Ngakhale kuti gout ingawoneke bwino kwambiri chifukwa cha maonekedwe okha, dokotala nthawi zambiri amafuna kuchita mayesero kuti atsimikizidwe kuti ali ndi vutoli komanso kuti athetse zifukwa zina. Monga nthendayi yomwe imadziwika ndi chikhomo cha uric acid makalumikila, dokotala akhoza kufunafuna umboni wa izi mwa kutulutsa madzi ophatikizana ndi singano kuti aone pansi pa microscope.
Nthawi zina, matenda othetsera matendawa amatha kuyerekeza zizindikiro ndi zovuta za ma lab ndi / kapena kujambula.
Kufufuza Kwambiri
Nthawi zambiri, matenda opatsirana amatha kupangidwa pogwiritsa ntchito ndondomeko ya zizindikiro zanu ndi mbiri yachipatala. Kuphatikizapo kuyezetsa thupi, dokotala wanu akufuna kufotokozera za kuukira (kuphatikizapo momwe zinayambira komanso nthawi yaitali bwanji) ndikufufuza zinthu zomwe zingachititse ngozi.
Zizindikiro zina zowonjezera zingakhale zokwanira kuti matendawa, monga:
- Kuthamanga kwa mono-nyamakazi (kutanthawuza kamodzi kokha kamodzi kakhudzidwa)
- Kupweteka kwakukulu mu choyamba cha metatarsal-phalangeal chala chachikulu chala
- Kutupa kwakukulu ndi redness tsiku limodzi
- Pokhala ndi zowonongeka imodzi mu mgwirizano womwewo
Ngakhale kuti izi ndizo zonse zomwe dokotala wanu akufunikira kupanga dongosolo la chithandizo , umboni wowonjezera ungafunikire d ngati uku ndiko kuyambitsa kwanu koyamba kapena ngati zizindikiro zowonongeka zakhala zovuta.
Mapulogalamu ndi Mayesero
Ndondomeko ya golide yopanga gout diagnosis ndiyo kuchotsa synovial madzi kuchokera palimodzi ndi kufunafuna umboni wa makina a uric acid (otchedwa monosodium urate crystals) pansi pa microscope. Synovial madzi ndi chinthu chobiriwira, chobiriwira chomwe chimayendera pamodzi ndi kuyika malo pakati pa ziwalo.
Ndondomekoyi, yomwe imadziwika ngati synovial fluid analysis , imayamba ndi jekeseni wa mankhwala osokoneza bongo kumalo osokoneza. Patapita mphindi zingapo, adokotala adzaika singano mu malo olowa nawo kuti atenge nyemba yamadzi yomwe ikatumizidwa ku labu kuti iwonetseredwe.
Kuphatikiza pa kufufuza makristasi amchere a monosodium, labu idzayang'ana mazinga a uric acid komanso umboni wa tophus , zipsinjo zolimba za uric acid zomwe zimapezeka mtsogolo mwa matenda.
Zina mwa mayesero ena omwe angathe kulamulidwa:
- Mungayesetse magazi a uric acid kuti muwone ma asidi pamwamba pa 6.8 milligrams pa deciliter (ngakhale anthu omwe ali otsika akhoza kukhala ndi gout).
- Urea ndi creatinine magazi ayesetsedwenso kuti aone ngati impso yanu imakhala yovuta chifukwa cha hyperuricemia (oric acid).
- Kugwiritsiridwa ntchito kwa urinali kungagwiritsidwe ntchito poyang'ana ma intric acid m'mikodzo yanu ndikuyesa kuopsa kwa miyala ya impso.
Mayesero Ojambula
Kuti athandizidwe ndi matendawa, dokotala akhoza kuitanitsa mayesero ojambula kuti aone momwe zimakhalira kapena kuteteza mafupa a mafupa aang'ono omwe amasonyeza nyamakazi. Zojambula zojambula zojambulazo zimaphatikizapo X-ray, computed tomography (CT) , kujambula maginito (MRI) , ndi ultrasound.
Mayeso aliwonse ali ndi ubwino wake ndi zoperewera:
- X-rays akhoza kuwulula fupa la mafuta ndi khunyu koma ndi zothandiza kokha pambuyo pa chaka cha matenda osadziletsa.
- CT ndi MRI akuyang'ana kungathandize kuzindikira kutupa, kutuluka kwa mafupa, ndi kupweteka kwa khungu koma, malinga ndi kafukufuku wofalitsidwa mu European Radiology, sangathe kuzindikira matenda oyambirira.
- Ultrasounds ndi opindulitsa monga momwe zimayendera, zimapezeka mosavuta, ndipo sizikusowa kuti ziwonongeke. Angathenso kuzindikira umboni woyambirira wa crystal deposits, madzi okwanira, ndi kufalikira kwa malo olowa. Pamapeto pake, sangathe kuwona zozama za mgwirizano.
Mwachizoloŵezi, ma ultrasound amatha kugwiritsidwa ntchito ngati mwangoyamba kumene kukumana ndi zizindikiro kapena zida zosavuta. Mayesero ena amalingaliro angapangidwe malinga ndi mbiri ya zizindikiro zanu kapena kuuma kwa chikhalidwe chanu.
Kusanthula Kusiyanasiyana
Ngakhale kuti zizindikiro za gout zingawonekere kukhala zowoneka ndi maonekedwe okha, palinso zinthu ziwiri zomwe madokotala adzaziwona zomwe zili ndi zofanana kwambiri: nyamakazi yodetsa matenda .
Pofuna kusiyanitsa, dokotala amayang'ana zinthu zinayi: kusanthula kwa madzi a synovial (kufufuza umboni wa crystallization), chiwerengero cha magazi oyera (kuyang'ana matenda), chikhalidwe cha magalamu a synovial fluid (kuti aone mabakiteriya), ndi malo omwe mumamva ululu.
Gout
Gout adzakhala ndi zizindikiro zina zomwe zimasiyanitsa ndi matenda ena, omwe ndi:
- Kusanthula kwa madzi a Synovial: makristasi ofanana ndi singano
- Nambala yoyera ya magazi: pansi pa 50,000
- Gram stain culture: zoipa (kutanthauza kuti palibe matenda)
- Malo: makamaka chala chala chachikulu, chapakatikati, bondo, ndi kumapeto kwenikweni (kuphatikizapo dzanja, goli, dzanja, kapena zala pamatenda otha msinkhu)
Pseudogout
Pseudogout ndi malo omwe makandulo a calcium (osati a monosodium urate crystals) amakhala mu malo olowa. Matendawa amatha kusiyanitsidwa ndi gout m'njira zotsatirazi:
- Kusanthula kwa madzi a Synovial: makina oyandikana ndi rhomboid
- Nambala yoyera ya magazi: pansi pa 50,000
- Gram stain chikhalidwe: zoipa
- Malo: kawirikawiri bondo, mkono, kapena chala chachikulu
Nyamakazi ya Septic
Nyamakazi ya Septic, yomwe imatchedwanso kuti nyamakazi yofalitsa, ndipo imayamba chifukwa cha matenda a bakiteriya ndipo ikhoza kupha ngati sichitsatiridwa. Zimasiyana ndi gout mu njira zotsatirazi:
- Kusanthula kwa madzi a Synovial: palibe makristasi
- Nambala yoyera ya magazi: pamwamba pa 50,000
- Zotsatira za tirigu: zabwino (kutsimikizira kachilombo ka bakiteriya)
- Malo: makamaka bondo
> Zotsatira:
> Rettenbacher, T .; Sewnerer, S .; Weirich, H. et al. "Zithunzi zojambulidwa za gout: kuyerekezera zapamwamba za US ndi zowononga X." Eur Radiol. 2008; 18 (3): 621-30. DOI: 10.1007 / s00330-007-0802-z.
> Tuhina, N .; Jansen, T .; Dalbeth, L. et al. "Zotsatira za Gout ya 2015 Gulu la American College of Rheumatology / European League Against Rheumatism Ogwirizanitsa Poyambira e." Arthritis Rheumatol. 2015; 67 (1): 2557-68. DOI: 10.1002 / luso.39254.