cuncunka iyo bararka xuubka patellar) ayaa inta badan ku dhaca wiilasha da'da yar, gaar ahaan xilliga korriinka 2 (Jaantuska 1) . jaranjarada hoos loo dhigo ama orda.

Baaritaanka jireed, xuubka patellar waa jilicsan, xanuunkana waxaa soo saara fidinta jilibka oo iska caabiyay. Caadiyan ma jiro wax dheecaan ah. Sawir-qaadista lama tilmaamin.

Epiphysis caasimeedka Femoral ee sibban

Xaalado dhowr ah oo pathologic ah ayaa keena u gudbinta xanuunka jilibka. Tusaale ahaan, suurtogalnimada in uu simbiriirixdo epiphysis femoral femoral raasumaalka ah waa in lagu tixgeliyo carruurta iyo dhalinyarada qaba xanuunka jilibka.

Bukaan-socodka caadiga ah ee raasumaalka ee epiphysis femoral femoral simbiriirixan waa miisaan xad dhaaf ah oo ku fadhiista miiska baaritaanka iyadoo sinta ay saameysay xoogaa dabacsanaan tahay oo dibedda u rogan. Baaritaanka jilibka waa caadi, laakiin sinta xanuunka waxaa lagu soo koobaa wareegtada gudaha ah oo aan fiicneyn ama kordhinta sinta ay saameysay.

Sawir-qaadista ayaa caadi ahaan muujisa barokaca epiphysis ee madaxa femoral. Si kastaba ha ahaatee, shucaaca xun kama saarayso ogaanshaha bukaanada leh natiijooyinka caafimaad ee caadiga ah. Sawirka sawir-gacmeedka (CT) ee la xisaabiyay ayaa lagu muujiyay bukaannadan.

Osteochondritis Dissecans

Osteochondritis discsecans waa osteochondrosis intra-articular osteochondrosis aan la garanayn etiology kaas oo lagu garto hoos u dhaca iyo dib u xisaabinta carjawda articular iyo lafaha hoose. Jilibka, kondyowga femoral ee dhexdhexaadka ah ayaa inta badan saameeya.7

Bukaanku waxa uu ka warbixiyaa xanuunka jilibka oo aan caddayn, si liidata, iyo sidoo kale qallafsanaanta subaxda ama dareere soo noqnoqda. Haddii jir dabacsan uu jiro, calaamadaha farsamada ee xiritaanka ama qabashada wadajirka jilibka ayaa sidoo kale laga yaabaa in la soo sheego. Baaritaanka jireed, bukaanku wuxuu muujin karaa atrophy quadriceps ama jilicsanaanta dusha sare ee chondral. Waxaa laga yaabaa in dheecaan fudud uu jiro.7

Sawir-qaade-filim ah ayaa laga yaabaa inuu muujiyo dhaawaca osteochondral ama jirka dabacsan ee wadajirka jilibka. Haddii la tuhunsan yahay osteochondritis discecans, shucaaca lagu taliyay waxaa ka mid ah anteroposterior, tunnel-ka dambe, lateral, iyo aragtida ganacsatada. Nabarada lafo-osteochondral ee dhinaca dambe ee kondhilaha femoral ee dhexdhexaadka ah ayaa laga yaabaa in lagu arki karo oo keliya aragtida tunnel-ka dambe. Magnetic resonance imaging (MRI) ayaa aad xasaasi ugu ah ogaanshaha cilladahan waxaana lagu tilmaamaa bukaanada looga shakisan yahay dhaawaca lafo-osteochondral.7 �

Dr Jimenez White Coat

Dhaawac jilibka ah oo ay sababaan dhaawacyada isboortiga, shilalka baabuurta, ama xaalad hoose, oo ay ka mid yihiin sababaha kale, waxay saameyn karaan carjawda, seedaha iyo seedaha kuwaas oo sameysma wadajirka jilibka laftiisa. Goobta xanuunka jilibka way kala duwanaan kartaa iyadoo loo eegayo qaabka ku lug leh, sidoo kale, calaamaduhu way kala duwanaan karaan. Jilibka oo dhan ayaa laga yaabaa inuu xanuunsado oo bararo natiijada caabuqa ama caabuqa, halka meniscus jeexan ama jabku uu calaamado u keeni karo gobolka ay dhibaatadu saameysey. Dr. Alex Jimenez DC, CCST Insight

Dadka waaweyn

Isticmaalka xad dhaafka ah Syndrome

Xanuunka Jilibka Hore. Bukaanada qaba xanuunka 'patellofemoral pain syndrome' (chondromalacia patellae) waxay caadi ahaan la yimaadaan taariikh aan caddayn oo ah xanuunka jilibka hore ee khafiifka ah ama dhexdhexaadka ah kaas oo badanaa dhaca ka dib wakhti dheer oo fadhi ah (oo loo yaqaan 'calaamad masraxa)) . xanuunka jilibka hore ee haweenka.

Baaritaanka jireed, dheecaan yar ayaa laga yaabaa inuu jiro, oo ay la socoto patellar crepitus ee kala duwanaanshaha dhaqdhaqaaqa. Xanuunka bukaanka waxaa dib loo soo saari karaa iyadoo cadaadis toos ah la saarayo dhinaca hore ee patella. Dareenka patellar waxaa laga yaabaa in lagu soo saaro iyada oo hoos loo dhigayo patella dhexdhexaad ahaan ama gees ahaan iyo in la dareemo sare iyo wajiyada hoose ee patella. Sawirada sida caadiga ah lama tilmaamo.

Dhexdhexaadka Jilibka Xanuun. Mid ka mid ah ogaanshaha inta badan la iska indho tiro waa medial plica syndrome. plica, dib-u-celinta wadajirka ah ee isku-dhafka ah ee dhexdhexaadinta, waxay noqon kartaa mid barara oo si xad dhaaf ah loo isticmaalo. Marka la eego baaritaanka jireed, hindise, nodularity mobilada ayaa jooga dhinaca dhexe ee jilibka, oo ka soo hor jeeda khadka wadajirka ah. Ma jiro dheecaan wadajir ah, inta ka hartay baaritaanka jilibka waa caadi. Sawir-qaadista lama tilmaamin.

Pes anserine bursitis waa sabab kale oo suurtogal ah ee xanuunka jilibka ee dhexdhexaadka ah. Gelitaanka jilicsan ee murqaha sartorius, gracilis, iyo semitendinosus ee dhinaca anteromedial ee tibia u dhow waxay sameeyaan pes anserine bursa. Bursitis-ka 'pesanserine bursitis' wuxuu si fudud ugu khaldami karaa murgacashada seedaha dammaanadda dhexdhexaadka ah ama, inta badan, osteoarthritis ee qaybta dhexe ee jilibka. �

Bukaan-socodka qaba pes anserine bursitis wuxuu soo sheegaa xanuunka dhinaca dhexe ee jilibka. Xanuunkan waxaa laga yaabaa inuu ka sii daro dabacsanaan soo noqnoqda iyo kordhinta. Marka la eego baaritaanka jireed, jilicsanaanta ayaa ku jirta dhinaca dhexe ee jilibka, oo kaliya gadaal iyo fogaan xariiqda wadajirka ah ee dhexdhexaadka ah. Ma jiro wax dheecaan ah oo ka soo baxa jilibka, laakiin waxaa laga yaabaa in barar yar la geliyo murqaha murqaha dhexe. Baaritaanka cadaadiska Valgus ee booska dhabarka ama jilibka jilbaha ee booska u nugul ayaa soo celin kara xanuunka. Sawirada sida caadiga ah lama tilmaamo.

Xanuun Jilibka ah. Khilaafaadka xad dhaafka ah ee u dhexeeya bandowga iliotibial iyo kondyle femoral lateral waxay u horseedi kartaa iliotibial tendonitis.9 Cudurkan xad-dhaafka ah wuxuu caadi ahaan ku dhacaa orodyahannada iyo baaskiilleyda, inkastoo ay dhici karto in ay ku dhacdo qof kasta oo ka dambeeya dhaqdhaqaaqa ku lug leh jilbaha jilicsan ee soo noqnoqda. Cidhiidhiga kooxda iliotibial, cagaha xad-dhaafka ah ee cagaha, genu varum, iyo torsion tibial ayaa ah arrimo soo jeedinaya.

Bukaan-socodka qaba iliotibial tendonitis ayaa ka warbixiya xanuunka dhinaca dambe ee wadajirka jilibka. Xanuunka waxaa sii xumeeya dhaq-dhaqaaqa, gaar ahaan hoos u orda iyo jaranjarada la fuulo. Baaritaanka jireed, jilicsanaanta ayaa ku jirta epicondyle lateral ee femur, qiyaastii 3 cm oo u dhow xariiqda wadajirka ah. Bararka jilicsan ee nudaha jilicsan iyo dhaleeceynta ayaa sidoo kale laga yaabaa inay jiraan, laakiin ma jiro dheecaan wadajir ah. Sawir-qaadista lama tilmaamin.

Tijaabada Nobles waxaa loo isticmaalaa in lagu soo saaro xanuunka iliotibial band tendonitis. Isagoo bukaanku ku jiro meel dhabarka ah, dhakhtarku wuxuu suulka saarayaa suulka dambe ee epicondyle femoral maadaama bukaanku si isdaba joog ah u jilicsan yahay oo uu u fidinayo jilibka. Calaamadaha xanuunka ayaa inta badan caan ku ah jilibka oo ah 30 darajo dabacsanaan.

Cudurka 'Politeus tendonitis' waa sabab kale oo suurtagal ah oo ah xanuunka jilibka. Si kastaba ha ahaatee, xaaladdan waa dhif.10

Qaxarka

Murugada hore ee Cruciate. Dhaawaca seedaha hore ee cruciate wuxuu caadi ahaan u dhacaa sababtoo ah xoog-dejinta aan la xiriirin, sida marka orodyahanku beero hal cag oo si fiican ugu leexdo jihada ka soo horjeeda. Cadaadiska valgus-ka ee ka dhashay jilibka wuxuu keenaa barokaca hore ee tibia iyo murgacasho ama dillaaca seedaha. Bararka jilibka laba saacadood gudahood ka dib dhaawaca ayaa tilmaamaya dillaaca seedaha iyo natiijada hemarthrosis.

Baaritaanka jireed, bukaanku wuxuu leeyahay dheecaan wadajir ah oo dhexdhexaad ah ama daran kaas oo xaddidaya xajmiga dhaqdhaqaaqa. Tijaabada khaanadaha hore waxa laga yaabaa inay togan tahay, laakiin waxay noqon kartaa mid taban sababtoo ah hemarthrosis iyo ilaalinta muruqyada muruqa. Tijaabada Lachman waa in ay noqotaa mid togan oo aad looga kalsoonaan karo marka loo eego imtixaanka khaanadaha hore (eeg qoraalka iyo sawirka 3 ee qaybta I ee maqaalka1).

Sawir-qaadista ayaa la tilmaamayaa si loo ogaado jabka laf dhabarta tibia ee suurtogalka ah. MRI ee jilibka ayaa lagu tilmaamay qayb ka mid ah qiimeynta qalliinka.

Murugada Xidhiidhka Dhexdhexaadka ah. Dhaawaca seedaha dammaanadda dhexdhexaadka ah waa caadi oo badanaa waa natiijada dhaawaca ba'an. Bukaanku waxa uu soo sheegaa talaabadii khaldanayd ama isku dhaca kaas oo dhigaya cadaadiska valgus jilibka, oo ay ku xigto xanuun iyo barar isla markiiba ah dhinaca dhexe ee jilibka.11

Marka la eego baaritaanka jireed, bukaanka qaba dhaawaca laf-dhabarka dhexdhexaadka ah ayaa leh jilicsanaan dhibicda xariiqda wadajirka ah. Baaritaanka cadaadiska Valgus ee jilibka oo u leexday 30 darajo ayaa soo saara xanuunka (eeg qoraalka iyo sawirka 4 ee qaybta I ee maqaalkan1). Barta ugu dambeysa ee si cad loo qeexay ee baaritaanka cadaadiska valgus waxay muujineysaa murgacasho fasalka 1 ama 2, halka xasilooni darida dhexdhexaadka ah oo dhameystiran ay muujineyso dillaac buuxa ee seedaha (murgacashada darajada 3).

Murgacashada Xiddigga Dammaanadda dambe. Dhaawaca seedaha dammaanadda dambe aad ayuu uga yar yahay dhaawaca seedaha dammaanadda dhexe. Murgacashada seedaha dammaanadda dambe waxay inta badan ka timaadaa cadaadiska varus ilaa jilibka, sida ay dhacdaa marka orodyahanku uu beero hal cag ka dibna u leexdo jilibka ipsilateral.

Marka la eego baaritaanka jirka, jilicsanaanta dhibcaha ayaa ku jirta xariiqda wadajirka ah ee dambe. Degenaansho la'aan ama xanuunku waxay ku dhacdaa baaritaanka cadaadiska varus ee jilibka oo u leexday 30 darajo (eeg qoraalka iyo sawirka 4 ee qaybta I ee maqaalkan1). Sawir-qaadista inta badan lama tilmaamo.

Jeexitaanka Meniscal Meniscus waxaa si ba'an loo jeexjeexi karaa dhaawac lama filaan ah oo jilibka ah, sida laga yaabo inuu dhaco marka orodyahanku si lama filaan ah u beddelo jihada. jilibka seedaha-yar. Bukaanku wuxuu inta badan ka warbixiyaa xanuunka jilibka ee soo noqnoqda iyo dhacdooyinka qabashada ama qufulka wadajirka jilibka, gaar ahaan jilbaha ama leexinta jilibka.

Marka la eego baaritaanka jireed, dheecaan khafiif ah ayaa inta badan jira, waxaana jira jilicsanaan dhexdhexaad ah ama xariiqda wadajirka ah. Atrophy ee vastus medialis obliquus qaybta muruqa quadriceps ayaa sidoo kale laga yaabaa in la dareemo. Imtixaanka McMurray waxa uu noqon karaa mid togan (fiiri sawirka 5 ee qaybta I ee maqaalkan1), laakiin tijaabada taban ma baabi'inayso suurtogalnimada jeexjeexa meniscal.

Raad-garaafyada filimada sida caadiga ah waa taban oo marar dhif ah ayaa la tilmaamaa. MRI waa baaritaanka shucaaca ee doorashada sababtoo ah waxay muujinaysaa ilmada meniscal ee ugu muhiimsan.

Caabuqa

Caabuqa wadajirka jilibka ayaa laga yaabaa inuu ku dhaco bukaanka da' kasta, laakiin wuxuu ku badan yahay kuwa habka difaaca jirkooda uu wiiqay kansar, sonkorowga mellitus, khamriga, cilladda difaaca jirka, ama daaweynta corticosteroid. Bukaan-socodka qaba septic arthritis-ku wuxuu soo sheegaa xanuun degdeg ah iyo barar jilibka ah oo aan lahayn wax dhaawac ah oo hore u soo baxay.13

Baaritaanka jireed, jilibku waa diirimaad, barar, iyo jilicsanaan jilicsan. Xitaa dhaqdhaqaaqa yar ee wadajirka jilibka wuxuu keenaa xanuun daran.

Arthrocentesis waxay muujinaysaa dareeraha synovial turbid. Falanqaynta dareeraha waxay soo saartaa tirada unugyada dhiigga cad (WBC) oo ka sarreeya 50,000 halkii mm3 (50? 109 per L), oo leh in ka badan 75 boqolkiiba (0.75) unugyada polymorphonuclear, borotiinka sare leh (ka weyn 3 g per dL [30) g per L]), iyo fiirsashada gulukooska oo yar (in ka badan 50 boqolkiiba ka hooseysa fiirsashada gulukooska serum). Cudurrada caadiga ah waxaa ka mid ah Staphylococcus aureus, noocyada Streptococcus, Haemophilus influenza, iyo Neisseria jabtoeae.

Cilmi-baadhisyada dhiig-baxa ayaa muujinaya WBC-da sare, tirada korodhay ee unugyada polymorphonuclear-ka ee aan qaan-gaarin (ie, isbeddelka bidix), iyo heerka sedimentation erythrocyte oo sarreeya (badanaa in ka badan 50 mm saacaddii).

Dadka waaweyn ee waawayn

Osteoarthritis

Osteoarthritis ee wadajirka jilibka waa dhibaato caadi ah ka dib da'da 60 sano. Bukaanku wuxuu soo bandhigayaa xanuun jilibka ah oo ay sii xumeeyaan waxqabadyada culeyska iyo nasashada. Marka lagu daro qallafsanaanta joogtada ah iyo xanuunka, bukaanku wuxuu soo sheegi karaa dhacdooyinka synovitis ba'an.

Natiijooyinka baaritaanka jireed waxaa ka mid ah dhaqdhaqaaqa dhaqdhaqaaqa oo yaraada, crepitus, dheecaan fudud oo wadajir ah, iyo isbeddellada lafaha lafaha ee lafaha jilibka.

Marka la tuhunsan yahay xanuunka lafo-arthritis, shucaaca lagu taliyay waxaa ka mid ah aragtiyaha anteroposterior-ka-xameeya iyo tunnel-ka dambe, iyo sidoo kale baayacmushtar aan miisaan lahayn iyo aragtiyo dambe. Raadyagaraafka ayaa muujinaya cidhiidhi-goysyada-meel-goysyada, sclerosis-hoosaadka lafaha, isbeddellada cystic, iyo samaynta hypertrophic osteophyte.

Lafo-xannuunka bararka ee Crystal-Induced

Caabuqa ba'an, xanuunka, iyo bararka maqnaanshaha dhaawacyada waxay soo jeedinayaan suurtogalnimada infakshanka xinjirowga bararka ee crystal-induced sida gout ama pseudogout.16,17 Gout wuxuu caadi ahaan saameeyaa jilibka. Cudurka arthropathy-ga, kiristaalo urate sodium ayaa ku soo daada wadajirka jilibka waxayna keenaan jawaab celin barar ah. Pseudogout, kalsiyum pyrophosphate crystals waa wakiilada sababaha.

Baaritaanka jireed, wadajirka jilibka waa erythematous, diiran, jilicsan, iyo barar. Xataa dhaqdhaqaaqa ugu yar ee dhaqdhaqaaqa aad buu u xanuunsadaa.

Arthrocentesis wuxuu daaha ka qaadaa dareeraha synovial oo cad ama waxoogaa daruur ah. Falanqaynta dareeraha waxay soo saartaa tirada WBC ee 2,000 ilaa 75,000 halkii mm3 (2 ilaa 75? 109 per L), borotiinno sare (in ka badan 32 g dL) 320 boqolkiiba fiirsashada gulukooska serum.75 Microscope-ka-iftiin ee dareeraha synovial wuxuu muujinayaa ulaha birefringent taban ee bukaanka qaba gout iyo rhomboid togan oo birefringent ah bukaanka pseudogout.

Cyst Popliteal

cyst popliteal (Baker's cyst) waa cystka ugu caansan jilibka. Waxay ka timaadaa dhinaca dambe ee isgoysyada jilibka ee heerka gastrocnemio-semimembranous bursa. Bukaanku wuxuu ka warbixiyaa bilawga aan fiicneyn ee xanuunka fudud ilaa dhexdhexaad ee aagga popliteal ee jilibka.

Marka la eego baaritaanka jireed, buuxnaanta la dareemi karo ayaa ku jirta dhinaca dhexe ee aagga popliteal, ama meel u dhow asalka madaxa dhexe ee muruqa gastrocnemius. Tijaabada McMurray waxa laga yaabaa inay togan tahay haddii meniscus-ka dhexe uu dhaawacmo. Cilad qeexan oo ah cyst popliteal waxaa lagu samayn karaa arthrography, ultrasonography, CT scanning, ama, inta badan, MRI.

Qorayaashu waxay muujinayaan inaysan lahayn wax iskahorimaadyo ah oo dano ah. Ilaha maalgelinta: midna lama sheegin.

Gabagabadii, inkasta oo jilibku yahay laf-dhabarta ugu weyn ee jidhka bini'aadamka halkaasoo qaababka cirifka hoose ay ku kulmaan, oo ay ku jiraan femur, tibia, patella, iyo unugyo kale oo badan oo jilicsan, jilibka ayaa si fudud u soo gaari kara dhaawac ama dhaawac iyo natiijada. jilbo xanuun. Xanuunka jilibka waa mid ka mid ah cabashooyinka ugu badan ee dadweynaha guud, si kastaba ha ahaatee, waxay caadi ahaan ku dhacdaa ciyaartoyda. Dhaawacyada ciyaaraha, shilalka silbashada iyo dhaca, iyo shilalka baabuurta, iyo sababaha kale, waxay u horseedi karaan xanuun jilibka ah.

Sida lagu qeexay maqaalka kore, ogaanshaha ayaa lagama maarmaan u ah go'aaminta habka daaweynta ugu fiican ee nooc kasta oo dhaawac jilibka ah, marka loo eego sababta asaasiga ah. Iyadoo meesha iyo darnaanta dhaawaca jilibka ay kala duwanaan karaan iyadoo ku xiran sababta arrinta caafimaadka, xanuunka jilibka ayaa ah calaamadda ugu caansan. Ikhtiyaarada daawaynta, sida daryeelka xanuunka loo yaqaan 'chiropractic care' iyo daawaynta jireed, ayaa kaa caawin karta daawaynta xanuunka jilibka. Baaxadda macluumaadkayadu waxay ku kooban tahay xanuunka loo yaqaan 'chiropractic' iyo arrimaha caafimaadka laf dhabarta. Si aad ugala hadasho mawduuca, fadlan xor u noqo inaad waydiiso Dr. Jimenez ama nagala soo xidhiidh at�915-850-0900 .

Waxaa diyaariyay Dr. Alex Jimenez�

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Mawduuc Dheeraad ah oo Wadahadal ah: Nasinta Jilibka Xanuunka Qalliin la'aan

Xanuunka jilibka waa calaamad caan ah oo ku dhici karta dhaawacyo jilibka ah iyo/ama xaalado kala duwan, oo ay ku jiraandhaawacyada isboortiga. Jilibku waa mid ka mid ah kala-goysyada ugu adag ee jidhka bini'aadamka maadaama uu ka kooban yahay isgoysyada afar lafo, afar seediyo, seedooyin kala duwan, laba menisci, iyo carjawda. Sida laga soo xigtay Akademiyada Maraykanka ee Dhakhaatiirta Qoyska, sababaha ugu badan ee xanuunka jilibka waxaa ka mid ah subluxation patellar, patellar tendinitis ama jilibka jumper, iyo cudurka Osgood-Schlatter. Inkasta oo xanuunka jilibka ay u badan tahay inuu ku dhaco dadka ka weyn 60 sano, xanuunka jilibka wuxuu sidoo kale ku dhici karaa carruurta iyo dhalinyarada. Xanuunka jilibka waxaa lagu daweyn karaa guriga iyadoo la raacayo hababka RICE, si kastaba ha ahaatee, dhaawacyada daran ee jilibka ayaa laga yaabaa inay u baahdaan daryeel caafimaad oo degdeg ah, oo ay ku jiraan daryeelka xanuunka loo yaqaan 'chiropractic care'.

sawirka blog ee wiil warqad kartoon ah

DHEERAAD AH | Mawduuca MUHIIMKA AH: El Paso, TX Chiropractor ayaa lagu taliyay

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tixraacyada
1. Calmbach WL, Hutchens M. Qiimaynta bukaanada soo bandhiga xanuunka jilibka: qaybta I. Taariikhda, baadhitaanka jireed, shucaaca, iyo shaybaadhka. Am Fam Physician 2003;68:907-12.
2. Walsh WM. Dhaawaca jilibka. Gudaha: Mellion MB, Walsh WM, Shelton GL, eds. Buug-gacmeedka dhakhtarka kooxda. 2d ed. St. Louis: Mosby, 1990: 554-78.
3. Dunn JF. Cudurka Osgood-Schlatter. Am Fam Dhakhtar 1990;41:173-6.
4. Stanitski CL. Xanuunada xanuunka jilibka ee hore ee dhalinyarada. Casharka Casharka 1994;43:211-20.
5. Tandeter HB, Shvartzman P, Stevens MA. Dhaawacyada jilibka ee ba'an: isticmaalka qawaaniinta go'aanka ee dalbashada shucaaca xulashada. Am Fam Physician 1999;60: 2599-608.
6. Biyaha PM, Millis MB. Dhaawaca miskaha iyo miskaha ee ciyaartoyda da'da yar. Gudaha: DeLee J, Drez D, Stanitski CL, ed. Daawooyinka isboortiga ee Orthopedic: mabaadi'da iyo dhaqanka. Vol. III. Daawooyinka ciyaaraha carruurta iyo dhalinyarada. Philadelphia: Saunders, 1994: 279-93.
7. Schenck RC Jr, Goodnight JM. Osteochondritis discs. J Lafo Joint Surg [Am] 1996;78:439-56.
8. Ruffin MT 5th, Kiningham RB. Xanuunka jilibka ee hore: caqabada xanuunka patellofemoral syndrome. Am Fam Physician 1993;47:185-94.
9. Cox JS, Blanda JB. Cudurrada Peripatellar. Gudaha: DeLee J, Drez D, Stanitski CL, ed. Daawooyinka isboortiga ee Orthopedic: mabaadi'da iyo dhaqanka. Vol. III. Daawooyinka ciyaaraha carruurta iyo dhalinyarada. Philadel-phia: Saunders, 1994:1249-60.
10. Petsche TS, Selesnick FH. Popliteus tendinitis: Talooyin ku saabsan ogaanshaha iyo maaraynta. Phys Sportsmed 2002; 30 (8): 27-31.
11. Micheli LJ, Foster TE. Dhaawacyo ba'an oo jilibka ah oo soo gaaray ciyaartooyga aan qaan-gaarin. Casharkii Casharkii 1993;42:473-80.
12. Smith BW, Green GA. Dhaawaca jilibka ba'an: qaybta II. ogaanshaha iyo maaraynta. Am Fam Physician 1995;51:799-806.
13. McCune WJ, Golbus J. Monarticular arthritis. Ku: Kelley WN, ed. Buug-yareedka rheumatology. Qormada 5aad. Philadelphia: Saunders, 1997: 371-80.
14. Franks AG Jr. Dhinacyada Rheumatologic ee xanuunka jilibka. Ku: Scott WN, ed. Jilibka. St. Louis: Mosby, 1994: 315-29.
15. Brandt KD. Maareynta osteoarthritis. Ku: Kel-ley WN, ed. Buug-yareedka rheumatology. Qormada 5aad. Philadelphia: Saunders, 1997: 1394-403.
16. Kelley WN, Wortmann RL. Synovitis-ka-xiriirka Crystal. Ku: Kelley WN, ed. Buug-yareedka rheumatol-ogy. Qormada 5aad. Philadelphia: Saunders, 1997:1313- 51. 1
7. Reginato AJ, Reginato AM. Cudurada la xidhiidha kaydinta calcium pyrophosphate ama hy-droksyapatite. Ku: Kelley WN, ed. Buug-yareedka rheumatology. Qormada 5aad. Philadelphia: Saunders, 1997: 1352-67.
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Arthritis-ka Jilibka: Qaababka Sawirka ogaanshaha I | El Paso, TX.

Arthritis-ka Jilibka: Qaababka Sawirka ogaanshaha I | El Paso, TX.

by | Arthritis, Sawirka & Cilad-sheegista

Arthritis jilibka oo xumaada

  • Arthritis jilibka
  • Jilibka OA (arthrosis) waa m/c calaamada OA oo leh 240 xaaladood 100,000kiiba, 12.5% ​​dadka>45 yo
  • Waxyaalaha khatarta ah ee wax laga beddeli karo: dhaawac, cayil, taam ahaansho la'aan, daciifnimo muruqa
  • Aan la beddeli karin: dumarka>ragga, gabowga, hidde-sideyaasha, jinsiyadda/qowmiyad
  • Pathology: waa cudur ku dhaca carjawda articular. Kicinta farsamada oo sii socota waxa ay daba socotaa korodhka bilowga ah ee biyaha iyo dhumucda carjawda. Si tartiib tartiib ah u lumin borotiinka iyo walxaha dhulka. Feedhsanid/kala qaybsanaan. Chondrocytes waa ay dhaawacmaan waxayna ku sii daayaan enzymes gudaha wadajirka. Horumarka cystic iyo luminta carjawda oo dheeraad ah. Lafaha subchondral waa la demi oo waxay la kulmaan cadaadisyo farsamo. Waxay noqotaa hypervascular samaynta osteophytes. Fiix-hoosaadka hoose iyo dhumucda lafaha/sclerosis ayaa kobca.
  • Sawirku waxa uu door muhiim ah ka ciyaaraa Dx/gradeynta iyo maamulka
  • Caafimaad ahaan: xanuun socodka/nasasho, crepitus, barar d/t synovitis, quful/qabsashada d/t jajabyada osseocartilaginous iyo luminta tartiib tartiib ah. Jilibka OA wuxuu caadi ahaan u soo bandhigaa mono iyo oligoarthritis. DDx: xanuunka subaxdii/ qallafsanaanta waa>30-daqiiqo DDx oo ka yimi arthritis-ka bararka
  • Daawaynta: xaalad dhexdhexaad ah ama dhexdhexaad ah-daryeel muxaafid ah. Ba'an OA-wadarta arthroplasty jilibka

OA: KHASAARE soo jeedinta shucaaca

daryeelka xanuunka loo yaqaan 'chiropractic care' el paso tx.

 

  • Soo bandhigida shucaaca-caafimaadka caadiga ah ee OA: lumin
  • Luminta meel bannaan oo wadajir ah (aan ahayn labiska/simmetrical)
  • Osteophytes
  • Subchondral sclerosis
  • Fiix subchondral
  • Deformity lafaha: Genu Varum- waa qallooca m/c d/t qaybta dhexe ee jilibka oo aad u saamaysay
  • Intaa waxaa dheer: daciifinta unugyada jilicsan ee periarticular, xasillooni darro iyo isbeddello kale

sawirka

daryeelka xanuunka loo yaqaan 'chiropractic care' el paso tx.

 

  • Radiography waa habka doorashada
  • Muuqaallada waa inay ku jiraan b/l miisaan
  • Qiimaynta booska wadajirka ah waa muhiim. Meesha wadajirka ah ee caadiga ah -3-mm
  • Qiimayntu waxay ku salaysan tahay heerka cidhiidhiga booska wadajirka ah (JSN), osteophytes, qallafsanaanta lafaha, iwm.
  • Fasalka 1: ugu yar JSN, osteophytes laga shakiyo
  • Fasalka 2: osteophytes la mahadiyo iyo JSN ee aragtida miisaan-qaadista AP
  • Fasalka 3: osteophytes badan, qeexan JSN, subchondral sclerosis
  • Fasalka 4: JSN aad u daran, osteophytes waaweyn, sclerosis subchondral calaamadeysan iyo qallafsanaan lafo oo qeexan
  • Luuqada warbixinta ee caadiga ah ayaa sheegi doonta:
  • Yar, khafiif, dhexdhexaad ah ama daran aka arthrosis horumarsan

Technique

daryeelka xanuunka loo yaqaan 'chiropractic care' el paso tx.

 

  • Radiography: AP miisaanka jilbaha: u fiirso JSN daran ee qaybta dhexe oo aad u daran oo leh jilibka dambe. Osteophytes iyo qallafsanaanta genu varum iyo qallafsanaanta lafaha
  • Caadi ahaan qaybta dhexe ee femorotibial waxay u saamaysaa goor hore oo aad u daran
  • Qaybta patellofemoral sidoo kale waa la saameeyaa oo sida ugu fiican ayaa loo arki karaa dhinaca dambe iyo aragtida Qorraxdu
  • Aragtiyo: arthrosis jilibka saddex-qaybood oo daran
  • Talooyin: u gudbinta dhakhtarka lafaha

JSN dhexdhexaad ah

daryeelka xanuunka loo yaqaan 'chiropractic care' el paso tx.

 

  • Miisaanka B/L AP (sawirka sare ee sare): Dhexdhexaad JSN ugu horrayn ee qaybta femorotibial dhexdhexaad ah. Osteophytosis, sclerosis subchondral iyo qallafsanaan lafo khafiif ah (genu varum)
  • Tilmaamo dheeraad ah: PF OA, osteophytes intra articular, jidhka dabacsan osteocartilaginous sare iyo cysts subchondral (korka fallaadho)

Osteochondromatosis labaad

daryeelka xanuunka loo yaqaan 'chiropractic care' el paso tx.

 

  • Jidhka dabacsan ee laf-dhabarka osteocartilaginous loo yaqaan osteochondromatosis sare
  • Caadi ahaan DJD gaar ahaan kala-goysyada waaweyn
  • Waxa laga yaabaa inay soo dedejiso burburinta carjawda oo dheeraad ah iyo horumarka OA
  • Waxay ka sii dari kartaa calaamadaha synovitis
  • Xiritaanka gudaha articular, qabashada iwm.

Maareynta Jilibka Daran ee OA

daryeelka xanuunka loo yaqaan 'chiropractic care' el paso tx.

 

  • Daryeelka konserfatifka: NSAID, jimicsi, miisaan lumis iwm.
  • Daryeelka qalliinka waa in la isticmaalo haddii daryeelka muxaafidka ahi guuldareysto ama calaamaduhu horumaraan inkastoo dadaallada muxaafidka ah ee xaaladaha daran OA
  • Dib u eeg maqaal
  • www.aafp.org/afp/2018/0415/p523.html

Calcium Pyrophosphate Fuuqbax Cudur Dhigista

daryeelka xanuunka loo yaqaan 'chiropractic care' el paso tx.

 

  • CPPD arthropathy oo ku badan jilibka
  • Waxaa laga yaabaa inay u soo baxdo asymptomatic chondrocalcinosis, CPPD arthropathy oo u eg DJD oo ay ku badan tahay fiix-hoosaadka hoose ee waaweyn. Badanaa waxaa loo helaa sidii go'doon PFJ DJD
  • Pseudogout oo leh weerar degdeg ah oo xanuun jilibka ah oo u eg gouty arthritis
  • Radiography waa tallaabada 1aad oo inta badan muujisa Dx
  • Arthrocentesis oo leh mikroskoob kala-sooc leh ayaa laga yaabaa inay ku caawiso DDx inta u dhaxaysa CPPD iyo Gouty arthritis

Arthritis rheumatoid

  • RA: cudur bararka habdhiska difaaca jirka oo bartilmaameedsada unugyada jilicsan ee kala-goysyada synovium, seedaha / seedaha, bursiyada iyo goobaha ka baxsan articular (tusaale, indhaha, sambabada, habka wadnaha)
  • RA waa m/c bararka arthritis-ka, 3% dumarka iyo 1% ragga. Da'da: 30-50 F>M 3: 1, laakiin waxa laga yaabaa inay koraan da' kasta. Runta RA waa wax aan caadi ahayn carruurta waana in aan lagu khaldin xanuunka Arthritis-ka ee Juvenile Idiopathic Arthritis
  • RA waxay inta badan ku dhacdaa kala-goysyada gacmaha iyo cagaha sida simmetrical arthritis-ku (2aad 3aad MCP, 3aad PIPs, curcurada & MTP-yada, ilaalinta DIP ee faraha iyo suulasha)
  • Shucaac ahaan: RA waxay soo bandhigtaa dheecaan wadajir ah oo keena hyperemia iyo nabaad-guurka hoose iyo lafo-beelka periarticular. Jilibka, qaybta dambe ayaa si joogto ah u saamaysa taasoo keenta qallafsanaanta valgus. Labbiska aka concentric/symmetrical JSN ayaa saameeya dhammaan qaybaha oo weli ah tilmaanta muhiimka ah ee Dx
  • Maqnaanshaha sclerosis subchondral iyo osteophytes. cyst Popliteal (Baker's cyst) waxaa laga yaabaa inay matasho synovial pannus iyo synovitis bararka oo ku fidsan gobolka popliteal kaas oo laga yaabo inuu kordho oo u fido qaybta dambe ee lugta.
  • NB Ka dib burburinta wadajirka ah ee bilawga ah, maahan wax aan caadi ahayn in la ogaado 2nd OA ee la kor-saaray
  • Shucaaca waa tallaabada 1-aad laakiin ka-qaybgalka hore ee wadajirka ah ayaa laga yaabaa in aan lagu ogaan karin raajo waxaana caawin kara Maraykanka iyo/ama MRI.
  • Tijaabada shaybaadhka: RF, CRP, unugyada difaaca jirka ee citrulline peptide anti-cyclic (anti-CCP Ab). CBC
  • Final Dx waxay ku salaysan tahay Hx, baadhis caafimaad, shaybaadhka, iyo shucaaca
  • Luul bukaan-socod: Bukaannada qaba RA waxay la imaan karaan hal jilib oo saameeya
  • Bukaanjiifka badankoodu waxay u badan tahay inay yeeshaan gacma/cagaha simmetrical laba geesood ah.
  • Laf-dhabarta ilmo-galeenka, gaar ahaan C1-2 waxay saamaysaa 75-90% kiisaska inta lagu jiro muddada cudurka.
  • NB Xanuunka degdega ah ee xanuunka wadajirka ah ee RA waa in aan la dhayalsanin septic arthritis-ka sababtoo ah bukaanada qaba RA-da hore waxay halis sare ugu jiraan arthritis-ka faafa. Hamiga wadajirka ah ayaa laga yaabaa inuu ku caawiyo Dx.

Radiographic DDx

daryeelka xanuunka loo yaqaan 'chiropractic care' el paso tx.

 

  • RA (korka bidix) vs. OA (korka midig)
  • RA: isku duubni (labis) luminta booska wadajirka ah, la'aanta osteophytes iyo osteopenia juxta-articular.
  • Pearls Clinical: Bukaanada qaba RA waxaa laga yaabaa inay si shucaac ah u soo bandhigaan sclerosis d/t subchondral sclerosis d/t superimposed DJD. Sifada dambe waa inaan loo fasirin OA balse taa beddelkeeda loo tixgeliyo inay tahay OA sare

AP Jilibka Radiograph

daryeelka xanuunka loo yaqaan 'chiropractic care' el paso tx.

 

  • Xusuusnow labbiska JSN ee calaamadeysan, osteopenia juxta-articular iyo isbeddellada cystic subchondral
  • Pearls Clinical: Fiixs-kortikal-hoosaadka ee RA waxay sifo ahaan ka maqnaan doonaan cirifka sclerotic ee lagu xusay fiix-kortikal-hoosaadka OA-da.

Dareenka MRI

daryeelka xanuunka loo yaqaan 'chiropractic care' el paso tx.

 

  • MRI waa mid xasaasi ah waxaana laga yaabaa inay ku caawiso xilliga hore ee Dx ee RA.
  • T2 fat-sat ama STIR iyo T1 + C gad isbarbardhigga taxanaha dufan-xakamaynta ayaa laga yaabaa in lagu daro.
  • MRI Dx of RA: bararka / dheecaanka synovial, hyperplasia synovial, iyo samaynta pannus waxay hoos u dhigtay dhumucda carjawda, cysts subchondral, iyo nabaad-guurka lafaha
  • MRI aad bay u xasaasi u tahay inay muujiso bararka dhuuxa laf dhabarta, horudhac u ah nabaad-guurka
  • Qaybaha fibrinoid ee articular ee loo yaqaan "Jidhka Bariiska" waa calaamada MR ee RA.
  • Fiiro gaar ah: T2 dufan-sat sagittal MRI oo muujinaya qulqulka wadajirka ah ee bararka iyo fidinta pannus synovial (korka sare ee fallaadhaha). Ma jiraan wax caddaynaya nabaad guurka lafaha shucaaca ama MRI. Dx: RA

STIR MR qaybo

daryeelka xanuunka loo yaqaan 'chiropractic care' el paso tx.

 

  • Fiiro gaar ah: Xaleefyada STIR MR ee axial (ka sarreeya sawirka hoose) iyo diyaaradaha wadnaha (ka sarreeya sawirka sare) waxay muujinayaan synovitis/effusion ballaaran (korka sare ee madaxyada) iyo nabaad-guuryo badan oo ku yaal saxanka tibial-ka ee dhexdhexaadka ah iyo kan dambe (sare ee fallaadhaha)
  • Intaa waxaa dheer, meelaha bararka dhuuxa ee kala firidhsan ee bararka dhuuxa lafta ayaa lagu xusay (korka xiddigiska) isbeddellada bararka dhuuxa ayaa tilmaamaya oo saadaaliya nabaadguurka lafaha mustaqbalka.
  • Sifooyin dheeri ah: dhuuban dhuuban iyo burburinta carjawda wadajirka ah

Arthritis jilibka

 

Cabashada Jilibka: Habka Sawirka ogaanshaha & Neoplasms

Cabashada Jilibka: Habka Sawirka ogaanshaha & Neoplasms

by | Sawirka & Cilad-sheegista, Dhaqdhaqaaqa & Dabacsanaanta

Lafaha Neoplasms Buro-Sida Xaaladaha

  • Neoplasms laf-dhabarta iyo xaaladaha burooyinka u eg ee saameeya jilibka waxay noqon kartaa benign ama malignant. Da'da Dx waxay muhiim u tahay DDx
  • Bukaannada <40: Neoplasms lafaha aan fiicnayn: Osteochondroma, Enchondroma waa kuwo soo noqnoqda
  • Ciladda kortikal fiiqan (FCD) iyo fibroma aan-ossifying fibroma (NOF) ayaa si gaar ah ugu badan carruurta
  • Burada unugga Giant (GCT) waa neoplasm benign neoplasm ee jilibka ee bukaanada u dhexeeya 20-40 sano
  • Neoplasms lafaha xun ee <40: m/c Osteosarcoma iyo 2nd m/c Ewing sarcoma
  • Bukaanka> 40: neoplasms malignant: m / c waa kuwa labaad ee d/t metastasis lafaha. Xumaanta lafaha aasaasiga ah:�m/c
  • Multiple Myeloma (MM). In ka yar:�A 2aad ee ugu sarreysa Osteosarcoma (radiation post ama Paget�s), Fibrosarcoma ama Malignant�Fibrous�Histiocytoma(MFH) ee lafaha
  • Kiliinik ahaan: xanuun jilibka ah, jabka cudurada
  • Qaar ka mid ah xaaladaha buro-u-eg sida FCD/Fibroma aan-ossifying waa asymptomatic waxaana laga yaabaa inay si kedis ah dib ugu soo noqdaan. Marmar NOF ayaa laga yaabaa inay la timaado jabka cudurada. NB xanuun kasta oo jilibka/lafaha ah oo ku dhaca ilmaha/dhallinyarada waa in lagu daaweeyaa tuhun caafimaad oo si waafi ah loo baaro.
  • Sawirka: tillaabada 1aad: raadiyaha
  • MRI leh T1+C waxay muhiim u tahay sifada nabarrada/ xadka gobolka, diyaarinta iyo qorshaynta qalliinka ka hor. CT waxa laga yaabaa inay caawiso ogaanshaha Fxs pathologic. Haddii neoplasms lafaha xun la tixgeliyo, CXR/CT, PET-CT si loo baaro faafidda metastatic iyo habaynta ayaa muhiim ah.

Imaging Approach Lafaha Neoplasms

  • Habka sawirka Dx ee neoplasms lafaha waxaa ka mid ah da'da, meesha lafaha (epiphysis vs. metaphysis vs. diaphysis), aagga kala-guurka ee ku hareeraysan nabarka, jawaabta periosteal, nooca matrix, qulqulaya ama burburka aboor-cuntay vs. sclerotic, galaaska dhulka, osteoid, cartilaginous matrix, soo galitaanka unugyada jilicsan iwm.
  • Calaamadaha raajo ee muhiimka ah ee DDx benign vs. neoplasm lafaha malignant:
  • Aagga kala-guurka: nabarku waa juqraafi leh aag cidhiidhi ah oo kala-guur ah vs. Aag ballaadhan oo kala-guur oo aan si fiican loo qeexin oo soo jeedinaysa dib-u-celin lafo gardarro ah
  • Waa maxay nooca burburka lafaha dhacay: muuqaalka saabuun-xumo vs. osteolytic vs. isbeddellada osteosclerotic
  • Ma jiraan muraayad wareeg ah? Ma jiraa cidhif si fiican loo qeexay ee xudduudaha sclerotic oo leh qaybo laga yaabo inay soo jeediyaan korriin gaabis ah iyo koobitaan sida hababka ugu fiican.
  • Kordhinta Periosteal: adag vs. gardaro ah spiculated/qorraxdu dilaacday/timo-on-dhamaadka oo leh duulaan unug jilicsan oo maxaliga ah iyo saddex xagal Codman (barashada bogga xiga)
jilibka xanuunka loo yaqaan 'chiropractic treatment' el paso tx.

FCD & NOF

jilibka xanuunka loo yaqaan 'chiropractic treatment' el paso tx.
  • FCD & NOF ama si ka sii habboon Fibroxanthoma ee lafta ayaa ah hababka lafaha aan fiicnayn ee m/c lagu arko carruurta. DDx oo ku salaysan cabbirka leh FCD oo soo bandhigaysa sida <3-cm iyo NOF>3cm nabar ka kooban matrix kala duwan oo fibrous ah. FCD waa asymptomatic waxaana laga yaabaa inay dib u noqdaan xaalado badan. Qaar baa laga yaabaa inay u gudbaan NOF. Goobta: oo lagu aqoonsaday gobolka jilibka inuu yahay dhaawac ku salaysan kortikal eccentric.
  • FCD waa in ay noqotaa DDx ka imanaysa avulsive irregularity d/t stress soo noqnoqda oo weheliya Linea aspera by extensions murqaha
  • Dx: radiography
  • Maareynta: nabar-kaligay iga tag. Marmar NOF ayaa laga yaabaa inay horumarto oo ay keento jabka cudurada u baahan latalinta lafaha

Osteochondroma

jilibka xanuunka loo yaqaan 'chiropractic treatment' el paso tx.
  • Osteochondroma: m/c neoplasm lafaha benign. Jilibka waa goobta m/c. Ka kooban dhammaan walxaha lafaha leh koofiyadda cartilaginous. Waxaa loo soo bandhigay sidii lafaha qallafsan ama qallafsan exostosis oo tilmaamaya ka fog wadajirka.
  • 1%.
  • Dhibaatooyinka kale: jabka (sawirka bidix ee sare) pseudoaneurysm ee halbowlaha Popliteal, samaynta bursa ee adventitious
  • Dhaxalka Multiple Exostosis (HME)- habka ugu sarreeya ee autosomal. Waxay soo bandhigtaa osteochondromas badan (nooca sessile ayaa ka sarreeya). Waxay u horseedi kartaa qallafsanaanta addimada (Madelung deformity, coxa valga) cadaadiska ST ee fal-celiska ah, xumaansho xun
  • Dx: shucaaca, MRI waxay caawisaa Dx malignant degeneration to chondrosarcoma by isbeddelka xajmiga iyo dhaqdhaqaaqa koofiyada cartilaginous (> 2-cm ee dadka waaweyni waxay muujin karaan xumaanta malignant). MRI waxay sidoo kale kaa caawin doontaa Dx dhibaatooyinka gobolka

HME & Xanuunka Jilibka

jilibka xanuunka loo yaqaan 'chiropractic treatment' el paso tx.

37-sano rag ah oo qaba HME iyo xanuun jilibka ah. Axial T1, T2 iyo STIR MRI jeexjeexyada gobolka popliteal. Koofida cartilaginous weyn iyo cadaadis suurtagal ah ee halbowlaha popliteal by osteochondroma. MRA waxaa loo sameeyay si loo qiimeeyo popliteal A. pseudoaneurysm (falaar weyn). Muundada cilmi-nafsiga ee laga helay koofiyadda cartilaginous waxay muujisay kororka unugga unugga ee tilmaamaya xumaanta xun. Daryeelka qalliin ayaa la qorsheeyay

Burada unugga Giant (GCT) oo loo yaqaan osteoclastoma

jilibka xanuunka loo yaqaan 'chiropractic treatment' el paso tx.
  • GCT- waa neoplasm lafaha aan fiicneyn ee aasaasiga ah oo caan ah. Da'da 25-40. M>F wax yar.
  • Goobta M/C: Femur Distal>Tibia u dhow>Distal fog>sacrum
  • GCT waa M/C buro sacral benign. 50% kiisaska, GCT waxay ku dhacdaa jilibka.
  • GCT waa taariikh ahaan benign, laakiin Mets sambabada ayaa laga yaabaa inay horumarto esp. haddii ay ku jiraan raadiyaha fog iyo gacmaha, oo inta badan loo yaqaan GCT Malignant
  • <1% GCT-yada aan jawaab-celinta lahayn/soo noqnoqda ayaa laga yaabaa inay ku dhacaan isbeddel xun ilaa sarcoma lafo heer sare ah
  • Pathology: Taariikh ahaan ka kooban unugyo waaweyn oo osteoclasts-multinucleated ah oo leh unugyo stromal ah oo ka yimid horudhaca monocyte-macrophage nooca. Waxay soo saartaa cytokines iyo osteolytic enzymes. GCT waxa ku jiri kara dhiig iyo xidhiidh la leh Aneurysmal Bone Cyst (ABC)
  • Caafimaad ahaan: xanuunka jilibka oo aan ka jawaabin daryeelka muxaafidka ah. Pathologic Fx ayaa dhici karta
  • sawirka: Had iyo jeer waxay ku bilaabataa shucaaca oo ay ku xigto MRI iyo biopsy qalliin oo muhiim u ah Dx.
  • Rx: Qalliinka leh daawaynta iyo sibidhka, qalab qalliin ayaa la isticmaali karaa haddii fx pathological jiro iyo jebinta kortikal. Xaalado aad u daran oo kale ayaa jira

Radiologic-Pathologic Dx

jilibka xanuunka loo yaqaan 'chiropractic treatment' el paso tx.
  • Radiologic-pathologic Dx: osteolytic iyo saabuun-bubbly lesion sida caadiga ah ku lug leh metaphysis iyo galay epiphysis (sifada muhiimka ah ee caadiga ah) oo leh fidin hoose. Aagga kala-guurka guud ahaan waa cidhiidhi laakiin marmar nabarrada gardarrada waxaa laga yaabaa in la arko aag kala-guur ah.
  • MRI: hooseeya T1, highT2 / STIR, heerarka dareeraha-dhecaanka sifo ee lagu xusay GCT iyo ABC. Histology ayaa muhiim u ah Dx.
  • DDx: ABC, burada unugga Brown ee HPT (osteoclastoma), Telangiectatic Osteosarcoma
  • Xeerka shucaaca: haddii saxanka koritaanka physeal uu joogo Dx of GCT waa laga saaray liiska iyada oo loo eegayo chondroblastoma iyo lidka ku ah.

Asal ahaan Saabuun-Muuqaalka Bubbly ee GCT

jilibka xanuunka loo yaqaan 'chiropractic treatment' el paso tx.

Coronal, Fat-Sat Sagittal & Axial MRI Qaybaha GCT

jilibka xanuunka loo yaqaan 'chiropractic treatment' el paso tx.
  • T1 coronal, T2 dufan-sat sagittal iyo T2 axial MRI jeexjeexyada GCT. Caadi ahaan: hooseeyo T1, highT2/STIR iyo heerka dareeraha- dareeraha

Sifada MRI Muuqashada GCT

jilibka xanuunka loo yaqaan 'chiropractic treatment' el paso tx.
  • Heerarka dareeraha-dheecaanka d/t ka kooban oo kala duwan ee alaabta xaalufka dhiigga
  • Muhiim DDx: ABC

Neoplasms xun oo ku saabsan jilibka

  • Carruurta iyo dadka aadka u da'da yar, m/c neoplasm malignant aasaasiga ah waa udubdhexaadka intramedullary (osteogenic) osteosarcoma (OSA). Heerka labaad ee OS:>70 yo d/t Paget�s (1%) iyo/ama shucaaca ka dib OSA.
  • Jilibku waa m/c goobta OSA (femur fog, prox. Tibia)
  • M/c 2aad ee aasaasiga ah ee carruurta malignant waa Ewing sarcoma.
  • Dadka qaangaarka ah>40 sano jir ah m/c aasaasiga ah waa Multiple Myeloma (MM) ama Plasmacytoma Keli ah
  • Guud ahaan m/c lafaha neoplasms ee dadka waaweyn d/t lafaha Mets ka sambabada, naaska, prostate, unug kelyaha, thyroid (laga hadlay)
  • Dx: bukaan-socod iyo shucaac leh biopsy qalliin
  • Sawirku waa u muhiim Dx. Talaabada 1-aad x-radiography. MRI + gad C waa muhiim
  • Baadhitaanka CT-ga mararka qaarkood waxay caawisaa in la qiimeeyo jabka cudurada

Dhexe (Intramedullary) Osteosarcoma (OSA)

jilibka xanuunka loo yaqaan 'chiropractic treatment' el paso tx.
  • m/c da'da: 10-20. m/c goobta: jilibka, ragga> dumarka. Khatarta sii korodhay qaarkood
  • cilladaha lagu dhasho iyo isbeddelka hidda-wadaha retinoblastoma: Rothmund-Thompson AR syndrome.
  • Dx hore waa muhiim d/t 10-20% la joogo sambabada Mets at Dx. Saadaasha waxay ku xiran tahay marxaladaha. Marxaladaha hore ee lafaha deegaanka iyo maya
  • la kulmay 76% badbaadada.
  • Rx: hababka badbaadinta addimada ayaa doorbidaya 8-12 toddobaad oo kiimiko ah, goynta haddii ay ku jiraan unugyada neerfaha, jidka Fx, iwm.
  • Sawirka: raajada iyo MRI.
  • Kiliinik ahaan: xanuunka lafaha, Inc. Alkaline Phosphatase
  • Laabta CT haddii sambabada Mets la tixgeliyo

Tilmaamaha Rad Classic ee OSA

jilibka xanuunka loo yaqaan 'chiropractic treatment' el paso tx.
  • Osteoid samaynta cufnaanta sclerotic oo leh timo gardarro leh oo-dhammaad/malo-awaal/qorrax-soo-baxa dareen-celinta periosteal, saddex-xagalka Codman iyo duulaanka unugyada jilicsan. Dalbo MRI si aad u diyaariso iyo xadka. Xabadka CT ayaa muhiim u ah Sambabka Mets dx.

MRI waxay muhiim u tahay Dx/Staging

jilibka xanuunka loo yaqaan 'chiropractic treatment' el paso tx.
  • Xusuusnow sagittal T1 (bidix) iyo STIR (midig) jeexjeexyada MR: cuf weyn oo ka soo bilaabmaya metaphysis femoral fog ilaa usheeda dambe. Calaamad hoose oo ku taal T1 oo sarreeya STIR d/t dhuuxa duulaanka oo leh barar, dhiigbax iyo duulaan buro. Duullaanka ST ee maxalli ah ayaa la arkay (Falaaraha cadcad). Kor-u-qaadista Periosteal iyo Saddex-xagalka Codman (Falaarta cagaaran) waa calaamado dheeraad ah oo ah neoplasmka gardarrada.
  • Ogsoonow muuqaal xiiso leh oo ah in epiphysis-ka uu ka badbaado d/t saxan physeal ah oo si ku meel gaar ah u adeegaya si ay caqabad dheeraad ah ugu noqoto faafitaanka burada.

Ewing Sarcoma

jilibka xanuunka loo yaqaan 'chiropractic treatment' el paso tx.

Ewing sarcoma: da'da: 2-20, aan caadi ahayn in bukaanka madow. 2nd m/c aadka u xun lafaha neoplasm ee carruurta kaas oo sida caadiga ah ka soo baxa dalool medullary (burooyinka unugyada wareega). Calaamadaha muhiimka ah: xanuunka lafaha ee laga yaabo inuu u ekaado caabuqa (ESR/CRP/WBC) PNET la tixgeliyey Furaha Rad Dx: Nabaro aad u daran oo aboor cunay/permeative ah oo ku yaala cidhifka lafaha dhaadheer ee leh soo galitaanka unug jilicsan oo la qiyaasi karo/maqaarka maqaarka basasha ee caadiga ah. Waxa laga yaabaa inay soo saarto suugo ayaa saamayn karta lafaha fidsan. Waxay u muuqan kartaa sida sclerotic 33%. Mets hore ee sambabada (25-30%) lafo-ilaa-lafo Mets Saadaasha liidata haddii ay daahdo Dx. Tallaabooyinka sawirka: Tallaabada 1aad x-rad, MRI waa v. muhiim ah oo ay ku xigto biopsy. CXR/CT PET-CT Rx: rad-chemo la isku daray, qalliin.

M/C Neoplasms Jilibka Malignant ee Dadka Waaweyn

jilibka xanuunka loo yaqaan 'chiropractic treatment' el paso tx.
  • 66-yo lab leh xanuunka jilibka
  • Ogow nabarka osteolytic ee fidsan ee gardarrada ah ee ku jira metaphysis femur fog ee epiphysis. Wax fal-celin ah oo periosteal ah ma jiro. Ka dib shaqo dheeraad ah oo laga sameeyay baarista CT-ga caloosha iyo laabta, Dx of Kansarka unugyada Kelyaha ayaa la sameeyay
  • Mets-ka fog ee cirifka hoose wuxuu ku badan yahay sambabada, unugga kelyaha, tayroodh iyo CA naaska.
  • Unugyada kelyaha iyo tayroodhku waxay caadi ahaan la imaan doonaan cufnaanta osteolytic expansile mass aka �blowout Mets.
  • Guud ahaan, habka sawir-qaadista waa inuu ka kooban yahay taxanaha jilibka ee Radiographic, oo ay ku xigto MRI haddii raajooyinka aan faa'iido lahayn
  • Tc99 scintigraphy lafaha waa qaabka doorashada ee lagu qiimeeyo cudurka lafaha metastatic

Neoplasms Unug Jilicsan oo ku saabsan Jilibka

jilibka xanuunka loo yaqaan 'chiropractic treatment' el paso tx.

Histiocytoma fayruuska xun (MFH) oo dib loo sifeeyay sida Pleomorphic Sarcoma Aan Kala Duwanayn (PUS) waa m/c ST sarcoma. MFH waa bayooloji gardarro leh oo leh saadaal liidata M>F (1.2:1) 30-80 oo leh heerkii ugu sarreeyay tobankii sano ee la soo dhaafay. 6-25% dhammaan dadka waaweyn ee sarcomas m/c xag-jirrada. Retroperitoneum xigta (saadaasha ugu xun d/t dabayaaqadii Dx iyo korriinka waaweyn w/o calaamadaha) Caafimaad ahaan: xanuun badan, barar adag oo caadi ahaan ku saabsan jilibka ama bowdada. Histology: Fibroblasts myofibroblasts oo si liidata loo kala soocay/la soocay, myofibroblasts, iyo unugyada kale ee mesenchymal Sawirka: MRI waa habka doorashada ee T1, T2, T1 + C. Caadi ahaan waxay u muuqataa mid gardarro ah oo dhexdhexaad ah oo dhexdhexaad ah oo dhexdhexaad ah ilaa calaamad hoose oo T1 ah iyo calaamad sare oo T2 ah oo leh meelo necrosis ah iyo kor u qaadida T1 + C. Waxaa laga yaabaa inay u muuqato si marin habaabin ah oo lagu daboolay w/o run kaabsal Maareynta: ku shaqeeya shucaac iyo kiimoterabi. Moolka burada ayaa muhiim u ah saadaasha. 80% badbaadada 5-sano haddii <5cm qoto dheer yahay ST iyo 50% haddii>5-cm qoto dheer ee ST.

Sarcoma Synovial

jilibka xanuunka loo yaqaan 'chiropractic treatment' el paso tx.

Synovial sarcoma: ST neoplasm esp malignant caadi ah. Bukaanka yaryar ama carruurta/dhallinyarada waaweyn. M/C laga helay aagga jilibka Caafimaad ahaan: waxay si tartiib tartiib ah u soo bandhigi kartaa sida cuf la dareemi karo ee cirifka inta badan la iska indho-tiray d/t koritaanka gaabis ah Sawirku waa furaha: raajada ayaa muujin karta ST. cufnaanta/cufnaanta. Qaar ka mid ah sarcomas synovial ayaa laga yaabaa inay muujiyaan xisaabin oo lagu qalday Myositis Ossificanse ama samaynta lafaha heterotopic MRI leh T1, T2 iyo T1 + C waa habka Dx ee doorashada. Hababka kale: US, CT waa DDx aan gaar ahayn: Maareynta MFH: hawlwadeen, kiimiko-radiation Saadaasha: doorsoome ku xiran xajmiga, duulaanka, metastasis

Si aad u hesho Liiska Dhamaystiran ee Neoplasms Lafaha & Tissue Jilicsan

Neoplasms ee jilibka

Xanuunka Jilibka & Sawirka Xanuunka Ba'an ee Gargaarka Qaybta II | El Paso, TX

Xanuunka Jilibka & Sawirka Xanuunka Ba'an ee Gargaarka Qaybta II | El Paso, TX

by | Sawirka & Cilad-sheegista, Dhaqdhaqaaqa & Dabacsanaanta

Ilmo yaryar

xanuun jilibka ah oo aad u daran el paso tx.

 

  • Ba'an ama dabadheeraad ah. Lagu sawiray MRI (95% dareenka & 81% gaar ahaan)
  • Menisci waxaa lagu sameeyay isku-dhafka fiilooyinka kolajka ee radial iyo wareegsan (97% nooca 1) oo lagu qaso carjawda, proteoglycans, iwm. 65-75% H2O
  • Gabowgu waxay u horseedi kartaa maskax-xumo
  • Ilmo ba'an waa d/t awood wareeg ah iyo xoog cadaadis leh, ACL liidata jilbaha ayaa muujinaya fursado badan oo ilmada meniscal
  • Geeska dambe ee meniscus medial waa jeexjeexay marka laga reebo mid degdeg ahCL ilmada marka meniscus-ka lateral uu dillaaco m/c
  • Meniscus si fiican ayaa xididdada dhiigga loogu shubay carruurta. Dadka qaangaarka ah, 3-aag ayaa ka jira: gudaha, dhexe iyo dibadda (sawirka hoose)
  • Dhaawaca aagga gudaha ma laha fursad bogsasho
  • Dhaawaca aagga dibadda (25% guud ahaan) wuxuu leeyahay xoogaa bogsasho/dayactir ah

Soo Bandhigida Caafimaadka

  • Xanuun, quful, barar
  • Calaamadaha jireed ee ugu xasaasisan: xanuun ku dhaca xariiqda wadajirka
  • Tijaabooyin: McMurry, Thessaly, Codso cadaadis u nugul
  • Maareynta: konserfatifka vs. operative waxay ku xiran tahay goobta, xasiloonida, da'da bukaanka, iyo DJD iyo nooca jeexjeexa
  • Meniscectomy qayb ah ayaa la sameeyaa. 80% hawlaha saxda ah ee dabagalka. Ka roon haddii> 40-yo iyo DJD
  • Wadarta guud ee meniscectomy lama sameeyo waxaana loo eegaa taariikh ahaan. 70% OA 3-sano ka dib qaliinka 100% OA ka dib 20 sano ka dib qalliinka.

Axial MR

xanuun jilibka ah oo aad u daran el paso tx.

 

  • Muuqashada dhexdhexaadka ah (buluug) iyo meniscus-ka dambe (cas)

Menisci Wuxuu Ciyaaraa Door Muhiim ah

xanuun jilibka ah oo aad u daran el paso tx.

 

Noocyada Goobta & Deganaanshaha

xanuun jilibka ah oo aad u daran el paso tx.

 

  • Noocyada, goobta, iyo xasiloonida ilmada ayaa v. muhiim ah inta lagu jiro MRI Dx
  • Illin toosan/dherer ah ayaa si gaar ah ugu dhacda ilmo ACL ba'an. Qaar ka mid ah ilmada dheer ee laga helo hareeraha ama "aagga cas" ayaa laga yaabaa inay bogsato
  • Baaldi gacanta ku jeexjeexa: jeexjeexa dheer ee cidhifka gudaha kaas oo qoto dheer oo toosan oo dhex fidsan dhidibka dheer oo laga yaabo inuu u guuro darajo
  • Baqbaq/qaraar/baq-baq waa ilmo kakan
  • Jeexitaanka shucaaca ee 90-degree ilaa taagga

Axial T2

xanuun jilibka ah oo aad u daran el paso tx.

 

  • Axial T2 WI dufan-fadhi iyo jeexjeexyada STIR ee geesaha dambe ee meniscus medial.
  • U fiirso jeex jeex ah oo geesaha dambe ee meniscus medial ee u dhow xididka meniscal. Kani waa suurtogal dhaawac aan degganayn oo u baahan daryeel qalliin
  • Meniscus, kiiskan, ma awoodo inuu bixiyo "habka buufiska-stress."

Qaybaha MRI ee Coronal & Sagittal

xanuun jilibka ah oo aad u daran el paso tx.

 

  • Dufan-fadhiga coronal iyo sagittal proton cufnaanta MRI jeexjeexyo muujinaya jeex toosan (kala-xoqid) jeexan taas oo inta badan ku badan meniscus da'da
  • Xaaladaha qaarkood, marka jeexan aanu ku jirin qayb shucaac ah, waxa laga yaabaa inay qayb ka bogsato baahida daryeelka qalliinka.

T2 w GRE Sagittal MRI Jeex

xanuun jilibka ah oo aad u daran el paso tx.

 

  • jeex isku dhafan oo leh qayb toosan iyo qayb radial ah.
  • Jeexitaanka noocaan ah waa mid aan degganeyn oo xaaladaha badankood waxay u baahan karaan daryeel qalliin

Jeexitaanka Gacanka Baaldiga

xanuun jilibka ah oo aad u daran el paso tx.

 

  • Jeexitaanka gacanta baaldigu waa m/c gudaha meniscus esp medial. oo leh ACL ba'an iyo jeexjeexa MCL
  • Calaamadaha MRI; calaamada PCL laba jibaaran oo ku taal jeexyada sagittal
  • Ka maqan calaamadda "bowdada" iyo kuwa kale
  • Inta badan kiisaska waxay u baahan yihiin daryeel qalliin

DDx Laga soo bilaabo Meniscal Degeneration

xanuun jilibka ah oo aad u daran el paso tx.

 

  • Mararka qaarkood ilmada meniscal waxay u baahan tahay inay DDx ka noqoto hoos u dhaca meniscal kaas oo sidoo kale laga yaabo inuu u muuqdo mid dhalaalaya (calaamad sare) oo dareere ah MRI
  • Xeerka ugu fudud ayaa ah in haddii ay jirto ilmo meniscal dhab ah aka Fasalka 3 lesion, had iyo jeer wuxuu gaaraa/u fidiyaa dusha sare ee tibial plateau

Doorka MSK Ultrasound (US) ee Imtixaanka Jilibka

  • MSK US ee jilibka ogolaadaa xallinta sare iyo sawirka firfircoon ee ugu horrayn anatomy dusha sare ah (tendons, bursae, seedaha kaabsal)
  • MSK US si ku filan uma qiimeyn karo seedaha cruciate iyo menisci-ga oo dhan
  • Haddaba sawirka MR wuxuu ahaanayaa habka doorashada

Cudurada Suurtogalnimada Leh waxaa si guul leh u qiimeeyay MSK US

  • Jeermiska patellar/ dilaaca seedaha patellar
  • Quadriceps Jeexitaanka Jeexitaanka
  • Bursitis Prepatellar
  • Bursitis Infrapatellar
  • Anserine bursitis
  • cyst Popliteal (Baker cyst)
  • Caabuqa/ shubanka wadajirka ah ee leh dhumucda synovial iyo hyperemia waxaa lagu sawiri karaa US (tusaale, RA) gaar ahaan marka lagu daro awoodda midabka Doppler

Bukaanka Lagu Soo Bandhigay Xanuunka Jilibka Atraumatic & Bararka

xanuun jilibka ah oo aad u daran el paso tx.

 

  • Radiography ayaa daaha ka qaaday cufnaanta unugyada jilicsan ee cabbirka ee gudaha gobolka pre-patella ee kore oo ay la socoto OA-dhexe-dhexe
  • MSK US waxay muujisay ururinta dareere kala duwan oo kala go'ay oo leh firfircooni Doppler oo khafiif ah oo ku yaal durugsan oo muujinaya caabuq d/t Dx of Superficial pre-patella bursitis

Sawirada Axis Long Axis

xanuun jilibka ah oo aad u daran el paso tx.

 

  • Ogsoonow meniscus lateral caadi ah iyo fiilooyinka LCL (ka sarreeya sawirka hoose) marka la barbar dhigo
  • Jeexitaanka jeexjeexa ee horizontal oo ay weheliso soo bixidda meniscus lateral iyo bararka LCL (sawirka sare)
  • Xadid weyn: awoodin in la sawiro dhammaan meniscus iyo ACL/PCL
  • Tilmaanta MRI ayaa la soo jeediyay

Dildilaaca Tendon fog ee Quadriceps

xanuun jilibka ah oo aad u daran el paso tx.

 

  • Fiiro gaar ah dillaacay seedaha fog ee muruqa Quadriceps oo loo soo bandhigay sida kala-soocidda fiber-ka iyo dareeraha (hypo to anechoic) dareeraha ururinta gudaha walaxda seedaha
  • Faa'iidooyinka MSK US ee ka sarreeya MRI si loo qiimeeyo dhismayaasha kore:
  • Sawirka firfircoon
  • Helitaanka
  • Kharash-ool ah
  • Diyaarinta bukaanka
  • Khasaaraha: qoto dheer ee qaabdhismeedka xaddidan, awood la'aanta in la qiimeeyo lafaha iyo carjawda, iwm.

Dhaawacyada Jilibka Osteochondral (OI)

  • Dhaawacyada jilibka osteochondral waxay ku dhici karaan carruurta da'doodu u dhaxayso 10-15 yo oo loo soo bandhigay sida Osteochondritis Disseance (OCD) iyo qalfoofka baaluq ee m/c ka dib hyperextension iyo dhaawac wareeg ah, gaar ahaan ilmo ACL.
  • OCD-sida caadiga ah waxay ka soo baxdaa xoogaga soo noqnoqda ee lafaha aan qaan-gaarin waxayna saameeyaan m/c qaybta dambe ee kondhilaha femoral ee dhexdhexaadka ah.
  • OI ee lafta qaangaarka ah waxay dhacdaa m / c inta lagu jiro ilmada ACL inta badan waxay saamaysaa waxa loogu yeero sulcus terminal ee kondhile femoral lateral ee isgoyska qaybta miisaanka ee ka soo horjeeda tibial plateau iyo qaybta ku qeexan patella
  • Dhaawacyada lafaha lafaha ayaa laga yaabaa inay waxyeeleeyaan carjawda articular ee sababa OA-da labaad. Markaa waxa loo baahan yahay in qaliin lagu qiimeeyo
  • Sawirku waxa uu ka ciyaaraa door muhiim ah waana in lagu bilaabo shucaaca inta badan oo ay raacdo MR imaging iyo u gudbinta lafaha.

Jilibka OCD

xanuun jilibka ah oo aad u daran el paso tx.

 

  • 95% waxay la xidhiidhaan dhaawacyada qaarkood. etiology kale: ischaemic lafaha necrosis gaar ahaan dadka waaweyn
  • Meesha kale ee caanka ah ee dhaawacyada lafaha lafaha: suxulka (capitellum), talus
  • Talaabada 1aad: raajada ayaa laga yaabaa in lagu ogaado jajabka osteochondral ee suurtogalka ah in lagu lifaaqo ama go'o
  • Goobta: dhinaca dambe-dhinac ee kondyle femoral dhexdhexaad ah. Tunnel (intercondylar notch) aragtida waa muhiim
  • MRI: qaabka doorashada> 90% gaar ahaan iyo dareenka. Muhiim u ah maaraynta dheeraadka ah. Qadka calaamadaynta calaamadda T1-hoose oo leh T2 xariiq calaamadeed sare oo tilmaamaysa go'o iyo bogsasho aan suurtagal ahayn. Tixraac dhakhtarka lafaha
  • Maareynta: nabar deggan esp. carruurta yaryar
  • Dhaawac aan degganayn iyo ilmo ka weyn ama xidhitaan jidheed oo soo socda> hagaajinta qalliinka.
xanuun jilibka ah oo aad u daran el paso tx.

 

Dhaawaca Jilibka