Ogaanshaha Cabashooyinka Sinta: Arthritis & Neoplasms Qaybta I | El Paso, TX.

Cudurka wadajirka ah ee xumaada (DJD)

Makroscopic & Muuqashada Maqalka ee Caadiga vs. Burburtay Carjawda Hyaline Articular ee DJD

Hip Osteoarthritis (OA) oo loo yaqaan Osteoarthrosis

• Astaamaha iyo suurtagalnimada curyaaminta DJD
• Burbur horusocod ah iyo luminta carjawda articular taasoo keenta canbaar iyo gubasho lafta articular
• Isbeddellada cystic, osteophytes, iyo burbur wadajir ah oo tartiib tartiib ah
• Waxay horumarisaa d/t soo noqnoqda rarka wadajirka ah iyo microtrauma
• Cayilka, dheef-shiid kiimikaadka / arrimaha hiddaha
• Sababaha Labaad: trauma, FAI syndrome, osteonecrosis, pyrophosphate crystal deposition, arthritis bararka hore, Slipped Capital Femoral Epiphysis, Lugaha-Calves-Perthes cudurka carruurta, iwm.
• Hip OA, 2nd m/c ka dib jilibka OA. Dumarka>ragga
• 88-100 kiis oo astaamo ah 100000kiiba

Radiography waa Habka Doorashada ee Dx iyo Dejinta DJD

• Sawir gaar ah looma baahna ilaa arrimo kale oo murugsan ay jiraan mooyaane
• Isku-dhafka acetabular-femoral wuxuu u qaybsan yahay qaybo sare, axial iyo qaybo dhexdhexaad ah
• Meesha wadajirka ah ee caadiga ah ee qaybta sare waa in ay ahaataa 3-4-mm dhinaca miskaha/miskaha AP
• Fahamka qaabka isku-duubnida/guuritaanka sinta wadajirka ah waxay ka caawisaa DDx ee DJD vs. Inflammatory Arthritis
• DJD dhexdeeda, m/c cidhiidhiga misigta ayaa ah mid ka sareysa-lateral (aan ahayn labbis) vs. axial bararka (labis)

AP Hip Radiograph wuxuu muujinayaa DJD

• Iyada oo lumis aan labis ahayn ee meel wadajir ah (guuritaanka sare), cysts subcortical weyn iyo sclerosis subchondral
• Tilmaamaha shucaaca:
• Si la mid ah isbeddelada DJD kasta: raajada ayaa daaha ka qaadi doonta khasaare
• L: luminta meel wadajir ah (aan labis ahayn ama aan asymmetrical ahayn)
• O: osteophytes aka fidinta lafaha / kicinta
• S: Subchondral sclerosis / dhumucdiisuna
• S: Subcortical aka subchondral cysts "geodes."
• Hijrada miskaha ayaa ka sarreeya m/c taasoo keentay "qalloocinta leexday."

Soo bandhigida shucaaca ee Hip OA way kala duwanaan kartaa iyadoo ku xidhan darnaanta

• OA khafiif ah: hoos u yar ee booska wadajirka ah inta badan w/o calaamadsan lafo-beelka iyo isbeddellada cystic
• Inta lagu jiro isbeddelada dheeraadka ah, osteophytes collar waxay saameyn kartaa isgoysyada qoorta-femoral oo leh luminta booska wadajirka ah ee lafaha iyo sclerosis subchondral (gubasho)
• Samaynta qanjidhada ayaa inta badan ku dhici doonta dhinaca acetabular iyo madaxa femoral ee lafaha hoose ee "geodes" oo badanaa waxaa ka buuxsamaya dareeraha wadajirka ah iyo qaar ka mid ah gaas-gaas gudaha ah.
• Fiix-hoosaadka hoose ayaa laga yaabaa inay marmar aad u weynaadaan iyo DDx oo ka yimaadda neoplasms ama caabuqa ama cudur-sidaha kale

Qaybaha CT-ga ee dib-u-dhiska lagu sameeyay ee Daaqadda Lafaha

• Ogow cidhiidhinta wadajirka ah ee dhexdhexaadka ah oo u muuqata mid aan labis ahayn
• Samaynta cysts-ka-hoosaadka (geodes) ayaa lagu xusaa iyadoo ay weheliso acetabular iyo madaxa femoral lafta subchondral
• Astaamaha kale waxaa ka mid ah osteophytes-ka-jiifka ee ku yaal isgoyska madaxa-qoorta
• Dx: DJD ee xoojinta dhexdhexaadka ah
• U gudbinta dhakhtarka lafaha ayaa caawin doona bukaankan

AP Pelvis (ka hooseeya sawirka koowaad), AP Hip Spot (ka hooseeya sawirka labaad) CT Coronal Slice

• Ogsoonow cysts-hoosaadyo badan, cidhiidhi aan labis lahayn oo daran oo wadajir ah (sare-lateral) iyo sclerosis subchondral oo leh osteophytes
• arthrosis sinta horumarsan

DJD daran, Misigta Bidix

• Markaad akhrinayso warbixinnada shucaaca si gaar ah u fiirso qiimaynta sinta OA
• Kiisaska ugu daran (horumarsan) OA waxay u baahan yihiin wadarta arthroplasty (THA)
• U dir bukaankaaga dhakhtarka lafaha si uu ula taliyo
• Inta badan kiisaska fudud ayaa ah musharax wanaagsan oo loogu talagalay daryeelka konserfatifka

Hip arthroplasty aka Beddelka Sinta

• Waxay noqon kartaa wadarta ama hemiarthroplasty
• THA waxay noqon kartaa birta birta, birta polyetylenka iyo dhoobada dhoobada ah
• Qayb acetabular isku-dhafan leh oo leh polyetylen iyo taageero bir ah ayaa sidoo kale la isticmaalaa (sawirka sare ee midig)
• THA waxa lagu shubi karaa sibidh (sawirka sare ee midig) iyo mid aan sibidhka ahayn (sawirka sare-bidix)
• Arthroplasty-ka aan sibidhka lahayn ayaa loo isticmaalaa bukaanada da'da yar ee isticmaalaya qaybo macdan ah oo dalool leh taasoo u oggolaanaysa fiyuus wanaagsan iyo lafo-soo-baxa sanaaciga

Fashilantay ee THA laga yaabaa in ay horumariso

• Badankoodu waxay ku horumaraan sanadka ugu horeeya waxayna u baahan yihiin dib u eegis
• Jirka dheddigga ayaa laga yaabaa inuu jabo (korka bidix)
• Caabuqa qaliinka kadib (midig sare)
• Jab ku dheggan sanaaciga (cadaadiska kicinta)
• Cudurka qayb ka mid ah

Femoroacetabular Impingement Syndrome

• (FAI): aan caadi ahayn ee qaab-dhismeedka caadiga ah ee sinta taasoo horseedaysa dhaawaca carjawda iyo DJD dhicis ah
• Caafimaad ahaan: sinta/gumaarka xanuunka fadhiga ayaa uga sii daray (tusaale, sinta rogmantay & dibeda wareegaysa). Xanuunka dhaqdhaqaaqa la xidhiidha ee ku saabsan axial loading esp. oo leh miskaha dabacsanaan (tusaale, kor u socda)
• Nooca Pincer-acetabulum: > dumarka da'da dhexe waxay suurtogal u tahay sababo badan
• Naafanimada nooca CAM:�> ragga ku jira 20-50 m/c 30aad
• Nooca isku dhafan (pincer-CAM) ayaa ah kuwa ugu badan
• Ilaa 90kii, FAI si fiican looma aqoonsanin

FAI Syndrome

• CAM-nooca FAI syndrome
• Raadyoograafigu wuxuu noqon karaa qalab la isku halayn karo oo Dx ah
• Natiijooyinka raajada:�����������������������������������������������������������������������Qallafsanaanta bastoolad-qabsiga. Luminta wareegga caadiga ah ee madaxa. Astaamaha la xidhiidha: os acetabule, godka herniation synovial (Pit's pit). Caddaynta DJD ee kiisaska horumarsan
• MRI iyo MR arthrography (Dx ee ugu saxsan ee ilmada shaybaarka) ayaa caawin kara ogaanshaha jeexjeexa shaybaarka iyo isbeddelada kale ee FAI
• U dirida takhtarka lafaha waa lagama maarmaan si looga hortago horumarka DJD iyo hagaajinta cilladaha shaybaarka. Dx dambe waxa laga yaabaa inay u horseeddo isbeddelo aan laga noqon karin ee DJD

AP Pelvis: B/L CAM-nooca FAI syndrome

Pincer-Nooca FAI oo leh Acetabula-daboolan

• Calaamadaha shucaaca ee muhiimka ah: "Calaamadda gudubta" iyo hababka qiimaynta xagal-xagalka aan caadiga ahayn

Dx ee FAI

• Xagasha cidhifka dhexe (ka sarreeya sawirka koowaad) iyo Alfa-xagalka (ka sarreeya sawirka labaad)
• Nooca B/L CAM ee FAI oo leh os acetabule�(sawirka sare ee midig)

MR Arthrography

• Jeexitaanka shaybaarka iyo CAM-nooca FAI syndrome ee axial (korka bidix) iyo coronal T2 W (korka midig) MR arthrography
• Ogow jeexjeexa shaybaarka ee acetabula. U dirida dhakhtarka lafaha ayaa loo baahan yahay. Wixii macluumaad dheeraad ah:
• radiopaedia.org/articles/femoroacetabular-impingment-1

Hip Pelvis Arthritis & Neoplasms