Oi ponoi gonatos apoteloyn mia syxnh enoxlhsh, aformh pollwn iatrik. episkepsewn.

Prokeitai gia ena symptwma poy mporei na proklhthei apo poikiles aities, poly diaforetikes h mia

apo thn allh:

mporei na afora ena nearo atomo poy ypoferei apo pono eksaitias enos diastremmatos (me synepakoloytho traymatismo stoys syndesmoys h ston mhnisko). enan hlikiwmeno me problhma arthritidas sto gonato. enan athlhth me flegmonh toy epigonatidikoy tenonta (“jumpers knee”).h enan efhbo me pono sthn knhmiaia apofysh (nosos toy Osgood Schlatter). reymatoeidhs arthritida.pathologies toy xondroy ths epigonatidas (xondropatheia ths epigonatidas, gnwsth kai san “gonato toy dromea”) .thylakitida (“gonato ths noikokyras”).Profanws, ta symptwmata einai ligotero h perissotero entona kai poikiloyn, analoga me th sobarothta kai to eidos ths pathologias poy eythynetai gia ton pono toy gonatos, kai epomenws tis diafores emplekomenes domes aytoy. Genika, einai dynaton na diakrinei kaneis periptwseis entonoy ponoy, syxna apotelesma enos traymatismoy, apo alles, xronioy ponoy.

Sthn periptwsh toy diastremmatos mporei na diapistwthei sto gonato mia kakwsh (poy mporei na ftasei mexri th rhksh) se enan h perissoteroys apo toys syndesmoys, tis tainies inwdoys istoy poy enwnoyn to mhriaio osto me thn knhmh kai eggywntai th statherothta ths arthrwshs (plagioi kai xiastoi syndesmoi). Se aytes tis periptwseis, to gonato prhzetai, o ponos einai oksys kai epideinwnetai me thn epibarynsh kai thn kinhsh ths arthrwshs, h opoia, paroysia rhkshs enos syndesmoy, apokta mia asynhthisth astatheia.

Enas traymatismos mporei na prokalesei, epishs, blabh se enan apo toys dyo mhniskoys, ta hmiselhnoeidh inoxondrina tmhmata poy paremballontai metaksy mhriaioy ostoy kai knhmhs. Sthn periptwsh traymatismoy, ektos toy ponoy kai toy oidhmatos, mporei na emfanistoyn kai alla symptwmata. Ean h rhksh mhniskoy einai epimhkhs me anadiplwsh (“dikhn labhs kadoy”), mporei to kommeno tmhma toy mhniskoy na anashkwthei apo th thesh toy kai na prokalesei emplokh ths arthrwshs. Ena allo symptwma ths kakwshs mhniskoy einai h ksafnikh xalarwsh toy gonatos, otan, gia paradeigma, katebainei kaneis tis skales.

Orismenes fores, oi traymatismoi poy eythynontai gia ton pono sto gonato den einai okseis. Prokeitai gia thn periptwsh ths tenontitidas ths epigonatidas, opoy h flegmonh ofeiletai synhthws se leitoyrgikh yperfortwsh. Prokeitai gia mia synhthh blabh, poy parathreitai kyriws se athlhtes poy ekteloyn syxna almata (paiktes toy mpasket, toy bolei, alla kai athlhtes toy badhn), kai ekdhlwnetai me pono kai oidhma sthn mprostinh pleyra toy gonatos, akribws katw apo thn epigonatida. O ponos epideinwnetai otan o tenontas kataponeitai me almata, treksimo, k.a.

Merikes fores, oi epanalambanomenoi traymatismoi mporei na odhghsoyn se thylakitida, th flegmonh, dhladh, toy thylaka poy fysiologika periexei mia elaxisth posothta arthrikoy ygroy, poy dra ws lipantiko, meiwnontas tis tribes metaksy ostwn, mywn kai tenontwn. Kata thn yparksh thylakitidas (“gonato ths noikokyras”), h perioxh emfanizetai prhsmenh, zesth kai ponemenh, mporei na yparxei aisthhsh akampsias kata to lygisma toy gonatoy kai, profanws, o ponos epideinwnetai sth gonatisth thesh.

Mia syxnh aitia ponoy gonatoy stoys efhboys einai to syndromo toy Osgood-Schlatter, poy xarakthrizetai apo thn paroysia ponoy kai oidhmatos ths ostikhs proeksoxhs poy brisketai akribws katw apo thn epigonatida (knhmiaios kondylos) kai ofeiletai se flegmonh toy akroy toy knhmiaioy ostoy, poy den exei osteopoihthei plhrws. O ponos epideinwnetai otan to agori (synhthws prosballei ta agoria) askeitai, eidika me to treksimo h ta almata, kai beltiwnetai me thn anapaysh. Genika, diarkei ebdomades h kai mhnes kai mporei na epanemfanistei, ews otoy oloklhrwthei h diadikasia anaptykshs toy efhboy.

Antitheta, pio synhthismenh stis kopeles kai stoys athlhtes twn agwnwn dromoy einai h xondropatheia ths epigonatidas, h alliws “ponos sthn prosthia epifaneia toy gonatoy”. To xarakthristiko symptwma einai o ponos sth mprostinh pleyra toy gonatoy, o opoios synhthws epideinwnetai otan kaneis paramenei gia wra kathistos me ta podia lygismena se gwnia 90 moirwn (to legomeno “syndromo toy sinema”) h otan pragmatopoioyntai diadromes se kathfora.

H paroysia arthritidas sto gonato ekdhlwnetai me pono diaforwn entasewn, endexomenws synodeyomeno apo oidhma, kai o opoios epideinwnetai sthn orthia thesh kai me to perpathma. Eidika tis prwines wres, meta to ksypnhma, mporei na yfistatai kai mia sxetikh akampsia ths arthrwshs, poy genika epilyetai mesa se diasthma merikwn leptwn.

Poly sobarotera einai ta symptwmata ths reymatoeidoys arthritidas: h pathoysa arthrwsh (h pathhsh synhthws plhttei kai ta dyo gonata sygxronws) einai zesth, ponemenh kai prhsmenh. H reymatoeidhs arthritida, ektos apo to gonato, plhttei kai alles arthrwseis (synhthws ekeines twn xeriwn). Typikh einai h prwinh akampsia poy diarkei gia arketh wra, se genikes grammes perissotero apo mish wra. Epishs, makroprothesma prokaleitai paramorfwsh twn arthrwsewn.

Polyarithmoi einai oi paragontes kindynoy poy mporoyn na eynohsoyn thn emfanish pathologiwn sto gonato. H paxysarkia, oi traymatismoi, h yperxrhsh einai paragontes poy eynooyn thn arthritida gonatos, sthn emfanish ths opoias paizoyn, epishs, rolo to fylo kai mia sxetikh genetikh prodiathesh. Apo thn allh pleyra, h ektelesh epanalambanomenwn drasthriothtwn, poy ekthetoyn tis domes toy gonatos se yperbolikh kataponhsh, mporei na eynohsei thn tenontitida. Epipleon, h yparksh mhxanikwn problhmatwn, opws to na exei kaneis “straba” gonata (raiba kai blaisa gonata), mporei na eynohsei thn emfanish problhmatwn sta gonata.

Ta diastremmata kai oi synepakoloythes blabes se syndesmoys kai mhniskoys prokaloyntai apo mia isxyrh dynamh, poy anagkazei thn arthrwsh na ektelesei mia kinhsh peran twn fysiologikwn oriwn.

H tenontitida ths epigonatidas einai mia pathologia leitoyrgikhs yperfortwshs, poy ofeiletai sthn yperbolikh kataponhsh sthn opoia ypoballetai o tenontas, apo toys athlhtes poy ekteloyn kinhseis poy prokaloyn synexeis kai epanalambanomenes kataponhseis ayths ths domhs.

H proepigonatidikh thylakitida ekdhlwnetai meta apo drasthriothtes poy anagkazoyn ena atomo na paramenei gia pollh wra se gonatisth thesh, opws mporei na symbei, gia paradeigma, stoys khpoyroys h stoys plakades.

Sthn periptwsh ths nosoy toy Osgood Schlatter, h flegmonh prokaleitai apo th synexh piesh poy askeitai ston epigonatidiko tenonta sto akro ths knhmhs, poy einai akoma se anaptyksh. Se ayth thn periptwsh, oi drasthriothtes poy eynooyn thn emfanish ths diataraxhs einai ekeines poy, opws ta almata kai to treksimo, prokaloyn entones pieseis ston tenonta poy prosfyetai sthn knhmh.

Enas paragontas poy eynoei thn emfanish ponoy sthn prosthia epifaneia toy gonatos einai h alloiwsh toy systhmatos metaksy epigonatidas kai mhriaioy ostoy. H epigonatida einai ena osto se sxhma diamantioy poy akoympa se mia koilh epifaneia toy mhriaioy ostoy, opoy olisthainei. Ean h epigonatida, anti na akoloythei th fysiologikh troxia olisthhshs, teinei na metakineitai plagiws, h epafh ths me to mhriaio osto alloiwnetai. Otan symbainei ayto, h epigonatida arxizei na dysleitoyrgei kai o xondros, poy kalyptei thn epifaneia toy mhriaioy ostoy panw sthn opoia olisthainei h epigonatida, ftheiretai(xondropatheia epigonatidas).

Ayto poy symbainei sthn arthritida einai h stadiakh apwleia toy xondroy poy kalyptei tis arthrikes epifaneies. Ayto to fainomeno prokaleitai, afenos, apo thn yperfortwsh ths arthrwshs kai, afeteroy, apo thn aykshmenh drasthriothta sygkekrimenwn enzymwn, ikanwn na afomoiwnoyn ton xondrino isto. Etsi ekshgeitai to giati h hlikia einai enas paragontas amesa syndedemenos me thn emfanish ths arthritidas.

Sth bash ths reymatoeidoys arthritidas yparxei ena "sfalma" toy anosopoihtikoy systhmatos( toy mhxanismoy poy fysiologika prostateyei ton organismo apo molynseis kai ogkoys) .Etsi sthn prokeimenh periptwsh, anti na kateythynei th drash toy enantia se enan “eisbolea”, thn kateythynei stoys dikoys ths arthrikoys istoys, dhmioyrgwntas mia flegmonh, h opoia toys ftheirei.

Oi traymatismoi kai oi ekfylistikes alloiwseis twn xondrwn twn arthrwsewn poy ypoballontai se kataponhsh, prokaloyn arnhtikes synepeies braxyprothesma kai makroprothesma. Prepei, edw, na anaferthei oti stoys arthrikoys xondroys den yparxoyn aimofora aggeia kai, epomenws, steroyntai twn synthrhtikwn kai epanorthwtikwn diadikasiwn poy odhgoyn sthn apokatastash twn blabwn. Oi yparxoyses alloiwseis teinoyn, loipon, na ekselissontai kai na kathistantai olo kai pio sobares, me apotelesma metaboles stis mhxanikes idiothtes twn arthrwsewn.

Prokeitai gia mia katastash poy prodiathetei gia peraiterw ekfylismo twn arthrwsewn kai gia thn epideinwsh twn symptwmatwn.

H paroysia tmhmatwn xondroy sto eswteriko ths arthrwshs parempodizei th fysiologikh kinhtikothta ths arthrwshs kai "anatrofodotei" to problhma dhmioyrgwntas nees sobares blabes. Profanws, ena typiko symptwma einai o ponos poy mporei na synodeyetai me oidhma ths arthrwshs kai poy synhthws ekdhlwnetai to prwi, atonei me th drasthriothta, alla teinei na epanemfanizetai otan kataballetai entonh prospatheia.

H emfanish alloiwsewn sto xondro poy kalyptei thn epifaneia twn ostwn poy erxontai se epafh se mia arthrwsh, mporei na einai synepeia enos traymatismoy h na eksartatai apo ekfylistika fainomena.

H xondropatheia mporei na ekdhlwthei stoys athlhtes poy ypoballoyn tis arthrwseis toys (synhthws ekeines poy yposthrizoyn fortia) se epanalambanomenes kataponhseis.

Orismenes synthhkes mporoyn na ekthesoyn thn arthrwsh se megalytero kindyno na ypostei traymatismoys twn xondrwn,opws proyparxoysa astatheia , fainomeno poy mporei na parathrhthei se enan athlhth poy synexizei thn athlhtikh drasthriothta paroysia traymatismoy twn syndesmwn.

Epishs, mia alloiwsh twn fysiologikwn arthrikwn domwn einai dynaton na eynohsei th fthora toy xondroy, opws symbainei sthn periptwsh ths xondropatheias ths epigonatidas, sthn opoia parathreitai allagh ths troxias olisthhshs ths epigonatidas se sxesh me to mhriaio osto. Kata thn kinhsh, h epigonatida brisketai se plagia thesh se sxesh me th fysiologikh, me apotelesma o xondros poy kalyptei thn epifaneia opoy h epigonatida erxetai se epafh me to mhriaio osto na ftheiretai.

Basiko rolo sthn leitoyrgia toy wmoy paizoyn kapoioi myes kai oi antistoixoi tenontes poy tyligontai gyrw -gyrw apo thn kefalh toy braxionioy(to anw akro toy braxionioy ostoy poy arthrwnetai me thn wmoplath) kai oi opoioi sxhmatizoyn to legomeno strofiko petalo .

H kefalh toy braxionioy, malista, einai sxedon apla akoympismenh panw sthn arthrikh koilothta ths wmoplaths (wmoglhnh) kai gi ayto h diathrhsh ths sth swsth thesh kai h statherothta ths arthrwshs eksartwntai kata kyrio logo apo to petalo strofewn kai apo alloys statheropoihtes poy einai seires syndesmwn kai mywn.

Prokeitai gia ena systhma me pente "ypoarthrwseis" poy mporei na ftharei me sxetikh eykolia ean xalasei mia toylaxiston apo tis ypoarthrwseis dhmioyrgwntas fainomeno ntomino meta apo okseis traymatismoys, gia paradeigma ptwseis, h akoma syxnotera logw xronias yperkopwshs.

To kyrio symptwma ths tenontopatheias toy petaloy strofewn einai anamfisbhthta o ponos, poy paroysiazetai kata thn ektelesh orismenwn kinhsewn, opws h anypswsh toy braxiona h h topothethsh toy pisw apo thn plath prokalwntas periorismo ths kinhtikothtas ths arthrwshs

Etsi, teinei kaneis na th xrhsimopoiei logw toy ponoy oso to dynaton ligotero, me apotelesma o wmos na “mplokarei” olo kai perissotero, mexris otoy katalhksei ston legomeno “pagwmeno wmo”, mia katastash sthn opoia h kinhsh ginetai sxedon adynath.

O ponos kanei syxna thn emfanish toy akoma kai kata th diarkeia ths nyxtas kai mporei, gia paradeigma, na empodisei thn plagia kataklish apo th meria toy ponemenoy wmoy h akoma kai na dwsei eikona kardiakoy problhmatos ton asthenh. Se pio sobares periptwseis, o ponos mporei na einai aisthhtos akoma kai kata th diarkeia ths meras. Syxna teinei na aktinobolei pros thn ekswterikh pleyra toy braxiona se ena shmeio sta misa peripoy ths apostashs metaksy wmoy kai agkwna.

Diaforoi einai oi paragontes poy symballoyn sthn proklhsh enos traymatismoy h mias blabhs twn tenontwn.

Ektos apo toys spanioys okseis traymatismoys apo mia ptwsh, opoy h kefalh toy braxionioy mporei na “tentwsei” toys tenontes traymatizontas toys, yparxoyn ta pio synhthh traymata logw yperxrhsimopoihshs. Mporei na ofeilontai se epanalambanomenes kinhseis anypswshs twn braxionwn h entonh prospatheia logw arshs barwn h akoma kai se epanalambanomenes kinhseis

Oi tenontes mporei na flegmainoyn, gegonos poy symbainei se athlhtes poy ypoballoyn toys wmoys se synexh entash enw mporei na symbei kai se atoma poy asxoloyntai me sygkekrimenes epaggelmatikes drasthriothtes opoy xrhsimopoioyn ta anw akra se epipedo pshlotera apo ton wmo h kanoyn epanalambanomenes kinhseis me xeirotero ton syndyasmo aytwn twn dyo.

Prepei, epishs, na shmeiwthei oti, otan kaneis anypswnei kai ekteinei ton braxiona, o diathesimos xwros mesa ston opoio brisketai to petalo strofewn meiwnetai kai, kata synepeia, oi tenontes mporei na “egklwbistoyn” metaksy twn ostwn ths wmoplaths. Orismena atoma exoyn ena ek geneths “kataskeyastiko elattwma” sthn wmoplath: o xwros ston opoio brisketai to petalo strofewn einai poly stenos, gegonos poy odhgei se blabes twn tenontwn.

Se bathos xronoy , an h tenontitida den therapeytei, prokalei thn eksasthenish twn tenontwn, enw, se kapoies periptwseis, akoma kai th rhksh toys. Enas allos paragontas poy prepei na lhfthei ypopsh einai h hlikia: me thn parodo toy xronoy oi tenontes ftheirontai kai ypokeintai eykolotera se mikrotraymatismoys.

Epipleon, me to perasma toy xronoy mporei na parathrhthei mia enapothesh asbestioy stis prosbeblhmenes perioxes poy basika einai h prospatheia apokatastashs poy kanei o idios o organismos sthn blabh poy exei dhmioyrghthei (prokeitai gia thn klasikh periptwsh ths asbestopoioy tenontitidas toy wmoy.

Me to perasma twn xronwn oi mesospondylioi diskoi, ta maksilarakia poy einai metaksy twn spondylwn kai poy energoyn ws “amortiser”, gernoyn, xanoyn ta systatika toys kai thn

elastikothta toys.

Metaksy twn aitiwn twn diadikasiwn aytwn einai sigoyra to ghras: meletes exoyn apodeiksei oti aktinologikes endeikseis ayxenikhs arthropatheias parathroyntai sto 13% twn andrwn metaksy twn 30 kai twn 40 xronwn kai sto 100% twn 70arhdwn,enw ta antistoixa pososta stis gynaikes einai to 5% sta 40 xronia kai to 96%

sta 70.

Paragontes poy mporei na aykshsoyn ton kindyno prosbolhs apo ayxenikh arthropatheia einai i hlikia , to fylo, oi epanalambanomenoi traymatismoi, h klhronomikh prodiathesh kai to kapnisma .

To ayxeniko syndromo einai mia pathhsh synhthhs, poy ofeiletai sthn fthora twn mesospondyliwn diskwn poy paremballontai metaksy twn spondylwn.

Synhthws emfanizetai meta thn hlikia twn 40 etwn kai, parolo poy prosballei toso tis gynaikes oso kai toys antres, paroysiazetai pio prowra stoys antres. Oi alloiwseis twn spondylwn mporei na prokalesoyn erethismo twn neyrikwn rizwn poy anafyontai apo ton nwtiaio myelo kai ekserxontai apo th spondylikh sthlh.

O ponos arxika einai hpios, alla proodeytika teinei na epideinwnetai kai mporei na ginei sobaros kai anypoforos.Synhthws aktinobolei stoys wmoys kai toys braxiones, enw merikes fores mporei na synodeyetai apo moydiasma stoys braxiones kai sta xeria me apwleia ths aisthhshs kai adynamia.

Peristrefontas to kefali, mporei na parathrhthoyn triksimata ston ayxena, enw kapoies fores mporei na ekdhlwthei ponokefalos, synhthws sthn pisw pleyra toy kefalioy.

Οι Oi tenontes einai tainies inwdoys istoy poy syndeoyn toys myes me ta osta.

Me ton oro tenontitida orizetai h flegmonh poy ekdhlwnetai se mia apo aytes tis domes.

Ta symptwmata ths tenontitidas poikilloyn analoga me thn perioxh sthn opoia ekdhlwnontai,omws panta oi "traymatismenoi" tenontes prokaloyn pono kata thn kinhsh , sthn piesh, akoma kai se mikres kinhseis.

Antitheta, milame gia tenontoelytritida otan h flegmonh plhttei, ektos apo ton tenonta, kai thn prostateytikh thhkh (elytro) poy ton periballei. Einai dynaton se ayth thn periptwsh na paroysiastei diogkwsh, logw sygkentrwshs antidrastikoy flegmonwdoys ygroy.

Kapoioi tenontes pathainoyn pio syxna tenontitida,prokeitai :

gia toys tenontes twn mywn toy wmoy- se periptwsh flegmonhs toy petaloy twn strofewn mywn ston wmo.

toy Axilleioy tenonta opoy o ponos entopizetai sthn perioxh akribws panw apo th pterna

twn tenontwn toy karpoy.

twn tenontwn twn mywn toy antibraxioy sto ypsos toy agkwna- sthn periptwsh ths epikondylitidas o ponos entopizetai ston agkwna.

toy epigonatidikoy tenonta poy prosfyetai sto gonato -an h tenontitida afora ton epigonatidiko tenonta o ponos entopizetai akribws katw apo thn epigonatida.

twn prosagwgwn mywn sthn eswterikh pleyra toy mhroy.

toy makroy apagwgoy kai toy braxews ekteinonta ton antixeira (syndromo toy De Quervain) ston karpo apo th pleyra toy antixeira kai sth bash toy daktyloy -sthn periptwsh ths tenontoelytritidas .

Se periptwsh flegmonhs twn kampthrwn tenontwn twn daktylwn einai dynaton na paroysiastei to fainomeno toy ektinassomenoy daktyloy. Ayto symbainei giati o erethismenos tenontas , de mporei na kinhthei eleythera mesa sthn prostateytikh toy thhkh,epeidh exei diogkwthei,me apotelesma na

“egklwbizetai” kai na mhn mporei pia na gyrisei pisw, prokeimenoy na tentwsei ksana to daxtylo. Gia na apeleytherwthei einai aparaithto na eksanagkastei h kinhsh toy daktyloy, wste na proklhthei ena eidos “ektinakshs”.

Oi pio shmantikes aities ths tenontitidas einai anamfisbhthta:

oi palaioteroi traymatismoi.

oi mikrotraymatismoi (poy ofeilontai sthn yperbolikh xrhsh h sthn lanthasmenh texnikh kata thn epaggelmatikh drasthriothta h kata thn athlhsh) einai mia apo tis kyries aities twn pathologiwn twn tenontwn.

h aykshsh ths hlikias opoy oi tenontes xanoyn thn elastikothta toys, gegonos poy toys kathista pio epirrepeis stoys traymatismoys.

reymatikes pathhseis opws reymatoeidhs arthritida kai alles mporei na synodeyontai apo thn emfanish tenontitidas.

Einai eynohto oti atoma poy askoyn drasthriothtes poy apaitoyn epanalambanomenes kai akraies kinhseis sygkekrimenwn shmeiwn toy swmatos, diatrexoyn megalytero kindyno na ypoferoyn apo tenontitida.

Etsi,enas tenistas exei perissoteres pithanothtes na ypoferei apo mia epikondylitida, poy tha plhksei to xeri me to opoio paizei .

enas podosfairisths einai pio ektetheimenos stis flegmones twn tenontwn twn podiwn, opws, gia paradeigma, twn prosagwgwn

enw oi athlhtes poy eksaskoyn ena athlhma poy problepei syxna almata mporoyn na prosblhthoyn eykolotera apo tenontitida ths epigonatidas.

To syndromo thwrakikhs eksodoy ofeiletai kyriws:

sthn piesh ths ypokleidias arthrias kata thn eksodo ths apo to thwraka kai kata th diadromh ths mexri th masxalh.

se piesh toy braxionioy plegmatos se ayth thn perioxh.

se paroysia yperarithmhs ayxenikhs pleyras h ypertrofikoy prosthioy skalhnoy myos.

spaniotera se paroysia ogkoy Pancost -koryfhs pneymonwn.

Ekdhlwnetai me dialeiponta pono toy anw akroy o opoios entopizetai sthn perioxh ths wmikhs zwnhs me epektash sthn esw epifaneia toy anw akroy kai thn perioxh katanomhs toy wlenioy neyroy enw mporei na antanakla pros ton ayxena kai thn perioxh toy aytioy kai toy proswpoy (Neyrologikhs aitiologias syndromo thwrakikhs eksodoy).

Eidikes dokimasies gia th diagnwsh toy syndromoy einai h dokimasia Adson kata thn opoia o kerkidikos sfygmos pshlafatai prin kai meta thn arsh toy wmoy se apagwgh, ektash kai eksw strofh opote h meiwsh h kai eksaleipsh einai endeiktika shmeia ths nosoy. Alles dokimasies einai epishs h dokimasia toy pleyrokleidikoy xwroy me thn opoia symplhsiazetai h prwth pleyra pros thn kleida me apotelesma na steneyei o xwros metaksy toys. O eksetazomenos se ayth th dokimasia einai se orthia stash kai meta apo batheia eispnoh steketai se stash prosoxhs , dhladh proteinei to thwraka kai kataspa toys wmoys. H eksasthenish h kai eksafanish toy kerkidikoy sfygmoy apotelei thetikh dokimasia.

Gia th diagnwsh toy syndromoy aparaithtos einai :

o aktinologikos elegxos o opoios tha apokleisei thn paroysia yperarithmhs pleyras h ogkoy Pancost ,

yperhgografikos elegxos twn aggeiwn me Triplex

ligotero syxna aggeiografia.

O hlektromyografikos elegxos an kai ligotero xrhsimos mporei na paokalypsei shmeia pieshs kai ektos apo thn perioxh toy braxionioy plegmatos opws se piesh sthn aylaka toy wlenioy neyroy h ston karpiaio swlhna (double crush syndrome).

Diaforikh diagnwsh ginetai apo:

periptwseis wlenias neyritidas,

ayxenikhs myelopatheias,

pathhsewn toy wmoy ktl.

H therapeia einai:

katarxhn synthrhtikh kyriws me askhseis endynamwshs twn mywn ths wmikhs zwnhs

ekpaideysh swsths stashs kai xalarwshs

enw se apotyxia ginetai xeiroyrgikh apeleytherwsh.

H epikondylitida xarakthrizetai apo th ashpth flegmonh twn tenontwn twn mywn toy antibraxioy, poy katalhgoyn sto ypsos toy agkwna. H flegmonh mporei na afora eite toys eksw plagioys tenontes (eksw epikondylitida, o gnwstos “Tennis Elbow”), eite thn eswterikh pleyra toy agkwna (esw epikondylitida), kai ofeiletai sthn yperbolikh xrhsh twn mywn toy antibraxioy.

Ayth h tenontitida logw yperbolikhs kataponhshs einai synhthhs se osoys ergazontai h genika exoyn drasthriothtes poy apaitoyn entonh prospatheia sto ypsos toy agkwna. O ponos entopizetai synhthws sthn ekswterikh h thn eswterikh pleyra toy agkwna kai mporei na aktinobolei pros ta katw, kata mhkos toy antibraxioy mexri ton karpo.

Kyriws o ponos megalwnei otan askeitai piesh sthn perioxh poy exei to problhma , kata thn kinhsh toy karpoy h otan ekteloyntai diafores synhthismenes kinhseis opws h xeirapsia h to shkwma akoma kai enos pothrioy me nero. Etsi eksaitias toy ponoy ths epikondylitidas, h dynamh toy xerioy teinei na meiwthei. Ean o ponos den antimetwpistei, einai dynaton na epideinwthei kai me to perasma toy xronoy na einai aisthhtos akoma kai kata thn anapaysh.

Aitia ths epikondylitidas einai h yperbolikh kataponhsh twn tenontwn. H yperbolikh syspash twn mywn toy antibraxioy kai h entash, opws ekeinh poy prokaleitai apo th metadosh ths dynamhs apo th raketa, kata th stigmh poy xtypaei to mpalaki, mporoyn na dhmioyrghsoyn flegmonh kai mia seira mikroskopikwn traymatismwn sto ypsos twn tenontwn poy prosfyontai ston agkwna.

Perissotero ektetheimenoi ston kindyno einai oi ellipws proetoimasmenoi, apo texnikhs apopshs, latreis toy tenis, eidika an xrhsimopoioyn syxna thn anapodh mpalia me lanthasmenes kinhseis.

H onomasia “tennis elbow” den apokleiei to endexomeno ta aitia ths epikondylitidas na entopizontai kai se alles drasthriothtes poy apaitoyn epanalambanomenes kinhseis, opws h xrhsh sfyrioy, h zwgrafikh, h xrhsh katsabidioy, tsoygkranas k.l.p. Ayto shmainei oti kai oi ksyloyrgoi, oi khpoyroi, oi elaioxrwmatistes, alla kai orismenoi moysikoi einai ektetheimenoi ston kindyno.

To diastremma einai to apotelesma enos emmesoy traymatismoy poy anagkazei thn arthrwsh na ektelesei mia yperbolikh kinhsh,pera apo ta oria ths se sxesh me th synhthh kinhtikothta ths, me synepeia thn yperbolikh kataponhsh twn arthrikwn domwn kai thn pithanh proklhsh blabhs ston arthriko thylaka kai toys syndesmoys.

Idiaitera ektetheimenoi ston kindyno na ypostoyn diastremma einai h arthrwsh toy gonatos, toy astragaloy(podoknhmikh), toy agkwna, twn daktylwn kai ths spondylikhs sthlhs.

Milame gia

1.diastremma 1oy bathmoy, h “gyrisma”, otan diapistwnetai aplh diatash twn syndesmwn h toy arthrikoy thylakoy , h blabh einai elaxisth kai parathroyntai mono mikres rhkseis orismenwn inwdwn istwn.O ponos einai, genika, pio hpios kai mporei na yparxei elafry oidhma.

2.diastremma 2oy bathmoy yfistatai merikh rhksh o arthrikos thylakos kai oi syndesmoi.

3.enw sto diastremma 3oy bathmoy yparxei olikh rhksh aytwn twn domwn.

Profanws, h sobarothta twn symptwmatwn einai analogh ths barythtas toy traymatismoy:

O ponos mporei na mh ginei amesa antilhptos th stigmh toy traymatismoy, eidika an symbei kata th diarkeia mias entonhs drasthriothtas, wstoso, emfanizetai sth synexeia kai teinei na epideinwnetai me thn kinhsh.

H diogkwsh ths arthrwshs einai ena akomh typiko symptwma toy diastremmatos.

Syxna synodeyetai apo ekxymwsh (melaniasma), poy ofeiletai sth diarroh aimatos stoys istoys meta ton traymatismo.

Orismenes fores, stis pio sobares periptwseis, parathreitai kai h ekxysh aimatos sto eswteriko ths arthrwshs (aimarthrwma).

Yfistatai periorismos ths leitoyrgikothtas kai syspash twn mywn, fainomeno poy dra analghtika, dhladh me skopo th meiwsh toy ponoy.

Otan oi syndesmoi exoyn ypostei kakwsh, kai dedomenoy oti o rolos toys einai h diathrhsh ths statherothtas ths arthrwshs, mporei na parathrhthei mia aykshsh toy eyroys twn pathhtikwn kinhsewn, h opoia, an h kakwsh den antimetwpistei katallhla, mporei na ekselixthei se plhrh xronia astatheia ths arthrwshs , analoga me thn ektash toy traymatismoy.

Ta diastremmata einai enas syxnos traymatismos logw yperbolikhs diatashs h streblwshs mias arthrwshs.

Mporei na symbei, gia paradeigma, sto gonato otan kaneis pesei kanontas ski kai to podi meinei “mplokarismeno”, enw o kormos strefetai me aksona to gonato. Se aytes tis periptwseis, to apotelesma einai, syxna, h kakwsh toy prosthioy xiastoy syndesmoy, enos apo toys kyrioys syndesmoys poy eksasfalizoyn th statherothta toy gonatoy.

Profanws, einai eykolotero na ypostei kaneis ena diastremma otan eksaskei ena athlhma xwris prohgoymenh proponhsh, xrhsimopoiwntas lanthasmenh texnikh kai otan einai koyrasmenos.

THLASH

Kata th diarkeia ths swmatikhs askhshs, idiaitera an ginei mia apotomh kai ksafnikh kinhsh, poy exei ws apotelesma th biaih syspash h thn yperbolikh diatash enos my, isws na aisthanthei kaneis enan ksafniko kai dynato pono.

O logos poy ton prokalese mporei na einai ena trabhgma toy my h akoma kai mia thlash. Se antithesh me th thlash, sthn periptwsh toy trabhgmatos den parathreitai traymatismos twn myikwn inwn, einai, wstoso, shmantiko na diakopei amesa h drasthriothta gia na apofeyxthei h proklhsh mias thlashs.

H myikh thlash einai ena mikro sxisimo (rhksh) twn myikwn inwn: mporei na prokeitai gia mia elaxisth blabh, poy afora pososto mikrotero toy 5% twn myikwn inwn (thlash prwtoy bathmoy), h gia enan sobarotero traymatismo me merikh rhksh twn myikwn inwn (thlash deyteroy bathmoy), ews kai thn plhrh rhksh toy my (thlash tritoy bathmoy).

Profanws, ta symptwmata eksartwntai apo to bathmo sobarothtas toy traymatismoy. Sthn periptwsh toy trabhgmatos, o ponos exei thn tash na ginetai proodeytika dynatoteros, enw ginetai aisthhth h paroysia toy san ena eidos “ponemenoy kordonioy”.

Sthn periptwsh ths myikhs thlashs, h rhksh twn myikwn inwn prokalei sygkentrwsh aimatos, poy sysswreyetai stoys istoys me apotelesma thn dhmioyrgia aimatwmatos, oi diastaseis toy opoioy einai analoges ths sobarothtas ths kakwshs.

To kyrio symptwma einai o ponos kata thn anapaysh, poy xeirotereyei me thn prospatheia kinhshs toy endiaferomenoy my kai synodeyetai apo leitoyrgikh anikanothta, ws apotelesma na ginetai adynath h xrhsh toy prosbeblhmenoy my. Sygxronws, einai dynaton na parathrhthei oidhma, kokkinisma kai ekxymwsh (melaniasma).Prokeitai gia poly synhthismena problhmata, ta opoia, tis perissoteres fores prokaloyn elafres blabes .

O mys mporei na ypostei thlash, otan h efarmozomenh dynamh einai megalyterh apo ekeinh poy mporei na anteksei h epeidh den einai proetoimasmenos gia thn prospatheia poy kaleitai na epitelesei h, akoma, epeidh einai hdh kataponhmenos logw yperbolikhs xrhshs.

Prokeitai gia katastaseis poy parathroyntai otan o mys tentwnetai yperbolika h me aifnidio tropo h otan syspatai entona kai ksafnika. Ayto symbainei, gia paradeigma, otan olisthainei kaneis se mia leia epifaneia h otan shkwnei ena bary antikeimeno me lanthasmenh texnikh. Orismenoi myes einai pio epirrepeis apo alloys sto na ypostoyn thlash. Prokeitai gia toys myes ths knhmhs, toy mhroy kai ths meshs.

Oi akoloythes synthhkes eynooyn thn emfanish thlashs:Elliphs proponhsh: einai pio eykolo na ypostei kaneis mia myikh thlash ean askei mia athlhtikh drasthriothta xwris na einai katallhla proetoimasmenos To kryo: h eksaskhsh enos athlhmatos se xamhles thermokrasies prokalei meiwsh ths elastikothtas twn mywn.Epifoba athlhmata: orismenes drasthriothtes poy perilambanoyn, gia paradeigma, almata kai treksimo, ekthetoyn perissotero apo alles ston kindyno myikwn traymatismwn Koyrash. Prokeitai gia enan akomh shmantiko paragonta: enas kataponhmenos mys “paradinetai” pio eykola, otan ektethei se mia dynamh ikanh na ton tentwsei yperbolika Elliphs prothermansh: prin thn enasxolhsh me mia apaithtikh swmatikh drasthriothta einai apolytws aparaithth h proetoimasia twn mywn, to katallhlo zestama toys kai h ektelesh askhsewn stretching Palaioteroi traymatismoi: enas mys poy exei hdh ypostei mia kakwsh sto parelthon exei meiwmenh elastikothta.

Sxedon oloi gnwrizoyn oti h osfyalgia apotelei mia apo tis synhthesteres enoxlhseis: einai h deyterh aitia iatrikwn episkepsewn, meta th griph, kai ektimatai oti 4 sta 5 atoma tha ypoferoyn kapoia stigmh sth zwh toys apo aythn.

H spondylikh sthlh apoteleitai apo toys spondyloys, metaksy twn opoiwn paremballontai oi mesospondylioi diskoi, oi opoioi leitoyrgoyn ws “amortiser”, kai h statherothta ths eksasfalizetai mesa apo ena synolo syndesmwn kai mywn poy toys periballoyn.

Sto eswteriko ths spondylikhs sthlhs-gia logoys prostasias brisketai o nwtiaios myelos, apo opoy anafyontai ta neyra, ta opoia pernane apo to spondyliko swlhna diamesoy twn spondylikwn trhmatwn kai phgainoyn sta diafora shmeia toy swmatos.

H osfyikh moira ths spondylikhs sthlhs, poy perilambanei 5 spondyloys, empleketai se oles tis kinhseis: einai themeliwdhs gia th diathrhsh ths orthias theshs, epitrepei thn peristrofh toy kormoy, thn kampsh ,thn ektash kai th systrofh toy(plagia kampsh).

H mesh yposthrizei, loipon, megalo meros toy baroys kai twn kinhsewn toy swmatos kai h parempodish twn leitoyrgiwn ths mporei na apodeixtei idiaitera perioristikh.

Syxna prokaleitai apo ena trabhgma twn mywn h twn syndesmwn kai paroysiazetai synhthws ksafnika, me aformh enan traymatismo(lubago)

O ponos mporei na einai synexhs kai, kapoies fores, na meiwnetai me thn allagh stashs h thn pragmatopoihsh elafrias swmatikhs askhshs. Antitheta, h entonh askhsh prepei na apofeygetai, kathws epideinwnei ta symptwmata.

Otan o ponos prokaleitai apo th sympiesh mias apo tis neyrikes rizes poy ekserxontai apo to spondyliko swlhna, teinei na antanakla sthn perioxh sthn opoia katalhgei to neyro ayto. Etsi, sthn , o ponos mporei na antanakla sta mikra h sta megala daktyla twn podiwn h akoma kai sthn patoysa(pelma) .

Se aytes tis periptwseis milame gia osfyoisxialgia . O ponos mporei na emfanistei meta apo mia entonh prospatheia, alla einai, epishs, dynaton na paroysiastei aythormhta, enw teinei na einai synexhs me paroksysmoys.

Syxna h osfyalgia ofeiletai se trabhgma twn mywn kai twn syndesmwn, logw aifnidiwn, parormhtikwn kinhsewn (gia paradeigma sthn periptwsh apwleias isorropias-pesimatos), ths arshs h elkshs yperbolikoy baroys h ths pragmatopoihshs mias yperbolikhs swmatikhs prospatheias.

Kyriws omws h aneparkhs proponhsh, h lathos stash toy swmatos, to yperboliko baros h arthropatheia ths spondylikhs sthlhs kai alloi paragontes prodiathetoyn thn anaptyksh tetoiwn peristatikwn.

To apotelesma einai o erethismos aytwn twn neyrikwn domwn poy shmatodotei thn emfanish ths osfyoisxialgias. Mia allh pithanh aitia ths sympieshs twn neyrikwn rizwn einai h khlh twn mesospondyliwn diskwn , poy apotelei shmantikh aitia isxialgias.

H osfyoisxialgia mporei, akoma, na ofeiletai se stenwsh toy myelikoy swlhna, sto eswteriko toy opoioy eyrisketai o nwtiaios myelos. Orismena atoma gennioyntai me to myeliko swlhna pio steno apo to kanoniko, enw, alles fores, h stenwsh mporei na einai synepeia mias arthropatheias.

Einai, epishs, dynaton na parathrhthei allagh ths fysiologikhs domhs ths spondylikhs sthlhs, logw metatopishs enos h perissoterwn spondylwn se sxesh me toys alloys poy legetai spondylolisthhsh.

SKOLIWSH

H skoliwsh einai h paramorfwsh ths spondylikhs sthlhs h opoia xarakthrizetai apo plagia klish kai sthn periptwsh ths organikhs skoliwshs kai apo strofh twn spondylwn.

Xarakthrizetai:

san aristerh h deksia analoga me th fora toy kyrtoy tmhmatos toy kyrtwmatos. kai thwrakikh, thwrakoosfyikh h osfyikh symfwna me thn perioxh h opoia pasxei.

Diakrinetai se dyo megales kathgories:

Sth leitoyrgikh skoliwsh h opoia onomazetai kai deyteropathhs kai sthn organikh skoliwsh poy einai kai h perissotero synhthismenh. H leitoyrgikh mporei na diorthwthei proswrina apo to giatro h ton idio ton asthenh kai ofeiletai se problhmata opws h anisoskelia, h piesh neyrikhs rizas sthn perioxh ths meshs se periptwsh diskopatheias , h kakh stash ktl. Otan to prwtarxiko aitio leipsei h paramorfwsh ayth diorthwnetai.

Sto megalytero pososto h skoliwsh einai organikh me mh diorthwsimo kyrtwma h kyrtwmata kai malista se ena pososto iso me 80 % den brisketai kapoio aitio opws syggenes, neyromyiko ktl. Sthn periptwsh ayth h paramorfwsh xarakthrizetai san idiopathhs.

Den einai gnwsta ta aitia ths idiopathoys skoliwshs gia thn opoia enoxopoioyntai pithanon genetikoi paragontes –klhronomikothta alla kai ormonika aitia opws diataraxes ths melatoninhs. H sxolikh tsanta kai idiaitera h bareia an kai ephreazei th genikh stash kai mporei na prokalei enoxlhseis sta paidia, entoytois den prokalei skoliwsh oyte fainetai na ephreazei thn ekseliksh ths.

H idiopathhs skoliwsh diakrinetai se:

brefikh (0-3 eth) einai spania kai synodeyetai syxna apo alles syggeneis paramorfwseis. paidikh skoliwsh (4-10 eth) afora peripoy to 20 % twn synolikwn paramorfwsewn paroysiazetai syxnotera sta koritsia kai tis perissoteres fores ta kyrtwmata einai sth thwrakikh moira ths spondylikhs sthlhs kai me deksia fora. Ligotero syxna einai ta dipla kyrtwmata (thwrakiko kai osfyiko) kai ta thwrakoosfyika.efhbikh (4-10 eth) einai agnwsths aitiologias kai sta mikra katw twn 10 einai to idio syxnh toso sta agoria oso kai sta koritsia. Se megala omws kyrtwmata einai pio syxnh sta koritsia. Kata thn enhliko zwh h pithanothta epideinwshs einai poly mikrh kai afora kyriws ta kyrtwmata megaloy bathmoy.

H skoliwsh diapistwnetai klinika me thn episkophsh h me th bohtheia organwn opws to skoliometro, alla epibebaiwnetai me ton aktinologiko elegxo.

Ta paidia me paramorfwseis ths spondylikhs sthlhs prepei na parakoloythoyntai me taktiko aktinologiko elegxo ana 6 ews 12 mhnes gia thn parakoloythhsh ths ekselikshs toy kyrtwmatos h twn kyrtwmatwn.

H skoliwsh kata kanona einai asymptwmatikh. Den prokalei pono stis synhthismenes periptwseis oyte periorismo twn kinhsewn otan den ksepernoyn tis 300. Se poly megala omws kyrtwmata anw twn 800 ephreazetai toso h anapneystikh oso kai h kardiaggeiakh leitoyrgia.

H skoliwsh epishs de fainetai na ephreazei dysmenws ths egkymosynh an kai einai dynato se skeletika anwrimoys egkyoys na proklhthei mikrh epideinwsh toy kyrtwmatos.

H prognwsh einai xeiroterh:

oso mikroterh einai h hlikia enarkshssta koritsia se sxesh me ta agoria kai oso megalyteros xronos ypolleipetai gia thn oloklhrwsh ths skeletikhs anaptykshs. oi aristeres thwrakikes skoliwseis h elattwsh ths fysiologikhs thwrakikhs kyfwshs H therapeia einai kata kanona synthrhtikh.

Analoga me to bathmo ths paramorfwshs kai an diapistwthei taxeia aykshsh ths efarmozontai eidikoi narthhkes-mhxanhmata san genikos kanonas. An kai oi sygxronoi khdemones einai mikroy baroys, forioyntai katw apo ta royxa kai ginontai genika apodektoi apo ta paidia, exoyn to meionekthma oti prepei na forioyntai gia polles wres (peri tis 20) kathe mera kai na afairoyntai mono gia mpanio kai askhseis.

H fysikotherapeia de fainetai na prosferei kapoia idiaiterh beltiwsh sthn prognwsh ths skoliwshs Entharrynontai omws oi askhseis poy diathroyn thn kinhtikothta ths spondylikhs sthlhs, oi askhseis koiliakwn kai raxiaiwn mywn kathws kai oi diataseis ths raxhs toy paidioy kai oi opoies mporoyn na ginoyn apo to idio to paidi.

Xeiroyrgikh therapeia apaiteitai mono se skoliwseis megalyteres apo 40-500 kai idiaitera an h skoliwsh einai dyskampth kai ekselissetai se grhgoro bathmo. Einai idiaitera apaithtikh texnika kai perilambanei tis sygxrones methodos spondylodesias.

ΓΟΝΑΤΟ

ΩΜΟΣ

ΙΣΧΙΟ

ΑΥΧΕΝΑΣ

ΜΕΣΗ

ΑΚΡΑ

ΟΡΘΟΠΑΙΔΙΚΟΣ ΧΕΙΡΟΥΡΓΟΣ ΑΘΛΗΤΙΑΤΡΟΣ

ΙΩΑΝΝΗΣ ΤΖΑΒΕΛΑΣ

πως θα ερθω ?

55 προσωπικά videos αθλητικών κακώσεων

This Site Was Created Using Wix.com . Create Your Own Site for Free >> Start