Hip xanuun waa arrin caafimaad oo caan ah oo ay sababi karaan dhibaatooyin badan oo kala duwan, si kastaba ha ahaatee, goobta xanuunka sinta ee bukaanku waxay ku siin kartaa macluumaad qiimo leh oo ku saabsan sababta asaasiga ah ee arrintan caafimaad ee caadiga ah. Xanuunka gudaha sinta ama gumaarka waxaa sabab u ah dhibaatooyinka gudaha laf-dhabarka sinta lafteeda halka xanuunka dibadda ee sinta, bowdada sare iyo barida dibadda laga yaabaa inay sabab u tahay dhibaatooyinka seedaha, seedaha iyo murqaha, iyo unugyada kale ee jilicsan. , oo ku hareeraysan wadajirka sinta. Intaa waxaa dheer, xanuunka sinta wuxuu noqon karaa dhaawacyo kale iyo xaalado, oo ay ku jiraan xanuunka dhabarka.
Contents
aan la taaban karin
Sinta xanuunka waa xaalad caadi ah oo naafo ah oo saamaysa bukaanada da 'kasta leh. Kala duwanaanshaha xanuunka sinta waa mid ballaaran, oo soo bandhigaya caqabada ogaanshaha. Bukaan-jiifku waxay inta badan sheegaan in xanuunka sinta uu ku yaal mid ka mid ah saddexda gobol ee anatomic: miskaha hore iyo gumaarka, sinta dambe iyo barida, ama sinta dambe. Sinta hore iyo xanuunka gumaarka ayaa caadi ahaan lala xiriiriyaa pathology-ga articular, sida osteoarthritis iyo jeexjeexyada miskaha. Xanuunka miskaha ee dambe wuxuu la xiriiraa piriformis syndrome, cillad la'aanta wadajirka ee sacroiliac, lumbar radiculopathy, iyo ischiofemoral impingement iyo xididdada xididdada dhiigga. Xanuunka miskaha ee dambe wuxuu ku dhacaa xanuunka xanuunka 'trochanteric syndrome'. Tijaabada baadhista kiliinikada, in kasta oo ay waxtar leedahay, maaha mid xasaasi u ah ama gaar u ah baadhitaannada intooda badan; si kastaba ha ahaatee, hab macquul ah ee baaritaanka sinta ayaa la isticmaali karaa. Shucaaca waa in la sameeyaa haddii la tuhunsan yahay jabka degdega ah, kala-baxa, ama jabka walaaca. Shucaaca cad ee hore ee sinta waa in ay ku jiraan aragtida anteroposterior ee miskaha iyo raha-lugta lateral ee sinta calaamadaha. Sawir-qaadista resonance magnetic waa in la sameeyaa haddii taariikhda iyo natiijooyinka shucaaca cad aysan ahayn mid la aqoonsan karo. Sawir-qaadista resonance magnetic waxay qiimo u leedahay ogaanshaha jabka naxdinta leh ee qarsoon, jabka walaaca, iyo osteonecrosis ee madaxa femoral. Arthrography resonance magnetic waa baaritaanka ogaanshaha doorashada ee ilmada shaybaarka.
Hordhac
Xanuunka miskaha waa soo bandhigid caadi ah oo lagu sameeyo daryeelka aasaasiga ah wuxuuna saameyn karaa bukaanada da 'kasta leh. Mid ka mid ah daraasadda, 14.3% dadka qaangaarka ah ee 60 sano iyo ka weyn ayaa soo sheegay xanuunka sinta inta badan maalmihii lixdii toddobaad ee la soo dhaafay. Cilad-sheegashada kala duwan ee xanuunka sinta (eTable A) waa mid ballaadhan, oo ay ku jiraan labadaba articular iyo pathology-ga ka baxsan, waxayna ku kala duwan yihiin da'da. Taariikhda iyo baaritaanka jireed ayaa lagama maarmaan u ah in si sax ah loo ogaado sababta xanuunka sinta.
anatomy
Isku-dhafka miskaha waa isku-dhafka kubbadda-iyo-socket synovial ee loogu talagalay in lagu oggolaado dhaqdhaqaaqa multiaxial iyadoo la wareejinayo culeyska inta u dhexeysa jirka sare iyo hoose. Cirifka acetabular waxaa lagu daboolay fibrocartilage (labrum), kaas oo ku daraya qoto dheer iyo xasilloonida wadajirka femoroacetabular. Sagxadaha articular waxaa daboolay carjawda hyaline taas oo kala firdhisa xiirta iyo xoogga cadaadiska inta lagu jiro rarka qaadista iyo dhaqdhaqaaqa sinta. Dareemaha ugu weyn ee miskaha ayaa ka soo jeeda gobolka lumbosacral, taas oo adkeyn karta in la kala saaro xanuunka sinta hoose iyo xanuunka lumbar ee radicular.
Dhaqdhaqaaqa ballaaran ee wadajirka sinta ayaa ah midka labaad ee kaliya ee wadajirka glenohumeral waxaana awood u leh tirada badan ee kooxaha murqaha ee ku wareegsan sinta. Muruqyada qalloocan waxaa ka mid ah iliopsoas, femoris malawadka, pectineus, iyo murqaha sartorius. Gluteus maximus iyo kooxaha murqaha murqaha ayaa u oggolaanaya fidinta sinta. Muruqyada yaryar, sida gluteus medius iyo minimus, piriformis, obturator externus iyo internus, iyo quadratus femoris murqaha, geli agagaarka trochanter weyn, oo u oggolaanaya afduubka, isku dhejinta, iyo wareegga gudaha iyo dibadda.
Dadka aan qaan-gaarin lafaha, waxaa jira dhowr xarumood oo koritaan ah oo miskaha iyo femur ah halkaasoo dhaawacyo ay ka dhici karaan. Goobaha suurtogalka ah ee dhaawaca apophyseal ee gobolka sinta waxaa ka mid ah ischium, lafdhabarta hore ee sare ee hore, laf dhabarta hoose ee hoose, iliac crest, trochanter yar, iyo trochanter weyn. Apophysis ee laf dhabarta iliac ee sare ayaa bislaaday waxayna u nugul tahay dhaawaca ilaa 25 sano jir.2
Labbada miskaha waa mid ka mid ah kala-goysyada waaweyn ee laga helo jirka bini'aadamka waxayna u adeegtaa meel bannaan marka bowdada hore iyo gadaal u socoto. Labbada sinta sidoo kale waxay wareegtaa marka la fadhiyo iyo isbeddellada jihada marka la socdo. Dhismayaal kala duwan oo isku dhafan ayaa ku wareegsan wadajirka sinta. Marka dhaawac ama xaalad ay saameeyaan kuwan, waxay ugu dambeyntii u horseedi kartaa sinta xanuun.
Dr. Alex Jimenez DC, CCST
Qiimaynta Sinta Xanuunka
History
Da'da kaligeed ayaa yarayn karta kala duwanaanshaha xanuunka sinta. Bukaanjiifka prepubescent iyo qaan-gaarka, cilladaha lagu dhasho ee wadajirka femoroacetabular, jabka avulsion, iyo dhaawacyada apophyseal ama epiphyseal waa in la tixgeliyaa. Kuwa qaan-gaadhka ah, sinta xanuunka badanaa waa natiijada muruqyada muruqyada, murgacashada ligamentous, contusion, ama bursitis. Dadka qaangaarka ah, osteoarthritis-ka xumaaday iyo jabka waa in marka hore la tixgeliyaa.
Bukaanka qaba xanuunka sinta waa in wax laga weydiiyo dhaawacyada hore ama kicinta dhaqdhaqaaqa, arrimaha kordhiya ama yareeya xanuunka, habka dhaawaca, iyo wakhtiga bilawga. Su'aalaha la xiriira shaqada sinta, sida sahlanaanta gelitaanka iyo ka degista baabuurka, xidhashada kabaha, orodka, socodka, kor iyo hoos jaranjarooyinka, waxay noqon karaan kuwo waxtar leh. ilaa mid ka mid ah saddexda qaybood ee anatomic ee aasaasiga ah: sinta hore iyo gumaarka, sinta dambe iyo barida, iyo sinta dambe (tusaale A).
Imtixaanka jirka
Baaritaanka sinta waa inuu qiimeeyaa sinta, dhabarka, caloosha, iyo xididdada dhiigga iyo hababka neerfaha. Waa inay ku bilaabataa falanqaynta socodka iyo qiimaynta mawqifka (Jaantuska 1), oo ay ku xigto qiimaynta bukaanka fadhiya, dhabarka, lateral, iyo meelaha u nugul (Jaantusyada 2 ilaa 6, iyo jaantus B). Tijaabada baadhista jidhka ee qiimaynta sinta xanuunka waxa lagu soo koobay shaxda 1.
sawirka
Raadiyaha. Shucaaca sinta waa in la sameeyaa haddii uu jiro wax shaki ah oo ku saabsan jabka degdega ah, kala-baxa, ama jabka walaaca. Shucaaca cad ee hore ee sinta waa in ay ku jiraan aragtida anteroposterior ee miskaha iyo aragtida rah-lugta dambe ee sinta calaamadaha leh.4
Sawirka Resonance Magnetic iyo Arthrography. Sawir-qaadista magnetic-ka ee caadiga ah (MRI) ee sinta waxay ogaan kartaa cillado badan oo jilicsan oo jilicsan, waana habka sawir-qaadista ee la doorbido haddii shucaaca cadi aanu aqoonsanayn pathology gaar ah ee bukaanka qaba xanuunka joogtada ah.5 MRI-ga caadiga ah wuxuu leeyahay dareenka 30% iyo saxsanaanta. ee 36% ee ogaanshaha ilmo-galeenka sinta, halka magnetic resonance arthrography uu bixiyaa dareenka dheeraadka ah ee 90% iyo saxnaanta 91% ee ogaanshaha ilmada shaybaarka.6,7
Ultrasonography. Ultrasonography waa farsamo faa'iido leh oo lagu qiimeeyo jilicsanaanta shakhsi ahaaneed, xaqiijinta tuhunka bursitis, iyo aqoonsiga dheecaanka wadajirka ah iyo sababaha shaqada ee xanuunka sinta. ultrasonographer khibrad leh si uu u sameeyo daraasadda ogaanshaha; si kastaba ha ahaatee, caddaymaha soo baxaya waxay muujinayaan in dhakhaatiirta khibradda yar leh ee leh tabobar ku habboon ay samayn karaan baaritaanno la isku halleyn karo oo la mid ah kan khabiirka ultrasonographer ee murqaha.8
Kuwani waa sababo badan oo xanuunka sinta. Inkastoo qaar ka mid ah sinta xanuunku ay noqon karaan kuwo ku meel gaar ah, noocyada kale ee xanuunka sinta waxay noqon karaan kuwo daba-dheeraada haddii aan la daweyn muddo dheer. Dhowr sababood oo caadi ah oo xanuunka sinta ah waxaa ka mid ah, arthritis, jabka, murgacasho, necrosis avascular, cudurka Gaucher, sciatica, cadaadiska muruqa, iliotibial band syndrome ama IT band syndrome iyo hematoma, iyo kuwo kale oo hoos lagu sharaxay.
Dr. Alex Jimenez DC, CCST
Calaamadaha Kala Duwan ee Xanuunka Sinta Hore
Sinta hore ama gumaarka xanuunka ayaa soo jeedinaya ku lug lahaanshaha sinta lafteeda. Bukaan-jiifka inta badan waxay soo koobaan xanuunka iyagoo ku dhejinaya miskaha anterolateral suulka iyo farta hore ee qaabka �C. Tan waxaa loo yaqaanaa calaamadda C (Jaantuska 1A).
Osteoarthritis
Osteoarthritis waa cudurka ugu badan ee lagu ogaado dadka waaweyn ee leh dhaqdhaqaaq xaddidan iyo si tartiib tartiib ah calaamadaha. Bukaanku waxay leeyihiin xanuun joogto ah, qoto dheer, xanuun xanuun iyo qallafsanaan kuwaas oo ka sii daran istaagid dheer iyo miisaan qaadis. Baaritaanku wuxuu muujinayaa hoos u dhaca dhaqdhaqaaqa dhaqdhaqaaqa, iyo dhaqdhaqaaqa miskaha ee ugu sarreeya ayaa badanaa keena xanuunka. Shucaaca cad ayaa muujinaya joogitaanka asymmetrical-meel-goysyada cidhiidhiga ah, osteophytosis, iyo sclerosis subchondral iyo cyst formation.12
Femoroacetabular Impingement
Bukaannada qaba femoroacetabular impingement inta badan waa da 'yar oo jir ahaan firfircoon. Waxay qeexayaan xanuunka bilawga ah ee ka sii daran fadhiga, ka kaca kursiga, fuulista ama ka degista baabuurka, ama hore u foorarsiga. Imtixaanka FABER ( dabacsanaan, afduub, wareeg dibadda ah; Jaantuska 13) waxa uu leeyahay dareenka 14% ilaa 3%. Tijaabada FADIR (rogid, isku duubni, wareeg gudaha ah; Jaantuska 96), imtixaanka duubista log (Jaantuska 99), iyo kor u qaadista lugta tooska ah ee ka soo horjeeda tijaabada iska caabinta (Jaantuska 4) ayaa sidoo kale waxtar leh, oo leh dareenno 5%, 6%, iyo 88% , siday u kala horreeyaan.56 Marka lagu daro aragtiyaha shucaaca anteroposterior iyo lateral, aragtida Dunn waa in la helaa si ay u caawiso ogaanshaha nabarrada qarsoon.30
Jeexitaanka Hip Labral
Ilmada miskaha ee miskaha waxay sababtaa xanuun gumaar ah oo caajis ah ama fiiqan, iyo badh ka mid ah bukaannada jeexjeexa shaybaarka waxay qabaan xanuun ka soo baxa sinta lateral, bowdada hore, iyo barida. Xanuunku inta badan waxa uu leeyahay bilow aan fiicneyn, laakiin marmar wuxuu si degdeg ah u bilaabmaa dhacdo naxdin leh ka dib. Qiyaastii nus ka mid ah bukaannada qaba dhaawacan ayaa sidoo kale leh calaamado farsamo, sida qabashada ama xanuunka garaaca dhaqdhaqaaqa. waana 17% ee tijaabada FABER), in kasta oo midkoodna aanu lahayn gaar gaar ah.96 Magnetic resonance arthrography waxa loo arkaa tijaabada ogaanshaha doorashada ee ilmada labral. Hababka sawir-qaadista ee ka yar, sida raajada cad iyo MRI-ga caadiga ah, waa in marka hore la isticmaalo si meesha looga saaro sababaha kale ee sinta iyo gumaarka xanuunka.
Iliopsoas Bursitis (Internal Snapping Hip)
Bukaan-socodka qaba xaaladdan waxay qabaan xanuunka miskaha ee hore marka ay sinta ka soo baxaan meel jilicsan, oo inta badan la xidhiidha qabashada isdaba-joogga ah, xoqista, ama soo-baxa sinta.
Sixir ama Cadaadis jab
Jajabka sinta ama diiqada waa in la tixgeliyaa haddii dhaawac ama jimicsi miisaan culus oo soo noqnoqda ay ku lug leedahay, xitaa haddii natiijooyinka shucaaca cad ay yihiin kuwo xun. la joogo darafyada dhaqdhaqaaqa, kor u qaadista lugaha tooska ah ee firfircoon, imtixaanka duubista log, ama hopping.21 MRI waxay faa'iido u leedahay ogaanshaha jabka dhaawacyada qarsoon iyo jabka cadaadiska ee aan lagu arag shucaaca cad.21
Synovitis Transient iyo Septic Arthritis
Bilawga ba'an ee xanuunka miskaha ee atraumatic ee ka dhasha culeyska daciifka ah waa inuu kor u qaadaa shakiga ku-meel-gaadhka ah ee synovitis iyo septic arthritis-ka. Waxyaalaha khatarta ah ee xanuunka septic arthritis-ka ee dadka qaangaarka ah waxaa ka mid ah da'da ka weyn 80 sano, sonkorowga mellitus, rheumatoid arthritis-ka, qalliinka wadajirka ah ee dhowaan, iyo prostheses sinta ama jilibka. si loo qiimeeyo khatarta xanuunka 'septic arthritis-ka' 24
Osteonecrosis
Legg-Calv�-Perthes cudurka waa osteonecrosis idiopathic ee madaxa femoral ee carruurta da'doodu tahay 12 ilaa 4 sano jir, oo leh saamiga lab iyo dheddig ee 1.4: 30,31 Dadka qaangaarka ah, arrimaha khatarta ah ee osteonecrosis waxaa ka mid ah lupus erythematosus systemic, sickle cell cudur, caabuqa difaaca jirka bini'aadamka, sigaar cabista, khamriga, iyo isticmaalka corticosteroid. Dhaqdhaqaaqa dhaqdhaqaaqa ayaa marka hore la ilaaliyaa laakiin wuxuu noqon karaa mid xaddidan oo xanuun badan marka uu cudurku sii socdo.32 MRI waxay qiimo u leedahay ogaanshaha iyo saadaalinta osteonecrosis ee madaxa femoral.30,33
Calaamadaha Kala Duwan ee Xanuunka Misigta iyo Barida ee Dambe
Cudurka Piriformis Syndrome iyo Ischiofemoral Impingement
Piriformis syndrome wuxuu keenaa xanuunka barida kaas oo ka sii daraya fadhiga ama socodka, iyada oo leh ama aan lahayn shucaaca ipsilateral hoos udhaca bowdada dambe ee cadaadiska dareenka sciatic. kaa caawin kara ogaanshaha.34,35
Ischiofemoral impingement waa xaalad aan si fiican loo fahmin taas oo keeni karta xanuunka barida ee aan khaaska ahayn ee shucaaca ee bowdada dambe.36,37 Xaaladdan ayaa loo maleynayaa inay tahay natiijada ka dhalatay murqaha quadratus femoris ee u dhexeeya trochanter yar iyo ischium.
Si ka duwan sciatica oo ka soo baxa herniation disc, piriformis syndrome iyo ischiofemoral impingement ayaa ka sii daraya wareegga miskaha ee firfircoon. MRI waxay faa'iido u leedahay ogaanshaha xaaladahan.38
kale
Sababaha kale ee xanuunka sinta ee dambe waxaa ka mid ah cillad la'aanta wadajirka ah ee sacroiliac, 39 lumbar radiculopathy, 40 iyo claudication vascular.41 Joogitaanka nabarka, xanuunka gumaarka, iyo wareegga gudaha ee xaddidan ee miskaha ayaa ka sii saadaaliya cilladaha sinta marka loo eego cilladaha ka soo jeeda dhabarka hoose. .42
Calaamadaha Kala Duwan ee Xanuunka Sinta Dambe
Xanuunka Badan ee Cudurka ah
Xanuunka sinta dambe wuxuu saameeyaa 10% ilaa 25% dadweynaha guud.43 Greater trochanteric pain syndrome waxaa loola jeedaa xanuunka ka badan kan weyn. Dhawr xanuun oo ka mid ah sinta lateral waxay u horseedi kartaa xanuunkan noocaan ah, oo ay ku jiraan dhumucda iliotibial band, bursitis, iyo ilmada gluteus medius iyo minimus muruqa ku xiran.43 dhinac. Gluteus minimus iyo dhaawacyada dhexdhexaadka ah waxay la socdaan xanuunka dhinaca dambe ee miskaha sababtoo ah qayb ahaan ama dhumuc buuxda oo jeexjeexa galinta gluteal. Bukaanjiifka badankoodu waxay leeyihiin calaamado atraumatic ah, oo si qarsoodi ah u bilaabay isticmaalka soo noqnoqda.45
Gabagabadii, sinta xanuunku waa cabasho caadi ah oo laga yaabo inay ku dhacdo arrimo caafimaad oo kala duwan awgeed. Waxaa intaa dheer, goobta saxda ah ee xanuunka sinta ee bukaanku waxay ku siin kartaa macluumaad qiimo leh xirfadlayaasha daryeelka caafimaadka ee ku saabsan sababta asaasiga ah ee dhibaatada. Ujeedada maqaalka kor ku xusan waxay ahayd in la muujiyo lagana hadlo qiimeynta bukaanka qaba xanuunka sinta. Baaxadda macluumaadkayadu waxay ku xaddidan tahay xanuunka loo yaqaan 'chiropractic' iyo sidoo kale dhaawacyada laf dhabarta iyo xaaladaha. 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
Data Sources: Waxaan ka raadinay maqaallo ku saabsan cudurada sinta ee Dhakhaatiirta Qoyska ee Mareykanka, oo ay la socoto tixraacooda. Waxa kale oo aanu baadhnay Wakaaladda Cilmi-baadhista Daryeelka Caafimaadka iyo Warbixinnada Caddaymaha Tayada, Caddaynta Kiliinikada, Machadka Horumarinta Nidaamyada Kiliinikada, Tilmaamaha Hawl-galka Adeegyada Ka-hortagga ee Maraykanka, Guriga Hagaha Qaranka, iyo UpToDate. Waxaan sameynay raadinta PubMed annagoo adeegsanayna ereyada muhiimka ah ee xanuunka 'trochanteric syndrome', baaritaanka jireed ee xanuunka sinta, sawirida jabka diiqada sinta, sawirida ilmada sinta, sawir-qaadista osteomyelitis, ischiofemoral impingement syndrome, dib u eegista meralgia paresthetica, MRI arthrogram hip labrum, dib u eegis nidaamsan arthritis-ka, iyo xanuunka sinta ee ultrasound. Taariikhaha raadinta: Maarso iyo Abriil 2011, iyo Ogosto 15, 2013.
Macluumaadka qoraaga: Aafp.org
Mawduucyo Dheeraad ah: Xanuun Dhabar Ba'an
Xanuunka dhabarka�waa mid ka mid ah sababaha ugu badan ee naafada iyo maalmaha shaqada ka baaqda ee adduunka oo dhan. Xanuunka dhabarka ayaa loo aaneynayaa sababta labaad ee ugu badan ee booqashooyinka xafiiska dhakhtarka, oo ay ka badan yihiin kaliya caabuqyada neef-mareenka sare. Qiyaastii 80 boqolkiiba dadku waxay la kulmi doonaan xanuunka dhabarka ugu yaraan hal mar noloshooda oo dhan. Laf-dhabarta waa qaab dhismeed kakan oo ka kooban lafo, kala-goysyo, seedaha, iyo murqaha, iyo unugyo kale oo jilicsan. Taas awgeed, dhaawacyada iyo/ama xaaladaha sii xumeeyay, sida�maqaarka herniated, ugu dambeyntii waxay keeni kartaa calaamadaha xanuunka dhabarka. Dhaawacyada isboortiga ama dhaawacyada shilalka baabuurta ayaa inta badan ah sababta ugu badan ee xanuunka dhabarka, si kastaba ha ahaatee, mararka qaarkood dhaqdhaqaaqa ugu fudud ayaa keeni kara natiijooyin xanuun leh. Nasiib wanaag, xulashooyinka daaweynta kale, sida daryeelka xanuunka loo yaqaan 'chiropractic care', ayaa kaa caawin kara yareynta xanuunka dhabarka iyada oo loo marayo isticmaalka isbeddelka laf-dhabarka iyo manfacyada gacanta, ugu dambeyntii hagaajinta xanuunka.
MAWDUUC DHEERAAD AH OO MUHIIM AH: Daawaynta Hip Pain Chiropractic
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Xir Accordion
Macluumaadka halkan ku qoran "Qiimaynta Bukaanka qaba Sinta Xanuunka"looma talagelin in lagu beddelo xiriirka qof-ka-qof ah ee leh xirfadle daryeel caafimaad oo u qalma ama takhtar shati haysta mana aha talo caafimaad. Waxaan kugu dhiirigelineynaa inaad sameyso go'aamo daryeel caafimaad oo ku saleysan cilmi-baaristaada iyo iskaashigaaga xirfadle daryeel caafimaad oo u qalma.
Macluumaadka Blog-ga & Wada-hadallada Xadka
Baaxadda macluumaadka waxay ku kooban tahay Chiropractic, murqaha, dawooyinka jireed, fayoobida, gacan ka geysata etiological khalkhalka viscerosomatic gudaha bandhigyada kiliinikada, dhaqdhaqaaqa kiliinikada ee somatovisceral reflex ee la xidhiidha, dhismooyinka subluxation, arrimaha caafimaadka xasaasiga ah, iyo/ama maqaallada daawada shaqaynta, mowduucyada, iyo doodaha.
Waanu bixina oo soo bandhignaa iskaashiga bukaan-socodka oo leh takhasusyo ka kala socda qaybo kala duwan. Khabiir kastaa waxa lagu maamulaa baaxadda ku-dhaqankooda xirfadeed iyo awooddooda shatiga. Waxaan isticmaalnaa borotokoolka caafimaadka iyo fayo-qabka shaqada si aan u daaweyno oo u taageerno daryeelka dhaawacyada ama cilladaha habka muruqyada.
Fiidiyowyadayada, qoraaladayada, mawduucyada, mawduucyada, iyo aragtiyadayadu waxay daboolayaan arrimaha kiliinikada, arrimaha, iyo mawduucyada la xidhiidha oo si toos ah ama si dadban u taageera baaxadda hawlqabadkayaga caafimaad.*
Xafiiskayagu waxa uu si macquul ah isku dayay in uu bixiyo tixraacyo taageero ah waxana uu aqoonsaday daraasadda cilmi-baadhiseed ee la xidhiidha ama daraasadaha taageeraya qoraaladayada. Waxaan siinaa nuqulo ka mid ah daraasadaha cilmi-baarista ee taageeraya ee loo heli karo golayaasha sharciyeynta iyo dadweynaha marka la codsado.
Waxaan fahamsanahay inaan daboolno arrimaha u baahan sharaxaad dheeri ah oo ku saabsan sida ay gacan uga geysan karto qorshe daryeel gaar ah ama hab maamuuska daaweynta; haddaba, si aad uga sii wada hadasho mowduuca kor ku xusan, fadlan si xor ah u weydiiso Dr. Alex Jimenez, DC, ama nagala soo xiriir 915-850-0900.
Waxaan halkan u nimid inaan kaa caawinno adiga iyo qoyskaaga.
Barako
Dr. Alex Jimenez DC, MSACP, RN*, CCST, IFMCP*, CIFM*, ATN*
email: Tababaraha@elpasofunctionalmedicine.com
Ruqsad u haysta sidii Dhakhtar Chiropractic (DC) gudaha Texas & New Mexico*
Shatiga Texas DC # TX5807, Shatiga New Mexico DC # NM-DC2182
Ruqsad u haysta Kalkaaliso Diiwaangashan (RN*) in Florida
Shatiga Florida ee RN # RN9617241 (Maamulka No. 3558029)
Xaaladda is haysta: Shatiga Dawlad-goboleed badan: Loo oggolaaday inuu ku tababarto Gobollada 40*
Dr. Alex Jimenez DC, MSACP, RN* CIFM*, IFMCP*, ATN*, CCST
Kadhkayga Ganacsiga Dijital ah
