Fa'afoma'i Falema'i Ata & Su'esu'ega Vaega. Dr. Alex Jimenez e galulue faʻatasi ma tagata suʻesuʻe faʻapitoa ma faʻataʻitaʻiga faʻapitoa. I la matou mafutaga, e maua ai e tagata poto faʻataʻitaʻi ata vave, faʻaaloalo, ma sili ona lelei taunuuga. I le galulue fa'atasi ai ma a matou ofisa, matou te tu'uina atu le tulaga lelei o le tautua o lo'o mana'omia ma e tatau ai. Diagnostic Outpatient Imaging (DOI) ose nofoaga fa'afoma'i fa'aonaponei i El Paso, TX. E na o le pau lea o le nofoaga tutotonu o lona ituaiga i El Paso, e umia ma faʻatautaia e le Radiologist.
O lona uiga pe a e sau i le DOI mo se su'ega radiologic, o auiliiliga uma, mai le mamanu o potu, filifiliga o meafaigaluega, tekinolosi filifilia lima, ma le masini komepiuta e faʻatautaia le ofisa, e filifilia ma le faʻaeteete e le Radiologist. ae le o se tausitusi. O le matou maketi maketi o se tasi o nofoaga autu o le lelei. O a matou fa'atauga e feso'ota'i ma le tausiga o ma'i: Matou te talitonu i le togafitia o gasegase i le auala matou te faia ai o matou aiga ma o le a matou faia le mea sili matou te mafaia e fa'amautinoa ai e te maua se poto masani lelei i le matou falema'i.
Spinal stenosis o le taimi lea e amata ai ona vaapiapi le avanoa i se mea i luga o poʻo totonu ole tuitua, tapunia ai le gafatia o gaioiga masani / faʻalelei ma le taʻavale neura. E mafai ona aafia ai vaega eseese, e aofia ai le faʻaʻautagata / ua, lumbar/maualalo tua, ma, e le masani ai, o le thoracic/pito i luga poʻo le ogatotonu pito i tua. e mafua ai le tingling, numbs, cramps, tiga, maso vaivai, po'o se tu'ufa'atasiga i tua, vae/s, ogavae, ma papa. E mafai ona i ai mea eseese e mafua ai le stenosis; o le su'esu'ega sa'o o le laasaga muamua lea, ma o lo'o i ai se fa'ama'i fa'ama'i MRI sau i totonu.
Spinal Stenosis MRI
E mafai ona lu'itau le su'esu'ega ona e sili atu o se fa'ailoga / fa'alavelave nai lo se tulaga, e masani ona mafua mai i le herniated discs, ponaivi spurs, se ma'i fanau mai, pe a uma le taotoga, po'o le mae'a o se fa'ama'i. Fa'ailoga fa'amaneta resonance/MRI ose su'ega masani e fa'aoga ile su'esu'ega.
faʻautaga maʻi
O se tagata tomai faapitoa i le soifua maloloina, e pei o se chiropractor, fomaʻi faʻapitoa, fomaʻi faʻapitoa, poʻo se fomaʻi, o le a amata i le malamalama i faʻamaoniga ma talaʻaga faafomaʻi.
O le a faia se su'ega fa'aletino e a'oa'o atili e uiga i le nofoaga, umi, tulaga, po'o gaioiga e fa'aitiitia pe fa'ateteleina ai auga.
O su'ega fa'aopoopo e aofia ai malosi maso, maua au'ili'iliga, ma su'ega paleni e fesoasoani ia malamalama atili i le mea e sau ai le tiga.
Ina ia faʻamaonia se suʻesuʻega, o le a manaʻomia ata e iloa ai le mea o loʻo tupu.
E faʻaaogaina se MRI ata fa'akomepiuta e maua ai ata e fa'aalia ai ponaivi ma aano vaivai, e pei o maso, neura, ma tendon, ma pe a oomi pe ita.
O se tagata tomai faapitoa tau soifua maloloina ma MRI technician o le a alu i luga ole tulaga saogalemu ao lei faia ata.
Talu ai ona o le masini e faʻaaogaina maneta malolosi, e le mafai ona i ai se uʻamea i luga poʻo totonu o le tino, e pei o mea faʻapipiʻi toto poʻo masini e aofia ai:
E mafai ona fa'aogaina se su'ega fa'ata'ita'iga ese pe a le mafai e se tagata ona maua se MRI pei o le a CT scan.
O se MRI e mafai ona amata mai ni nai minute i le itula pe sili atu, faʻalagolago i le tele o tulaga e manaʻomia e faʻaesea ai le vaega manua ma maua ai se ata manino. O le suʻega e leai se tiga, ae o nisi taimi e talosagaina tagata taʻitoʻatasi e tausia se tulaga faʻapitoa e ono le fiafia. O le a fesili le tekinisia pe i ai se faʻalavelave ma ofo mai soʻo se fesoasoani e faʻafaigofie ai le poto masani.
faiga
E le o tulaga uma o le stenosis e mafua ai auga, ae o loʻo i ai togafitiga e mafai ona fautuaina e se fomaʻi soifua maloloina.
O le tausiga faʻapitoa o le fautuaga muamua lea e aofia ai le faʻamaʻi, decompression, traction, ma togafitiga faʻale-tino.
Togafitiga e faʻateleina ai le malosi o maso, faʻaleleia le tele o gaioiga, faʻaleleia le tu ma le paleni, faʻaitiitia faʻafitauli faʻaletonu, ma faʻapipiʻi taʻiala e puipuia ma pulea ai faʻamaoniga.
O vaila'au talavai e mafai ona avea ma se vaega o se fuafuaga fa'apitoa mo togafitiga.
O le taotoga e mafai ona avea ma filifiliga i tulaga sili atu ona ogaoga pe a le aoga le tausiga faʻasao.
Spinal Stenosis
mau faasino
Fa'amaumauga o Fa'amatalaga o Fa'amatalaga o A'afiaga (DARE): Iloiloga Fa'apitoa-Su'esu'eina [Initaneti]. Ioka (Peretania): Nofoaga Autu mo Iloiloga ma Faʻasalalauga (Peretania); 1995-. Suʻesuʻega o le lumbar spinal stenosis: o se toe iloiloga faʻaleleia o le saʻo o suʻega faʻamaonia. 2013. Avanoa mai: www.ncbi.nlm.nih.gov/books/NBK142906/
Ghadimi M, Sapra A. Magnetic Resonance Imaging Contraindications. [Fa'afou 2022 Me 8]. I totonu: StatPearls [Initaneti]. Treasure Island (FL): StatPearls Publishing; 2022 Ian-. Avanoa mai: www.ncbi.nlm.nih.gov/books/NBK551669/
Gofur EM, Singh P. Anatomy, Tua, Vertebral Canal Sapalai Toto. [Fa'afou 2021 Iulai 26]. I totonu: StatPearls [Initaneti]. Treasure Island (FL): StatPearls Publishing; 2022 Ian-. Avanoa mai: www.ncbi.nlm.nih.gov/books/NBK541083/
Lurie, Jon, ma Christy Tomkins-Lane. "Faʻafoega o le faʻamaʻi o le lumbar spinal stenosis." BMJ (Clinical research ed.) vol. 352 h6234. 4 Ian. 2016, doi:10.1136/bmj.h6234
Stuber, Kent, et al. "Togafitiga faʻapitoa ole lumbar spinal stenosis: o se toe iloiloga o tusitusiga." Journal of chiropractic medicine vol. 8,2 (2009): 77-85. doi:10.1016/j.jcm.2009.02.001
Chiropractors ma spine specialists e faʻaogaina faʻataʻitaʻiga faʻataʻitaʻiga e ala i X-ray, MRIs, poʻo CT suʻesuʻe e iloa ai le mea e mafua ai faʻafitauli ma tiga. O ata e masani. Pe o le fomaʻi poʻo le taotoga faʻamaʻi, latou te fesoasoani tele i le mauaina o faʻafitauli tua ma faʻatagaina le tagata e vaʻai i le mea o loʻo tupu. Ituaiga mataupu e aofia ai tiga tua lena:
E fa'aaoga e foma'i nei ata pe a su'esu'eina o se ma'i ivi. O nisi nei o faʻamatalaga ile faʻataʻitaʻiga ole ivi.
X-ave
X-ray mo tiga i tua e mafai ona fesoasoani tele. An X-ray e faʻavae i le radiation ma e faʻaaogaina e suʻesuʻe ai tulaga o fausaga o ponaivi. X-ave e sili ona lelei mo aano o ponaivi po'o aano o lo'o fa'amama pe fa'ama. E sili atu lo latou galulue i aano maaa, aemaise ivi. E lē o iai fo'i a'ano aano vaivai e pei o maso, ligaments, po'o tisiketi intravertebral.
O tagata ta'ito'atasi o lo'o faia se X-ray i tua o le a su'esu'eina e se masini e fa'atupuina ai se la'au. E resitara e se tagata e pikiina le la'au pe a uma ona ui atu i totonu o le tino ma maua ai se ata. E tusa ma le lima minute e faʻamaeʻa ai ae e mafai ona umi e faʻatatau i le numera o ata a le fomaʻi. X-ave e fesoasoani mo faʻamoemoega inisiua ma faʻasaʻo tulaga o ponaivi e pei o gau faʻamalosi ma/poʻo ponaivi faʻaoso. X-ray e fa'atonu mo mafua'aga fa'apitoa ma e masani lava o se vaega o su'esu'ega fa'ata'ita'i o le tino atoa. E aofia ai le MRI ma/poʻo le CT scan.
CT Scan
CT e fa'atusa mo fatuina tomography. O se fa'asologa o X-ray e fa'akomepiuta i ata e fa'aaoga ai se komepiuta. O le lelei ole su'esu'ega CT ile X-ray masani e maua ai vaaiga eseese/matau ole tino ma e mafai ona iai ile 3D. O suʻesuʻega CT e masani ona faʻaaogaina i mataupu faʻalavelave poʻo tagata taʻitoʻatasi na faia taotoga. E tusa ma le lima minute e alu ai. Mo X-ray, o tagata taʻitoʻatasi e tutu i luga pe taoto i lalo o le X-ray masini aʻo suʻeina le tino. O le CT fa'ata'oto e taoto ai le tagata i totonu o se masini fa'ata'ali'o fa'ameamea e va'ai a'o ta'amilo i le taimi o le ata. E fautuaina tagata ta'ito'atasi e ofuina ni lavalava fa'atalatala, fa'alelei. O nisi taimi o se vali, po'o se va'aiga fa'atoto, e fa'aaogaina e fa'ailoa mai ai le aano o ga'o, fa'atupuina ata manino.
MRI
MRI e puupuu mo fa'ata fa'amaneta resonance. E fa'aogaina e MRI ni maneta e fa'atupu ai ata. O faʻataʻitaʻiga MRI e masani ona faʻaaogaina i tagata taʻitoʻatasi na faia taotoga. E umi se taimi, e masani lava pe a ma le 30 i le 45 minute. E leai ni mea u'amea e fa'atagaina ile MRI. Ua talosagaina tagata gasegase e aveese mea e pei o fusipaʻu, mea teuteu, ma isi. O le vali fa'atusatusa e mafai ona avea ma se vaega ole MRI. O le masini e pei o se alavai. E mafai ona avea lenei mea ma luʻitau mo tagata e iai le claustrophobia. Fa'atalanoa ma se foma'i ma su'e pe fa'afefea ona maua le to'a i le taimi o le fa'agasologa.
O Isi Ituaiga o Fa'ata'ita'i Tula'au
O isi ituaiga o ata e aofia ai:
CT folauga
O le fa'ata'ita'iga a le CT o lo'o fa'aalia ai su'esu'ega a le CT i le taimi tonu o le fa'atinoga.
Filososcopy
Fluoroscopy e aofia ai se ave X-ray e pasi sa'o i totonu o le tino e faʻaalia ai ata ola, feʻaveaʻi.
O nei ituaiga uma o ata faʻataʻitaʻiga e faʻaaogaina i taimi o taotoga. Mo nisi tulaga, fa'ata'ita'iga i totonu o le tino e fa'aaogaina. Ole ituaiga ata fa'ata'ita'i e fa'aogaina ai robotics fa'atekonolosi e fesoasoani i foma'i tipitipi e fa'atautaia avanoa pupuni a'o faia le fa'agasologa. O le mea lea e fa'ateleina ai le sa'o a le foma'i tipitipi ma fa'aitiitia ai le tele o le tipi.
Faatulagaga
E mafai ona fa'aoga le Ultrasound mo tulaga o le ivitū. Ole su'ega fa'ata'ita'i lea e fa'aogaina ai galu leo e fa'atupu ai ata. Ae ui i lea, o suʻega faʻataʻitaʻiga o loʻo faʻaaogaina ile faʻataʻitaʻiga ole tui ole faʻamuamua X-ray ma MRI.
Tofiga Ata
Talanoa ma lau fomaʻi poʻo le chiropractor i luma atu o le taimi e malamalama ai i mea e faʻamoemoeina i le faagasologa o ata. O le a latou faailoa atu ia te oe le auala e saunia ai ma soʻo se faʻatonuga faʻapitoa aʻo leʻi faia le taimi atofaina. Faʻatasi ai ma talaʻaga faʻafomaʻi ma se suʻesuʻega faʻaletino, faʻataʻitaʻiga faʻataʻitaʻiga o se vaega taua o le faʻagasologa o suʻesuʻega e suʻe ai le mea e mafua ai le tiga ma le atinaʻeina o fuafuaga sili ona lelei.
Tino Faʻatasia
Aafiaga Puupuu o le Kofe ma le toto
O le caffeine o loʻo i totonu o le kofe o se mea faʻaosofia poʻo se mea e faʻaosofia ai le tino o le tino. Pe a fa'a'ai le caffeine, e maua e tagata ta'ito'atasi le fa'atupula'ia o le fiafia, aemaise i le cardiovascular system. O lenei fa'afiafiaga e mafua ai ona si'itia le fatu ma le toto maualuga ona toe fa'amaualalo lea i se tulaga fa'avae mo tagata soifua maloloina. O le kofe e fa'atupula'ia teisi le toto maualuga mo taimi pupuu. E saogalemu le taumafaina o le kofe mo tagata ta'ito'atasi e leai ni ma'i fatu fatu.
X-Ray mo tiga i tua: Iloiloga i le taimi nei i Musculoskeletal Medicine. (Aperila 2009) "O le a le matafaioi a le faʻataʻitaʻiga i le tiga ogaoga o le tua?" www.ncbi.nlm.nih.gov/pmc/articles/PMC2697333/
O se iloiloga puupuu lea o nisi o faitioga taua a le tamaititi na feagai i le togafitiga faafomaʻi.
Faʻalavelave faʻafuaseʻi e aofia ai le ulu o le ulu
Faʻalavelave faʻafuaseʻi Faʻalavelave i tamaiti (tamaiti faʻamaʻavale)
Faʻasalaga Musukaloskeletal (Vasega o le Faʻasalaga Faʻasalaga o Tagata, scoliosis,
Neoplasms masani mo tamaiti (CNS & isi)
Faʻafitauli
Maʻi faʻasolosolo
Faʻafitauli ogaoga o le pediatric:
MANUIA manuaga (eg, paʻu ese le manuki-pa)
Supracondylar Fx, tulivae. I taimi uma d / t faʻalavelave faʻafuaseʻi. <10-yo
Faʻaopoopoga Fx
Gartland le faʻavasegaina o togi na sili atu le soloia ma le faʻaleagaina togafiti na togafitia i le faigofie faigofie le faʻamalosia ma le tosoina o le tulivae tuliloa
O se tulaga e lamatia ai le faʻataunuʻuina o mea faʻapitoa pe a fai e tolopo le tausiga (Volkmann konekarate)
E taua tele le faʻataʻitaʻiga ole radiology: saini folau & posterior fat pad sign faʻatasi ai ma le laina humeral i luma na le mafai ona faʻafesoʻotaʻi le ogatotonu / 2/3 o Capitellum.
Fediatric Fx le atoatoa:
Tele i le <10 yo Greenstick, Torus, Palasitika aka Faʻafefeteina faʻaletonu
E masani ona faʻamalolo lelei, togafitia ma le le mautonu
Faʻaletino palasitika pe afai> 20-tikeri manaʻomia tapunia faʻaititia
Ping pong ulupoo gau e mafai ona atiaʻe mulimuli ane afaina, faʻamalosia le tilivaina ma faʻafitauli o le fanau mai manua. Atonu e manaʻomia le suʻesuʻeina e tamaiti ole neurosurgeo.n
Salter-Harris ituaiga o mea e afaina ai le eletise faaletino
Pusa 1-slip. faataitaiga, Slipped Capital Femoral Epiphysis. E masani lava e leai se gau gau
Pusa 2-M / C ma faʻamatalaga lelei
Tusa 3-intra-articular, o lea e tauaveina ai le lamatiaga o le vave oʻo osteoarthritis ma e ono manaʻomia le tausiga o le d / t e le maluelue
Pusa 4- Fx i itu uma e uiga i le masini. Faʻamatalaga leaga ma le faʻapuupuuina o vae
Pusa 5-e masani lava e leai se faʻamaoniga o le gau moni o le ponaivi. Faʻaleagaina le faʻamaʻi faʻamaʻi manuʻa ma le faʻaleagaina o lapisi ma le faʻapuupuuina o vae
E taua tele le iloiloga o ata
Faʻaleagaina le faʻaleagaina (NAI) i Tamaiti
E i ai ituaiga faʻaleagaina o tamaiti. Faʻaleagaina faaletino e mafai ona aʻafia mai manuaga o le paʻu i faʻamaʻi maʻi MSK / faʻapitoa e aʻafia ai ponaivi ma masini mūmū. E taua le faʻataʻitaʻiina ma e mafai ona faʻamaonia ni faʻamatalaga manino e mataala ai i latou e tuʻuina atu fomaʻi ma faʻamalamalamaina le puipuiga o tamaiti ma ofisa o le tulafono e faʻaaogaina tulafono.
I se pepe: ua luluina le maʻi o le pepe`e ono iai ma faʻailoga CNS o le saei o le matua o le fesoʻotaʻiga o le uaua ma le hematoma subdural lea e ono afaina ai. O le toto toto e masani lava o se faʻailo. Head CT e taua tele.
MSK Radiological Red Flags:
1) ponaivi tele Fx i se tamaitiiti e le o mafaufauina le mafaufau (0-12 mo)
2) Nusipepa pito i tua Fx: e masani lava e le tupu se faalavelave i faalavelave faʻafuaseʻi. Masalo faʻaogaina: faʻapipiʻiina ma faʻamaʻi se tamaititi poʻo se lavea tuusao.
3) Faʻalavelave faʻalavelave faʻapitoa i fuataga o togafitiga faʻasolosolo taimi, o lona uiga, o faila o le ponaivi o loʻo faʻaalia ai le faʻaleagaina faifai pea o le tino
4) Metaphyseal tulimanu Fx lima Faʻatau Manua Fx, e masani ona faʻamaonia mo le NAI i tamaiti. E tupu pe afai e taofiofia le ita ma le feusuaʻi.
5) Ole vaeluaga o ponaivi uumi i se tamaititi o se isi faʻataʻitaʻiga o le NAI.
Isi faʻataʻitaʻiga taua o le NAI. Tusia le talafaasolopito e saunia e leoleo / tausi maʻi. E leai se faʻamaoniga o ni mea e le masani ai / gasegase o ponaivi pei o Osteogenesis Imperfecta poʻo Rickets / osteomalacia ma isi.
NB Pe a taʻua e le au vaʻavaʻaia se talaʻaga o loʻo lipotia ai le paʻu ma faʻalavelave i totonu o le fale, E taua le iloa o le tele o faʻalavelave / paʻu i totonu o le fale e seasea maua pe faʻapea e oʻo i ni ponaivi tetele.
Juvenile Idiopathic Arthritis (JIA)-Faʻaalia M / C faʻamaʻi tumau o le tamaitiiti. Fomaʻi Dx: soʻoga tiga / fulafula mo 6-vaiaso pe sili atu i se tamaititi <16-yo Eseese fomu o loʻo i ai: Early Dx e taua e puipuia ai le tuai faʻalavelave
Le tele o ituaiga masani o le JIA:
1) Pauciarticular faʻamaʻi (40%) - m / c ituaiga o JIA. E sili atu le lamatiaga o teine. O loʻo avea ma gugu ile <4 soʻoga: tulivae, tapuvae, tapulima. Eluga. Lenei ituaiga faʻaalia maualuga fesoʻotaʻiga ma ocular aofia ai pei iridocyclitis (25%) e ono ono taitai atu ai i le tauaso. Labs: RF-ve, ANA lelei.
2) Polyarticular disease (25%): RF-ve. O teine e sili atu ona lamatia. E afaina ai sooga laiti ma le tele e masani ona aʻafia ai le tui o le Cervical
3) Faiga faʻapitoa o le JIA (20%): e masani ona maua mai ai faʻamatalaga faʻapitoa e pei o le feversing o fevers, arthralgia, myalgias, lymphadeno [ala, hepatosplenomegaly, polyserositis (pericardial / pleural effusion). O mea taua o le Dx o loʻo faʻaalia ai le fuga o le lanu mama i luga o pito ma ogalaau. O le Faiga faʻavae e leai se faʻafitauli o le tino. O sooga e masani ona seevae e leai ni paʻu pe a faatusatusa i isi ituaiga. O lona uiga, o le faʻatafunaina faʻatasi e le masani ona vaaia
Ata i le JIA
O le ponaivi o le faʻasosolo e sili atu i le faʻamalosi o le patella cartilage / le ponaivi DJD
Uʻamea ma ponaivi uumi vave tapunia o le kesi / faʻapuupuuga lima
Rad DDx tulivae / tapuvae: Hemophilic arthropathy Rx: DMARD.
O faʻalavelave e mafai ona oʻo mai faʻaumatiaga faʻapitoa, faʻalavelave tuputupu aʻe / limite lima, tauaso, faʻalavelave faʻafitauli, le atoatoa.
Le tele o le faʻaleagaina o le pepe Neoplasms
Osteosarcoma (OSA) & Ewing's sarkoma (ES) o le 1 st ma le 2nd M / C o le ponaivi mumusu matua o le pepe (pito i luga i le 10-20 yo) Falemaʻi: paʻu o le ponaivi, suiga i le gaioiga, masini muamua masima ma faʻapipiʻi pulumu. Poloaʻi faʻataʻitaʻi
Ewing`s ono iai ma ponaivi tiga, fiva ma maualuga ESR / CRP mimicking faʻamaʻi. Vave Dx ma faʻataʻitaʻiga ma faʻavasegaina e taua tele.
Ata o OSA & ES: x-ray, sosoʻo ai ma le MRI, pusa CT, PET / CT. I x-ave: OSA ono afaina ai soʻo se ponaivi ae sili ona i ai nei o le malosi o ponaivi fausia neoplasms e uiga i le tulivae (50% mataupu) aemaise lava pei osteoid fausiaina se faʻamaʻi mataʻutia i le metaphysis ma speculated / sunburst periostitis & Codman tafatolu. Faʻailogaina le susulu o aano o manu.
E mafai e le ES ona tuʻu i totonu o le paʻu ma faʻaali vave le gasologa o le susu. E taua tele le MRI e faʻaalia ai le tele o le ponaivi ma le ST osofaiga, MRI manaʻomia mo le taotoga
OSA & ES Rx: O se tuʻufaʻatasiga o taotoga, radiation, chemo. O isi auala e faʻaalu ai le faʻasaoina o le tino. Le lelei le vavalo pe a fai e iloa tuai.
Ata o le Ewing's sarcoma
Faʻasaʻo le ponaivi i le faʻamalosi
Uluai osofaʻiga vaivai
Faʻalavelave faʻasolosolo agavaʻa ma le faʻalanu (lanu o le sisi)
Faʻamamāina o le ponaivi oona (fuga moli)
O le Lesion e masani ona faʻaaoga faʻasolitulafono ma se faʻaopoopoga faʻafaʻatusa
Faʻailoaina o le Round cell tumo faʻatasi ai ma Multiple Myeloma ma Lymphoma
Faʻasalaga Faʻatasi o Tamaiti
Neuroblastoma (NBL) M / C leaga o le pepe. E afua mai i neura crest cells aka PNET tumors (eg, ganglia alofa). Tele tupu i tamaiti <24-masina. O nisi faʻaalia lelei prognosis ae> 50% mataupu o loʻo iai ma faʻamaʻi alualu i luma. 70-80% i le tausaga 18-masina pe sili atu o loʻo iai nei ma metastasis alualu i luma. NBL ono tupu i le adrenal medulla, agaalofa ganglia ma isi nofoaga. Faʻaalia o se manava tele, puaʻi. > 50% meaalofa ma ponaivi tiga d / t metastasis. Togafitiga: suʻega faʻaletino, fale suʻesuʻe, faʻataʻitaʻiga: fatafata ma ave x-ave, CT manava ma le pusa e taua tele ia Dx. MRI ono fesoasoani. NBL mafai metastasize i le ulupoo ma faʻapipiʻi sutures ma se faʻalauiloaina faʻaaliga pei pathological sutural diastasis.
Leukemia Lisi Lymphoblastic o le m / c faʻamaoni o le tamaitiiti. Faʻasologa: faʻasologa o le lekikemiki le gaʻo o le ponaivi e oʻo atu ai i le ponaivi o le ponaivi ma suia ai isi fualaʻau masani o le suālaʻau i le anemia, thrombocytopenia, neutropenia ma aʻafiaga e aʻafia ai. Leukemic sela e ono mafai ona faʻaaogaina isi nofoaga e aofia ai le CNS, vaʻa, ponaivi ma isi itulagi. Dx: CBC, maualuga lactate dehydrogenase level, O le suamalie o le suga suamalie o le koko o le ki. E mafai ona fesoasoani faʻataʻitaʻiga ae le taua i le siama. I luga o le leitio, o le lekekemiki o le fausiaina o le ponaivi e masani lava ona foliga mai o ni laina eletise i luga o le eletise o le tuputupu ae o le physeal. Rx: chemotherapy ma togafitiga faʻafitauli
Medulloblastoma: M / C faʻaleagaina CNS neoplasm i tamaiti
Faateleina le atinaʻe i luma ole 10-yo
M / C nofoaga: cerebellum ma fossa
Faʻaalia i le talafaasolopito le tino o le tumo o le PNET e le o se glioma e pei ona muai mafaufauina
MBL, faʻapea foi Ependymoma ma le CNS lymphoma, e mafai ona taʻitaʻia ai gasegase e ala i le CSF ma faʻaalia ai se tulaga uiga ese e le pei o isi tumutumu o le CNS e faʻaalia ai le masini lautele i fafo atu ole CNS, m / c i le ponaivi
50% o le MBL e mafai ona faʻatino lelei atoatoa
Afai o le Dx ma togafitiga e amata i luma o metasisi, 5-tausaga e ola ai 80%
E taua le faʻataʻitaʻiina: E mafai ona faʻaaogaina le CT numera ae o le ata faataitai o le filifiliga o le MRI lea o le a faʻaopoopoina ai se maualuga o le iloiloga o le neuraxis atoa mo metastisi.
MBL e masani ona aliali mai o hytetetete hypo, leʻo ma le hyperintense lion i T1, T2 ma le FLAIR sikola (ata pito i luga) pe a faʻatusatusa i le mafaufau o le mafaufau. E masani ona faʻaosoina le ventricle 4th ma le faʻalavelave hydrocephalus. Ole tino e masani ona faʻaalia le faʻaleleia atili o le T1 + C gad (pito i lalo tauagavale). Faʻasologa o metastasis mai le MBL ma le T1 + C faʻalautele le liona i le maea
Telefoni Faʻasoifua Pediatric
I le neonate / pepe <1month: fiva> 100.4 (38C) ono faʻaalia siama ma nisi siama siama. Strep B, Listeria, E. Coli ono taitai atu i sepsis, meningitis. Faʻalatalata: pusa x-ray, lumbar puncture ma aganuu, toto aganuu, CBC, urinalysis.
I tamaiti laiti, o le Hemophilus influenza type B (HIB) e ono oʻo atu ai i le Epiglottitis se mea e seasea ae faigata. O le tui nei o loʻo fesoasoani e faʻaititia le numera o mataupu o Epiglottitis ma isi maʻi e aʻafia ai le HIB.
Parainfluenza poʻo le RSV siama e mafai ona taʻitaʻi atu i le Croup poo le Laryngotracheobronchitis.
Epiglottitis ma Croup o Dx clinically but AP and lateral soft muscle neck x-ave e aoga tele
O le Epiglottitis o loʻo iai ma se faʻailoga 'Thumbumb' e ogatusa ma le mafiafia ole epiglottis d / t epiglottic edema. Ole mea lea e ono avea ma faʻalavelave faʻafuaseʻi e afaina ai vaʻalele (tauagavale i luga)
Croup e mafai ona faʻaali mai le ―stepeple sign poʻo le bottlewine fagu faʻailoga ma le faʻaletonu o le hypopharynx e pei o le faʻaititia o subglottic airway i le AP ma le itu o le ua ivi ivi itu gofie (taumatau i luga)
Sini o le Syncytia Virus (RSV) ma le influenza e mafai ona oʻo atu ai i le vailaau vailaau e mafai ona i ai i faʻafitauli o le ola i faʻalavelave faʻafuaseʻi, matua laiti ma tamaiti faʻatasi ai ma le faʻamalosia. E taua tele le CXR (ogatotonu pito i luga)
Streptococcal pharyngitis ma le faʻamaʻi GABHS e ono iʻu ai i ni faʻalavelave faigata pe tuai foi (eg, Fiva Rheumatic)
Paʻu peritonsillar (i luga taumatau taumatau) e mafai ona atiae i nisi tulaga ma faigata ona o le faasalalauina o vaalele vaivai i totonu o le ua e mafai ona taitai atu ai ile faasalalauina i vaega ole lua / submondibular (Ludwig Angina) pe a manaʻomia le pulea o le ea i le gagana edema
O le atinaʻeina o le faʻaogalave o le faʻavavega o le tino e mafai ona oʻo atu ai i le salalau o le faʻamaʻi e ala i le faʻatalanoaina o le neck fascia lea e mafua ai le faʻataʻitaʻiina o le mediastinitis, Lemmier syndrome ma le osofaʻiga o avanoa vavalalata (o mea uma lava e lamatia ai le ola)
Griesel syndrome- (pito i luga i lalo) seʻi faʻalavelave faʻalavelave faʻamaʻi pipisi i le itulagi o le itulagi e mafai ona faʻasalalau i le vaeluaga o le vaʻaia e oʻo atu i le laxity o le C1-2 ma le le mautonu
O isi faʻamaʻi pipisi i tamaiti o siama faʻapitoa (Pneumococcal) pneumonia, siama o le Urinary ma Putelonephritis (aemaise i tamaʻitaʻi) ma Meningococcal Meningitis
Pediatric Metabolic Disease
Rickets: le mafaufau o le osteomalacia i le skeletal matua. O le faʻasologa o faʻatulagaga faʻatulagaina o le epiphyseal growth plate o loʻo afaina tele
Falemaʻi faʻapitoa ile tuputupu aʻe o le tuputupu aʻe, pito i lalo o le ifo, rosary rachitic, pusa lupe, afaina faʻalavelave, tapulima lautele ma fulafula, ma tapuvaevaevae
Faʻamatalaga: O le Vit D ma le mea e le o le tino o le calcium o le m / c lea. Le lava o le la susulu esp. paʻu paʻu-paʻu, lavalava faʻasaʻo e malamalama lelei, umi ole susu ole susu, veganism, syndromes malabsorption o le faʻaoga, faʻaleagaina tele ma isi
Faʻataʻitaʻiga: faʻasolosolo faʻasolosolo faʻasolosolo faʻasolosolo faʻasolosolo faʻamalositino ma faʻamalo, faʻalauteleina o le meaola tuputupu aʻe, faʻasalaga costochondral pulu e pei o le rosary rachitic, pito i lalo ifo
Rx: togafitia mafuaʻaga autu, saʻo lelei le soifua maloloina, ma isi.
Faʻamatalaga o faʻamaʻi o le manava e mafai ona faʻavasegaina i:
Faʻafitauli o le gastrointestinal tamaʻi ala (esophagus, manava, laʻititi & lapoʻa bowel, ma le faʻaopoopoga)
Le masani ai o totoga digestive totoga (Hepatobiliary & pancreatic faaletonu)
Le masani ai o genitourinary & reproductive totoga
Faʻalavelave faʻafuaseʻi o le paʻu o le manava ma vaʻa tetele
O lenei faʻaaliga faʻamoemoe e saunia le sili ona malamalamaʻaga lautele o le lautele faʻataʻitaʻiga ata faʻalatalata atu ma talafeagai faʻatautaia falemaʻi o tagata mamaʻi ma faʻamaʻi masani o le manava
Faʻafaigofieina o ata na faʻaaogaina i le taimi o suʻesuʻega o faitioga o le manava:
AP abdomen (KUB) ma le CXR saʻo
Suʻeina o le Abdominal CT (faʻatasi ma le tautala ma le iv ma le eseesega / w / contrast)
Maualuga suʻesuʻega i luga ma le Lower GI Barium
Faʻamatalaga
MRI (sili ona faʻaaogaina o le MRI Moto)
MRI ulufale tusi & enteroclysis
MRI rectum
Endoscopic Retrograde Cholangiopancreatography (ERCP) - tele o le hepatobiliary ma pancreatic lectal pathology
Faʻataʻitaʻiga Nuclear
Aiseā e Tatau ai le Faʻasologa o le Abdominal X?
Faʻaaofia se uluaʻi iloiloga o le manava o le manava i se tulaga faʻafuaseʻi. Mo se faʻataʻitaʻiga, o se le lelei suʻesuʻega i se maualalo ono onosaʻi ono faʻaleaogaina le manaʻoga mo se CT po o isi osofaʻiga osofaʻiga
Iloiloina o paipa, laina, ma leo i fafo
Faʻaleleia o faʻasalalauga faʻasalalauga / toe faʻapitoa i le gataifale
Mataʻituina le aofaʻi o le kulusini o le bowel ma le fofoina o le postoperative (adynamic) ileus
Mataʻituina le fua o le eseesega e ala i le manava
Suesuega faʻafefe i luga o mea faʻapitoa
Mataʻituina le faʻaaogaina o le taʻi
O le a le mea e tatau ona e maitauina i AP Abdomen: Supine ma le Faʻamasino vs. Tito
Faʻasaina o le ea (pneumoperitoneum)
Faʻasalaga o le Bowel: Faʻamau faʻapipiʻi: SBO vs LBO (3-6-9 tulafono) SB-pito i luga-3-cm, LB-upper limit-6-cm, Caecum-upper limit-9-cm. Manatua le leiloa o le haustra, faʻamatalaga dila (presence) o le valvule conivente (plica semilunaris) i le SBO
SBO: maitau eseese maualuga maualuga o le ea-suava maualuga i luga o le ata tifaga sitepu apefai foliga, masani o le SBO
Manatua le vaivai o le saʻo / colonic gas (faʻaaogaina) i le SBO
Suʻeina o le Abdominal CT -o le filifiliga o le filifiliga i le taimi o le suʻesuʻega o faitioga mataga ma le le mautonu faʻapitoa aemaise lava i tagata matutua. Mo se faʻataʻitaʻiga, e mafai ona faʻamaonia ma le manuia le faʻamausua o le manava o le tino e maua ai faʻamatalaga faʻamatalaga mo le fuafuaina o tausiga
Abdominal, faʻamau ma le pelvic ultrasound mafai ona faia e fesoasoani ai i le faʻamaoniga o le appendicitis (esp. i tamaiti), matuitui & faaeletonika pathological pathology, hepatobiliary faaletonu, obstetric ma gynecological pathology
Faʻaaogaina o le faʻamamaina o le radiation (x-ray & CT) e tatau ona faʻaititia i tamaiti ma isi vaega vaivai.
Faʻamatalaga Faʻataʻitaʻiga o Maʻi Taua o le Faigamaʻi Faʻatafunaina
1) Faʻafitauli o le gasegase
2) Gastric carcinoma
3) Gluten Sensitive Enteropathy
4) Fomalamory Bowel Disease
5) Pancreatic ductal adenocarcinoma
6) Carcinoma maʻaleʻale
7) Apisi Api
8) Faʻateʻaina le faʻalaumalie
9) Volvulus
Vaʻaia o le gasegase
Achalasia (uluai kalalasia): toilalo o le faʻatulagaina esophageal peristalsis d / t faʻaleagaina malologa o le lalo esophageal sphincter (LOS) ma faʻailogaina dilatation o le esophagus ma meaai stasis. O le poloka o le distal esophagus (e masani ona mafua i le tumo) ua faʻaigoaina o le "Second achalasia" poʻo le "pseudoachalasia. . Vagus neurons mafai foi ona aʻafia
Peraimeri: 30 -70s, M: F tutusa
Faʻamaʻi Chagas (siama o le Trypanosoma Cruzi) faʻatasi ai ma le faʻaleagaina o Myenteric plexus neurons o le GI system (megacolon & esophagus)
Ae ui i lea, o le fatu o le M / C aʻafiaga afaina
Falemaʻi: Dysphagia mo solids ma ava, pe a faʻatusatusa i le dysphagia mo naʻo solide i mataupu o le carcinoma esophage. Faʻanoanoa o le fata ma le faʻatonutonu. M / C i le ogatotonu o le esophage sosolo i le pe tusa o le 5% ona o le le mautonu masani o le mucosa i le tele o meaai ma mea faalilolilo. E mafai ona atiaʻe le niumonia. Candida esophagitis
Ata: irdBird -beak-- i luga o le GI barium folo, faʻateleina le esophagus, leiloa o peristalsis. E taua tele le suʻega ole endoscopic.
Rx: faigata. Kalisi poloka poloka poloka (puʻupuʻu -term). Pneatic dilatation, aoga i le 85% o tagata mamaʻi ma 3 -5% lamatiaga o le toto / perforation. Botulinum toxin injection e naʻo le approx. 12 masina ile togafitiga. Me maʻila le submucosa e tau atu ai i le faʻateleina o le aʻafia o perforation i le taimi o le myotomy. Myotomy taotoga (Heller myotomy)
10 -30% o tagata gasegase e faʻaleleia le reflux gastroesophage (GERD)
Presbyesophagus: faaaoga e faamatala ai le faʻaalia o degenerating afi galuega i le matua esophagus> 80-yo Ona o le motusia o le reflex arc ma faʻaititia le faʻaititia o lagona i le mimilo ma suiga i peristalsis.
Tagata mamaʻi ono faitio o le faʻaleagaina o le tino poʻo le fatafata, ae o le tele lava e leai se faʻailoga
Lafoaʻi / vaʻavaʻavea vaʻalele (DES) o se faʻamalosia o le le mautonu o le atuatuvale lea e ono foliga mai o se kesi poʻo le rosary o le siama i luga o le barium loli.
2% o le paʻu o le fatu e le o le fatu
Manometry o le suʻega auro-standard diagnostic test.
Zenker diverticulum (ZD) alo pharyngeal pouch
O se faʻalelei i le maualuga o le hypopharynx, lata ane i le sphincter luga o le esophage, o loʻo taʻua o le Killian dehiscence poʻo le tafatolu Taillian
O maʻi o 60-80 yo ma o loʻo i ai faʻatasi ma le dysphagia, regurgitation, phenosis, lagona o le globus
Malosiaga e faʻalavelave i faʻafitauli ma mea faʻalavelave elemene
E mafai e tagata maʻi ona faʻaputu fualaau
ZD- o se pseudodiverticulum poʻo se faʻasologa o le pulusaliga e mafua mai i le lalagaina o le submucosa e ala i le Killian dehiscence, faia ai se ato pe a mafai ona faaputuputu meaai ma isi mea.
Mallory-Weiss maʻi e faʻasino i mucosal ma submucosal loimata o le distal oesophageal venous plexus e fesoʻotaʻi ma sauā sauā / puaʻi ma faʻataʻitaʻiga o gastric mea faʻasaga i le pito i lalo esophagus. Tagata inu 'ava e i ai se tulaga lamatia. Mataupu o loʻo i ai ma le tiga tiga. Togafitiga e masani ona lagolagoina.
Dx: ata faʻataʻitaʻi e iai sona aoga tele, ae ole esstragram eseese e ono faʻaalia ai ni loimata loimata e tumu ile eseesega (ata taumatau i lalo). O le siakiina o le CT e ono fesoasoani e faʻateʻa ese ai isi mafuaʻaga o le toto maualuga o le GI
Maʻi maʻi Boerhaave: Vavaega o le esophage ile lua i le vomiting malosi
Tuuina atu: M> F, vomiting, tiga o le pusa, mediastinitis, septic mediastinum, pneumomediastinum, pneumothorax vasural effusion
I le taimi ua mavae, sa masani lava ona afaina
O masini e aofia ai le faʻamalosi o le faʻateʻaina o mea tau manava o loʻo i totonu o le gastric aemaise lava i meaʻai tetele e leʻo faʻatumuina pe a fai o le esophagus e faʻamalosia konekalate e tapuni ai le glottis ma le 90% o loʻo tupu i le itu tauagavale.
Hiatus hernias (HH): siama o mea o loʻo i totonu o le iniseti e ala i le faʻaoʻo o le isophage o le diaphragm i totonu o le vavalaʻau.
Ole tele o gasegase ile HH e leai se faʻailoga, ma o se mea e maua fua. Peitai, auga mafai aofia ai epigastric / fatafata tiga, postprandial atoaga, niniva ma puaʻi
O isi taimi o le HH e faʻapea e tutusa ma gastro-oesophageal reflux faʻamaʻi (GORD), ae o loʻo i ai le leaga faʻamaopoopoina i le va o tulaga e lua!
2-ituaiga: sliding hiatus hernia 90% & rolling (paraoesophageal) hernia 10%. O le mea mulimuli e ono faʻaosofia ai le taʻitaʻi atu i le ischemia ma faʻafitauli.
Leiomyoma o le Esophage o le M / C benign esophageal neoplasm. E tele lava ina tetele ae e le faʻalavelave. O le gasegase o le gasegase gasegase (GIST) e sili ona taatele i totonu o le esophagus. E tatau ona ese mai faʻataʻaloga o le Esophage.
Faʻataʻitaʻiga: vaʻaiga o le esophagram, GI barium pito i luga, loli CT. Gastroesophagoscopy o le auala Dx e filifili ai.
Carcinoma o le Esophage: na tuʻuina atu i le faʻateleina o le dysphagia, i le taimi muamua e faʻamalosi ma alualu i luma i le suavai ma le faʻalavelave i mataupu e sili atu ona maualuga
<1% o kanesa uma ma 4-10% o faʻamaʻi uma GI. O loʻo aloaʻia aliʻi e muaʻi vaʻaia ma le sooga sela subtype ona o le ulaula ma le 'ava malosi. Barrett esophagus ma adenocarcinoma
M: F 4: 1. Tagata lanu uliuli e sili atu ona faigofie nai lo White tagata 2: 1. Matitiva le faʻataʻitaʻi!
E mafai ona nofouta ile barium e mafai ona nofouta i le faailoaina o le esophage. Gastroesophagoscopy (endoscopy) faʻamaonia le faʻamautinoaina ma le pipisi o meaola
O le aotelega o le faʻaleagaina masani o le 2ndary gastric fundary carcinoma osofaʻi distal esophagus
O le televave o le televave e masani lava ona maua i le ogatotonu o le esophagus, Adenocarcinoma i le vaega vaʻavaʻa
Gastric carcinoma: uluaʻi faʻaleagaina o le epithelium gastric. E leʻi leva aʻo laʻititi le 40. O le vaitausaga laʻititi o suʻesuʻega i le Iunaite Setete o 70 tausaga mo tama ma 74 tausaga mo tamaitai. Iapani, Korea i Saute, Chile, ma atunuu Europa i Sasae o loo i ai le tasi o le maualuga o le maualuga o le kanesa o le manava i le lalolagi. O loʻo maualalo le aofaʻi o le kanesa i le lalolagi atoa. O le kanesa gastric o le 5th mafuaaga o le maliu o le kanesa. Faʻatasi ma le faʻamaʻi mai ile Helicobacter pylori 60- 80%, ae na o le 2% le faitau aofaʻi ma H. Pyloris e tupu ai le kanesa. 8-10% ei ai se faʻavae aiga tuʻufaʻatasia.
Gastric Lymphoma e fesoʻotaʻi foʻi ma le faʻamaʻi o le H. Pyloris. Suauu Auro o le Castrointestinal Stromal poʻo le GIST o se isi neoplasm e aafia ai le manava
Falemaʻi: Leai se faailoga pe afai e le lelei ma ono mafai ona faʻamalolo. E oo atu i le 50% o tagata maʻi e ono iai ni faitioga GI e le patino. E mafai e tagata maʻi ona maua i le anorexia ma le mamafa o le mamafa (95%) faʻapea foi le tiga o le manava o le tino. O le gase, vomiting, ma le vave teteʻese o le faʻalavelave / ono e ono tupu i ni tumutumu vevela poʻo ni faʻamaʻi pipisi e ono afaina ai le manava o le manava.
Faʻafitauli: O le tele o gasegase gastric ua maua i le tuai ma e mafai ona faʻaalia osofaiga i le lotoifale ma le adenopathy, le ate, ma le mesenteric faʻalautele. O le 5-tausaga o le ola o le 20% pe itiiti. I Iapani ma S. Korea, o polokalame vave e siaki ai polokalame na faʻaolaina ai le ola i 60%
Ata: Barium luga GI suʻesuʻega, CT suʻesuʻe. O le suʻesuʻega o le endoscopic o le auala e filifilia ai mo le faʻamaoniga. I ata, Gastric kanesa ono aliali mai o se exophytic (polypoid) tele poʻo Fungative ituaiga, Ulcerative po Infiltrative / diffuse ituaiga (Linitis Plastica). E taua le siakiina ole CT e iloilo ai osofaʻiga a le atunuʻu (nodes, mesentery, ate, ma isi)
Celiac faʻamaʻi e le o ni mea faʻapitoa ole telefoni ile aʻafia ile gasegase ole gasegase: O le T-cell na faʻalauteleina le autoimmune faʻasolosolo gluten-faʻatosina mucosal faʻaleagaina mafua ai le leiloa o villi i le vavalalata manava laiti ma gastrointestinal malabsorption (ie, sprue). Mafaufau i nisi tulaga o le uʻamea le atoatoa anemia o undetermined mafuaʻaga. Masani i Caucasians (1 i le 200) ae seasea maua i Asia ma tagata uli. Lua tumutumu: o se laʻitiiti fuifui i le amataga o tamaiti. Masani i le 3 ma le 4 tausaga o le olaga.
Falemaʻi: O le tiga o le abdomina o le m / c faailoga, malabsorption o meaʻai / vitamini: IDA ma guaiac-positive stools, manava manava, constipation, steatorrhea, gau o le mamafa, osteoporosis / osteomalacia, dermatitis herpetiformis. Faʻateleina le fegalegaleaiga ma le lymphoma T-cell, Faʻateleina le fegalegaleaiga ma le tui o le esophageal cell carcinoma, SBO
Dx: O le pito i luga o le GI e faʻauʻuina i le tele o biopsies duodenal o le a tulaga faʻamaonia mo le maʻi celiac. Faʻasolopito o loʻo faʻaalia mai le T-cell infiltration ma le lymphoplasmacytosis, Vropi atrophy, hyperplasia Crypts, Submucosa, ma Serosa. Rx: faʻamaʻalogaina o mea e maua ai le kulutena
Faʻamatalaga: E le manaʻomia mo le Dx ae o le Barium e faʻafefeteina le fesuisuiai: atrophy mucosal ma le faʻaumatia o le mucosal folds (naʻo tulaga faʻataʻitaʻi). O le SB dilation o le sailiga masani lea. Nodularity o le duodenum (bubble duodenum). Suiga o le faamasinoga ma le ileal mucosal folds:
O le jejunum e pei o le ileum, o le ileum e pei o le jejunum, ma le duodenum e pei o seoli.
CD: toe faʻasolosolo taimi-faʻafeiloaʻi o le mimimune inflammation lea e aʻafia ai soʻo se vaega o le GI mai le gutu i le aus ae i le amataga o le tele o mea e aofia ai le falemaʻa ileum. M / C faʻaaliga: tiga o le manava ma le manava. Auala: faʻatulagaina o le granulomata e le pei o le UC o loʻo faʻafeiloaʻi, e mafai ona taʻitaʻia ai i le tele o mea. O vaega e afaina i le mumū e masani lava ona lavelave
E tele faʻamaumauga: malabsorption o meaʻai / vitamini (anemia, osteoporosis, tuai o le atinaʻeina o tamaiti, faʻafitauli i le malupuipuia o le GI, faʻalavelave o le manava, fistula formation, faʻamaoniga o le abdominal: uveitis, arthritis, AS, erythema nodosum ma isi .. 10- 20% atonu e manaʻomia le taotoga o le tino pe a uma le 10-tausaga o le CD faʻapitoa mo taʻavale, fistiluisation, BO.
Dx: Clinical, CBC, CMP, CRP, ESR, faʻataʻitaʻiga faʻataʻitaʻiga: DDx o le IBD: anti-Saccharomyces cerevisiae antibodies (ASCA), anti-anticineutrophil cytoplasmic antibody (p-ANCA) histologically or in serum. Faʻamatalaga Calcaltectin feololo e fesoasoani i le DDx IBS ma iloilo le tali i togafitiga, faʻamaʻi / toe faʻafoʻi.
Dx o filifiliga: faʻasologa, siakiina, ma le tele o biopsies e mafai ona faʻaalia ai suiga faʻamalosi ma suiga o le talafaasolopito. O le faʻataʻitaʻiga o le capsule video (VCE), e mafai ona fesoasoani faʻamatalaga i le Dx o faʻafitauli. Rx: vailaʻau faʻamaʻi faʻamalosi, vailaʻau faʻapitoa, meaʻai, mea faʻapitoa, faʻamalosi. Leai se togafitiga ae o le sini o le faʻaosoina lea o faʻamagaloga, faʻataʻitaʻiga ma puipuia / togafitia faʻafitauli
Faʻataʻitaʻiga Dx: KUB i le DDx SBO, Barium enema (tasi ma le faʻasologa faʻalua), e mulimuli mai le faʻalaumalie. O faʻamaoniga: faʻailoga o leions, aphthous / deep ulcerations, fistula / trausus, faailoga faʻavae, gaʻo fetolofi tulei puipui o le LB, mea faʻapipiʻi mataga / / gasegase tuʻi mucosa, CT numera faʻatasi ma le tautala tautala ma IV.
Faʻaatafaufau mai se tagata maʻi o Crohn o lē na i ai sona faʻalaulelei ile vavalalata mo le faalavelaveina.
(A) CT scan faʻaalia ai le le faʻapitoa pupuga ae
(B) MRE o le lava itū e tasi e faʻaalia ai le fibrostenotic stricture
UC: uiga faʻapitoa aofia ai na o le kolone ae mafai ona tupu i tua ileitis ileitis. O le amataga e masani ona i le 15-40s ma e sili atu ona taatele i tama, ae o le amataga pe a maeʻa le 50 tausaga e masani foi. Sili atu taatele i Amerika i Matu ma Europa (amioga tumama). Etiology: O loʻo iai ni suiga ole siʻosiʻomaga, suiga ole genbi ma le manava o loʻo iai. O le ulaula ma le faʻaopopoga muamua e faʻaalia ai le le lelei o le fesoʻotaʻiga ma le UC, e le pei o le CD mafaufauina i nisi o tulaga lamatia.
Faiga Faʻapitoa: Toto toto (masani), manava tatā, tuli mucous tulu, tenesmus (taimi), maualalo manava tiga ma matuitui matitiva mai purulent sasaa sasaa (i matuia tulaga, aemaise lava i tagata matutua), fulminant colitis ma oona megacolon mafai fetal ae seasea faigata . Faʻamatalaga: Leai granulomata. O papala e aʻafia ai le mucosa ma le submucosa. Pseudopolyps o loʻo avea ma maualuga faʻasaoina mucosa.
O se amataga gaioiga taimi uma aafia ai le tumutumu ma tumau ai o se lotoifale faʻamaʻi (proctitis) i le (25%). 30% Proximal faamaʻi faʻalautele ono tupu. E ono iai le UC ile itu tauagavale (55%) male pancolitis (10%). Tele o mataupu e agamalu i le feololo
Dx: colonoscopy ma ileoscopy ma tele biopsies faʻamaonia Dx. Labs: CBC, CRP, ESR, Fecal calprotectin, Faʻafitauli: anemia, oona megacolon, kanesa o le kolone, faʻamaʻi faʻaopopo-colonic: gugu, uveitis, AS, Pyoderma gangrenosum, Peraimeri sclerosing cholangitis. Rx: 5-aminosalicylic acid tautala tuʻufaʻatasi poʻo le faʻaaogaina o vailaʻau faʻasolosolo, corticosteroids, vailaʻau puipuia, o le colectomy e faʻaola.
Faʻataʻitaʻiga: le manaʻomia mo Dx ae barium enema ono faʻaalia ulcerations, thumbprinting, i le alualu i luma tulaga leiloa o haustra ma le vaʻaia o le kolone faia lelead-paipa kolone. CT mafai ona fesoasoani scanning ma Dx vaʻaia pei mucosal mafiafia faʻamalosia naʻo i feololo ma faigata mataupu. CT ono fesoasoani ile Dx o faʻafitauli. O ata tifaga manino e faʻaalia ai le `` paipa paipa '' ma le sacroiliitis e pei o le Enteropathic arthritis (AS)
Carcinoma Colorectal (CRC) m / c kanesa o le GI tract ma le 2nd sili ona leaga le masani ai i tagata matutua. Dx: endoscopy ma le biopsy. CT o auala masani e masani ona faʻaaogaina mo le faʻatulagaina. O taotoga e mafai ona togafitia e ui lava o le lima tausaga le saoasaoa o le 40- 50% faʻamoemoe i luga o tulaga. Tulaga lamatia: maualalo alava ma maualuga gaʻo ma manu porotini meaai, lapoʻa (aemaise lava i tamaloloa), faaumiumi ulcerative colitis. Colonic adenomas (polyps). Aiga adenomatous polyposis syndromes (Gardener syndrome) ma le Lynch syndrome o le lē familial polyposis.
Falemaʻi: osofaʻiga amata ma suiga suiga o le manava, toto fou po o le melena, uʻamea le lava le toto mai le faaumiumi faʻataulaitu leiloa toto aemaise lava i le itu taumatau itu. O le punitia o le manava, oso ai le mafaufau, mamafa le tafe o le toto ma faʻamaʻi metastatic aemaise lava i le Ate atonu o le a avea muamua ma faʻalauiloaga. Ala: 98% o adenocarcinomas, tulaʻi mai muamua colonic adenomas (neoplastic polyps) ma suia leaga. O le lima-tausaga le saoasaoa fua faatatau o 40-50%, ma le laʻasaga i le faʻagaioiga o le tasi mea taua sili ona afaina ai le vavalo. M / C faʻasologa sao (55%),
NB O nisi adenocarcinomas esp. ituaiga mucinous masani e masani ona tuʻuina atu i le tuai ma e masani ona faʻaleagaina le faʻataʻitaʻiga ona o le tuai ona tuʻuina atu ma le puleaina o mucin ma le mamao mamao
Ata: Bema enema o ni mea taua mo polyps> 1 cm, tasi faʻatusatusaga: 77-94%, faʻalua faʻaeseesega: 82-98%. Colonoscopy o se tulaga masani o filifiliga mo le puipuia, mauaina, ma le faʻailogaina o le colorectal carcinoma. Faʻatusatusaga-faʻaleleia atili CT scanning o loʻo faʻaaogaina mo le tuʻuina atu ma le vaʻaia o faʻamaoniga o mets.
Iloiloina: colonoscopy: alii 50 yo-10-tausaga pe a masani, 5-tausaga pe a fai o le polyformomy, FOB, 1st faailoga e fesootai ma CA amata le mataituina i le 40 yo
Pancreatic Cancer: lectal epithelial adenocarcinoma (90%), faʻasolosolo matitiva ma le maualuga o le tino. 3rd M / C iniseti o le manava. O le kolini o #1, manava #2. O le kanesa Pancreatic e maua ai le 22% o maliu uma ona o le gasegase o le tino, ma 5% o maliu uma o le kanesa. 80% o mataupu i 60 +. O le ulaula tapaa o le mea aupito sili lea ona lamatia le siosiomaga, o se mea taumafa lelei i gaʻo manu ma le polotini. Mafuaaga. Talafaasolopito o aiga. M / C na iloa i le ulu ma le faʻaaogaina o le faagasologa.
Dx: E taua tele le siakiina ole CT. Osofaʻiga o le Superior Mesenteric Artery (SMA) faʻailoa mai le le mafai ona tatalaina faʻamaʻi. 90% o pancreatic adenocarcinomas e le mafai ona tatalaina i le Dx. Tele o tagata mamaʻi e feoti i totonu ole 1-tausaga ole Dx. Falemai: jaundice leai se tiga, abd. Paʻu, Courvoisier's gallbladder: jaundice leai se tiga ma faʻateleina gallbladder, Trousseau's syndrome: migratory thrombophlebitis, fou amata mai suka mellitus, faʻaitumalo ma mamao metastasis.
CT Dx: tele pancreatic ma le malosi desmoplastic tali atu, le lelei le faʻaleleia atili, ma teisi maualalo le faʻafefeteina faʻatusatusa i le tuaoi masani gland, SMA osofaʻiga.
Appendicitis: tulaga masani masani i le televise masani ma o se tasi o mafuaʻaga autu o le taotoga o le tino i gasegase talavou
CT o le uiga sili ona maaleale e iloa ai le appendicitis
E tatau ona faʻaaogaina le telefoni i tamaiti ma tamaiti laiti
KUB Radiographs le tatau ona faia se sao i le faʻamaoniga o le faʻaopoopoga
I luga o ata, appendicitis faʻaalia faʻaopoopoga faʻaopoopoga ma pa puipui mafiafia, faʻalauteleina, ma periappendiceal gaʻoa fua. O faʻamatalaga tali tutusa a le mafiafia o le puipui ma le faʻateleina o loʻo maitauina ile US. O faʻailoga masani e masani ona tusia ile siaki puʻupuʻu US tulaga suʻesuʻe.
Afai o le faʻaopoopoga o le toe-siaki nai lo le US e ono le mafai ona maua le faʻamaonia saʻo o le Dx ma CT
Rx: galue e aloese mai faʻalavelave
Laititi le faʻalavelave ile manava (SBO) -80% o le faʻalavelave uma ile inisinia; o le mea totoe o le 20% e mafua mai le faʻalavelaveina o le toto. O loʻo i ai se fuainumera o le tino o le 5.5%
M / C mafuaaga: soo se Hx o le taotoga o le taotoga muamua ma le taliaina
Faʻamatalaga faʻapitoa o le faʻailogaina, faʻalauteleina le manava o le abdomina ma le gaioiga ma le vomia
O le eletise e na o le 50% e maaleale mo le SBO
CT o le a faʻaalia le mafuaaga o le SBO i le 80% o mataupu
E i ai le tulaga fesuisuiai mo le faʻaitiitia o le faʻalētonu o le manava, ae o le 3.5 cm o se fua faʻasaʻo o le toto faʻalaʻo
I luga o Abd x-ray: supine vs. faʻasaʻo. Faʻapipiʻi le manava, faʻaloaloa valvulae conivente (mucosal gaugau), isi tulaga ea-suavai tulaga '' apefai sitepu. '' Gas o loʻo i le tumutumu / kolone
Rx: faʻagaioia e pei o le `` manaʻo fetaui ''
Volvulus-m / c i le Sigmoid colon esp. i tagata matutua. Le mafuaʻaga autu: faʻasolosolo taimi faʻasolosolo ma mumu sigmoid mimilo luga sigmoid mesocolon. Taʻitaʻi i Faʻalavelave pupuna o le manava (LBO). Isi mafuaʻaga masani: o le tuma o le kolone. Sigmoid vs. Caecum volvulus
Togafitiga: faʻailoga o le LBO ma le manava manava, manava manava, tiga, niniva, ma puaʻi. O le amataga e ono matuitui pe faaumiumi foi
Radiographically: leiloa o le haustra i le LB, LB faʻaletonu (> 6-cm), 'kopi faʻailoga saini' isi sosolo, o le pito i lalo o volvulus tusi i le pelvis
NB: Tulafono o le limamatua mo faʻalautele manava tatau ona 3-6-9 i le mea 3-cm SB, 6-cm LB & 9-cm Coecum
Matau augatupulaga o le tracheal-bronchial Tree, lobes, vaega, ma femalagaaʻiga. Faʻaaliga lona lua pulmonary lobule (1.5-2-cm) -o le autu aoga iunite o mama matauina luga HRCT. Manatua faʻatulagaina taua faʻatulagaina o alveolar avanoa ma fesoʻotaʻiga i le va o (pores o Kohn & alavai o Lambert) e faʻatagaina ai le tafetafea o le ea ma i le tutusa auala faʻatagaina faʻalautele suavai exudative poʻo transudative e sosolo atu i le māmā ma taofi i le vaelua. Manatua le anatomy o le pleura: parietal o se vaega o le endothoracic fascia ma le visceral e fausia ai se mama i luma pleura avanoa i le va.
Mediastinum: siosiomia e le tagi ma le pala. Faʻaaoga nofoaga tetele e aofia ai tele lymph nodes (silasila i le faʻataʻitaʻiga o nusipepa ma le latou auai i Lymphoma
Avanoa Lautele i le Suʻesuʻeina o Talosaga
Telefoni feaveaʻi (Chest X-ray CXR); sili atu 1st laasaga. Tau maualalo, maualalo o le faʻavelaina o le radiation, suʻesuʻega o faitioga e tele
CT numera: CT C, High Resolution CT (HRCT)
Faʻailoga o togafitiga o fata:
Tigā
Faʻafitauli
Neoplasms
O le edema palapone
Pulmonary emphysema
Atelectasis
Faʻafitauli faʻapitoa
Mediastinum
PA & Faʻatonu CXR
E mafai ona faʻaopopo manatu faaopoopo:
Manatu faʻapitoa: fesoasoani e iloilo vailaau faʻapitoa
Tusitusia taumatau i le taumatau ma le agavale: fesoasoani e iloilo vailaau faʻasalaga maaleale, pneumothorax ma isi togafiti
Masani CXR PA & Faʻamatalaga lautele. Faʻamautinoa lelei le faʻaalia: T-spine discs ma vaʻa ala i le fatu o loʻo vaʻaia i le PA vaʻaiga. Faitau le 9-10 taumatau ivi aso i tua e faʻamaonia ai taumafaiga lava faʻamalosia. Amata se suʻesuʻega maeʻaeʻa faʻaaoga le auala lea: E I Ai Tele Losi Lesona A-manava / diaphragm, T-thorax pa, M-mediastinum, L-mama tasi, Lua-uma. Atiina ae se lelei suʻesuʻega faʻataʻitaʻiga
1) Faʻamaʻi Airspace aka faʻamaʻi alveolar baga? Faʻatumuina o alveoli o le māmā, acini ma mulimuli ane ai le lobe atoa i suavai poʻo vailaʻau o soʻo se vaega (toto, nana, vai, proteinaceous mea poʻo sela foi) Radiographically: lobar poʻo vaevaega tufatufaina, airspace nodules mafai ona maitauina, agaʻi i le coalesce, ea bronchograms ma silhouette sign o loʻo iai. Batwing (butterfly) tufatufaina maitauina pei i le (CHF). Suʻesuʻe vave ile taimi, ie, faʻateleina pe faʻaititia (aso)
2) Faʻalavelave faʻafuaseʻi: ulufale i totonu o le pulmonary interstitium (alveoli septum, lung parenchyma, vaʻa o vaʻa, ma isi) e ala i faʻataʻitaʻiga e siama, tamaʻi siama, vailaʻau. Faʻapipiʻiina foʻi sela e pei o sela mumu / faʻamaʻi (eg, lymphocytes) Faʻaalia o se faʻamamafaina o le sela interstitium ma le reticular, nodular, feololo faʻatasi mamanu retulitonodular. Etiologies 'eseʻese: afaina afaina o le autoimmune, faʻamaʻi o le māmā i le fiva, faʻamaʻi o le mama i galuega, faʻamaʻi viral / mycoplasma, TB, sarcoidosis lymphoma / leukemia ma le tele o isi.
O le iloaina o faʻavae eseʻese o faʻamaʻi mama e mafai ona fesoasoani i le DDx. Misasa vs. tuʻufaʻatasia (agavale). Faʻailoa eseesega o faʻamaʻi o le pulmonary: faʻamaʻi o le malae vaʻalele e pei o le faʻamautuina o le palakalafa o le niumonia, faʻalauteleina o le tuʻufaʻatasia o faʻamaoniga o le edema pulmonary. Atelectasis (paʻu ma leiloa leiloa). Mamanu feololo o faamaʻi o le mama: reticular, nodular pe fefiloi. SPN vs. Multiple focal consolidations (nodules) e fai ma sui o mets infiltrates vs. septic infiltrates
A = le totogia
B = paʻu
C = faaopoopo faaopoopo
Ia iloa le mea taua o lupe
Faailoga taua: Faailoilo Silhouette: fesoasoani i localization ma DDx. Faataitaiga: Lalo pito tauagavale: leitio i totonu o le manava saʻo, o fea o iai? Taumatau MM ona o le saʻo saʻo o le fatu e latalata i le vaeluagalemu o le vavalalata e le o vaaia (silhouetted) Airchograms o le ea: ea o loʻo i ai bronchi / bronchioles o loʻo siomia e le suavai
Chet Trauma
Pneumothorax (PTX): ea (kesi) i le avanoa lautele. Tele mafuaaga. Faʻafitauli:
Tension PTX: faʻaauauina le maualuga o le ea i totonu o le vateatea lea e faʻavavevave ona faʻamalosi le mediastinum ma le tino e vave faʻaitiitia ai le toe foi mai o le fatu i le fatu. E ono afaina pe a le togafitia vave
Faʻafuaseʻi PTX: muamua (talavou matutua (30 -40) faʻapitoa aliʻi, manifinifi aliʻi. Mafuaʻaga mafuaʻaga: Marfan s syndrome, EDS, Homocystinuria, a - 1 -antitrypsin le lava. Lona lua: matutua pts ma parenchymal faʻamaʻi: neoplasms, abscess, empysema , māmā fibrosis ma honeycombing, catamenial PTX d / t endometriosis ma isi.
Traumatic pneumothorax: mama laceration, tuʻusaʻo manuʻa, iatrogenic (pusa o le pusa, ma isi) acupunkure, ma isi
CXR: tusi visceral pleura laina aka lung edge. O le toesea o pulmonary pepa solo / vaʻa i tala atu o le visceral pleural line. E mafai ona misia le paʻu o le pneumothorax. I luga o le tulaga faʻatuina, ea ea ma PTX e tatau ona sailia i le pito i luga.
Ivi ivi asoaso: v. Masani. Faʻalavelave pe faʻasolosolo (eg, mets, MM) Rib series x - ave e le aoga tele ona ole CXR ma / poʻo le CT scanning e sili atu le taua e iloilo ai posttraumatic PTX (lalo agavale) māmā laceration ma se isi auala tele
Faʻafitauli
Pomonia: siama vs. viral poʻo fungal poʻo i le fale talimalo puipuia (eg, Cryptococcus i le HIV / AIDS) Pulmonary TB
Pomaonia: faʻaleaganuʻu-mauaina vs. falemai-maua. Faʻasologa o le pneumonia ma le Lobar (e le o se vaega) o le niumonia ma le purulent mea e faʻatumu ai le alveoli ma faʻasalalau i le vavao atoa. M / C organismStreptococcus Pneumonia poʻo le Pneumococcus
Isi: (Staph, Pseudomonas, Klebsiella esp. I tagata inu ava malosi e ono taitai atu ai i le neroSIS / pulupulu gangrene) Mycoplasma (20-30s) aka savavali niumonia, ma isi.
Falemaʻi: o le gaosiga o le tale, fiva, paʻu o le fagu paʻu i nisi o taimi.
CXR: faʻalavelave faʻapitoa vaalele i luga o le vaalele e faʻatapulaʻaina i le vavao atoa. Mala uila. Faailoga silhouette fesoasoani i le nofoaga.
Viral: Influenza, VZV, HSV, EBV, RSV, ma isi mea o loʻo avea ma faʻamaʻi o le mama i le va o tagata e mafai ona lua felavasaʻi. E ono taitai atu ai i le manava fetuunai
Atypical pneumonia ma Fungal Pneumonia: Mycoplasma, faʻamaʻi o Legionnaire, ma nisi fungal / Cryptococcus pneumonia e ono iai faʻamaʻi pipisi i totonu.
Pulmonary abscess: o se faʻamaʻi pipisi o purulent mea i totonu o mama e masani ona necrotize. E ono taitai atu ai i le taua pulmonary ma faiga faʻalavelave / faʻafefe ola.
I luga o le CXR poʻo le CT: faʻasologa o lapotopoto ma ni vaʻaiga mafiafia ma le necrosis tutotonu o loʻo i ai le maualuga o le ea. DDx mai le faʻapipiʻi e faʻasaʻo ai le tino ma le totoga
Rx: antibiotic, antifungal, agents antiviral.
O le niumonia e tatau ona mulimulitaia ma toe fai CXR e faʻamautinoa le atoatoa o le iugafono
Le tele o le faʻalauiloaina o le eletise o le niumonia e ono faʻaalia ai le teenaina o le puipuiga, faʻamalositisi o siama, siakiina o le toto ma le isi mea faʻamalosia
TB Pulmonary
Faiga masani masani i le lalolagi atoa (3rd atunuu o le lalolagi). 1 i 3 tagata i le lalolagi atoa e aafia i le TB. TB e mafua mai i Mycobacterium TB poʻo Mycobacterium Bovis. Intracellular bacillus. O Macrophage e tāua se vaega taua.
Tulaga Mama o le Mumu TB & Post-muamua TB. Manaʻomia le toe faʻailoaina e ala i le manava. I le tele o talimalo talimalo, o le faʻamaʻi pipisi e le tupuola
TB e pei o 1) faʻamamaina e le 'auʻaunaga, 2) faʻamalosi i le Latent Tuberculosis Infection (LTBI) 3) mafua ai le maʻi TB. O tagata maʻi faʻatasi ma le LTBI latou te le faasalalauina le TB.
Ata: CXR, HRCT. Tulaga muamua TB: pulmonary airspace consolidation (60%) pito i lalo maualalo, lymphadenopathy (95% - hilar & paratracheal), pleural effusion (10%). Le Faʻasalalau o le muamua TB e foliga mai e puipuia ile faʻamalosiʻau ma tamaiti.
Milliary TB: pulmonary ma le faʻalauteleina o faʻalapotopotoga faʻasalalau e mafai ona afaina
Post-primary (secondary) poʻo le faʻafouina o le faʻafouina o tino: O le tele lava i totonu o Apices ma pito i tua o le pito i luga) maualuga le PO2), 40% -o le faʻamalosia o leona, maʻi poʻo le faʻalavelave faʻamaʻi vaalele, fibrocalcific. Faʻaputuga Latent: faʻamatalaga nodal.
Dx: Ava-fast bacilli (AFB) smear ma aganuu (sputum). Vailaʻau HIV i tagata uma e maua i le TB ma le le iloa le HIV
Rx: 4 fualaau faʻatau: isoniazid, rifampin, pyrazinamide, ma le ethambutol poʻo le streptomycin.
Neoplasms o le Pulmonary (o le tino o le kanesa o le tino ma le metastase pulmonary)
Kanesa o le susu: m / c o le kanesa i tane ma le 6th o le tele o le kanesa i tamaitai. Malosiaga malolosi ma le faʻamaʻiina o le tino. Falemaʻi: tuai ona maua, e faalagolago i le nofoaga o le paʻu. Fomaʻi (ituaiga): Tamaititi laititi (SCC) ma
Laititi laitiiti: (20%) e atiae mai le neuroendocrine ma le Kultchitsky cell, ma mafai ai ona faʻamalosi mea o loʻo faʻaalia i le biologically presenting with a paraneoplastic syndrome. O le mea e masani ona maua i totonu (95%) i le latalata i le masini autu / lobar bronchus. O le toʻatele e sili atu ona faʻaalia le leaga o le faʻasolosolo ma e le mafaamatalaina.
Laititi e le o se tamai: Alumini o le tino (40%) (M / C cancer), M / C i fafine ma tagata e le ulaula tapaa. Isi: Televave masima (atonu o iai ma le vevela), Fale tele ma isi
Laugatasi ata tifaga (CXR): fou pe faʻateleina faʻapitoa laʻau, faʻalauteleina mediastinum fautua mai o le lymph node aofia ai, pleural effusion, atelectasis, ma le tuʻufaʻatasia. SPN-atonu e faʻaalia ai ono maua i le kanesa kanesa aemaise lava pe a iai ni faʻaletonu faʻafitauli, fafagaina vaʻa, mafiafia pa, i le pito i luga mama. Tele nodules mama e ono avea ma sui metastasis.
Lelei sili ona lelei: HRCT faʻatasi.
Isi pusa o le pusa: Lymphoma e vatele i totonu o le fatafata aemaise lava i faʻamatalaga tusitusia ma mammary.
Ole aofaʻiga ole M / C pulmonary neoplasms ose metastasis. O nisi faʻamaʻi e faʻaalia ai le maualuga o le faʻavaʻa mo mama, pei o Melanoma, ae o soʻo se kanesa e mafai ona faʻasolosolo i māmā. Nisi mets taʻua o le "Canneball" metastasis
Rx: radiation, chemotherapy, resection
O le edema o le pulmonary: o se faaupuga lautele e faʻamatalaina ai le faʻaputuputuga o le suavai le masani ai i fafo atu o faʻavae o le tino. Lautele vaevaeina i Cardiogenic (eg, CHF, mitral regurgitation) ma Non-cardiogenic ma le tele o mafuaʻaga (eg, suavai soona, post-transfusion, neura mafuaʻaga, ARDS, latalata malemo / asphyxiation, heroin overdose, ma isi)
Mafuaaga: faʻalauteleina i le malosi o le vai ma vs faʻaititia i luga o le mamafa o le oncotic.
Ata: CXR ma CT: 2-ituaiga Interstitial ma Alveolar lologa. Faʻataʻitaʻiga ata e faalagolago i laʻasaga
I le CHF: Vaega 1: toe tufatufaina o vaʻa tafe (10- 18-mm Hg) taʻua o le `` faʻamamafaina '' o le pulmonary vasculature. Vaega 2: Faʻamatalaga vaeluaina (18-25-mm Hg) Faʻamatalaga o loʻo vaeluaina: peribronchial cuffing, Kerley laina (lymphatics tumu i suavai) A, B, C laina. Vaega 3: Alveolar edema: airspace faamaʻi: faʻapipiʻi faʻapipiʻi o loʻo tupu ae i faʻamaʻi vaʻai vaʻalele: Batwing edema, air bronchograms
Rx: 3 autu autu: Muamua O2 ia tausia O2 i le 90% saturation
Sosoo ai: (1) faʻaititia o pulmonary venous return (preload faʻaititia), (2) faʻaititia o systemic vascular tetee (afterload faʻaititia), ma le (3) inotropic lagolago. Togafitiga mafuaʻaga mafuaʻaga (eg, CHF)
O le ate atelectasis: faʻalauteleina le faʻalauteleina o pulmonary parenchyma. O le upu "paʻu māmā" e masani lava ona faʻasao pe a paʻu atoa le mama
1) Resorptive (faʻalavelave) atelectasis tupu o se faʻaiuga o le atoa poloka o se auala ea (eg tumo, manava mea, ma isi)
2) Passive (malologa) atelectasis tupu pe a faʻafesoʻotaʻi le va o le parietal ma visceral pleura ua faʻalavelaveina (pleural effusion & pneumothorax)
3) Faʻaleagaina le atelectasis e tupu mai ona o soʻo se vailaʻau vaʻaiga-o loʻo nofoia le liona e faʻapipiʻi ai le toto ma faamalosia ai fafo mai le alveoli
4) Cicatricial atelectasis: tupu o se faʻaiuga o maʻila poʻo fibrosis e faʻaititia ai le faʻalauteleina o le mama e pei o maʻamaʻi granulomatous, nerotizing niumonia, ma radiation fibrosis
5) O le ate elemene o le pulupulu e tupu mai i le tuai o le tuai ma le paʻu o le alveolar
6) E masani lava ona atiaʻe le faʻatalanoaga poʻo le mea e masani ai pe a uma ona mulimulitaʻi i le faʻalapotopotoga lautele
7) Ata faʻataʻitaʻi: paʻu o le mama, femalagaaiga o ponaivi o le māmā, feseʻeseaʻiga o le mediastinum, siʻi aʻe o le diaphragm, hyperinflation o faʻataʻamilosaga mama le afaina
Mediastinum: faʻasologa o togafitiga e mafai ona vaevaeina ia i latou e mafua ai le maualuga o le mamafa poʻo i latou e mafua ai le faasalalauina o faʻamaʻi e aofia ai le mediastinum. E le gata i lea, o le ea e mafai ona vaʻai i totonu o le mediastinum i le pneumomediastinum. O le malamalama i le faʻalauiloaina o le tino e fesoasoani i le Dx.
Manatu pito i luga o le mediastinal: lauroid, musika, teratoma / germ cell tumors, lymphoma, lymphadenopathy, oso aʻe aisicys aortic
Maualuluga mediastinal masses: lymphadenopathy, vascular, bronchial lions etc.
Faʻalauiloa pito i luga o le mediastinal: tima neurogenic, vaʻaia aisiki, tino o le esophage, faʻalaʻau o le fatulaʻau, faʻasalaga faʻasolosolo
Pulmonary empysema: leiloa o normal eletise / eletise toe faʻamamaina o le māmā ma le faʻatamaiaina o capillaries ma alveolar septum / interstitium.
Faʻaleagaina o pachyyma o le tino ona o le mumū masani. Puipuiga-faʻasalalau faʻasalalau o le elastin. Faʻaleleia o le ea / ea, hyperinflation, maualuga o le pulmonary, ma isi suiga. Falemaʻi: o le dyspnea alualu i luma, e le mafai ona suia. E oʻo ane i le taimi na faʻauluina ai le numera o le expiratory voltage i le 1 lua (FEV1) i le 50% o le tagata maʻi e le manava i luga o le galue malosi ma e fetaui ma olaga soifua.
O le COPD o le mafuaaga lona tolu o le oti i le lalolagi. E aafia ai le 1.4% o tagata matutua i le US. M: F = 1: 0.9. Pts 45 tausaga ma le matua
Faʻaiʻuga: Leʻa ulaula ma le-1-Antitrypsin le lava (vaevaeina i centrilobular (ulaula) ma panacinar.
Ata; faailoilo o le hyperinflation, felaʻi i luga o le ea, pullae, maualuga o le toto.
SKULL FX: FAIGALUEGA I LE FAATULAGAINA O LE AGAGA I LE LONA. SKULL FX O TOTONU I NISI MEA FAATINO FAAOFIA: INTRA-CRANALHEMORRHAGING, VAEGA TRAUMATIC BRAIN INJURY MA ISI COMPLICATIONS SERIOUS
SKull X-RAYS O LE MAUA FUA I LE FAʻAMATALAGA O LE MANUIA O LE ULU. CT SCANNING W / O CONTRAST O LE LALOLAGI AʻOAʻO GALUEGA LAUGA I LE iloiloga o le mataga ulu. TRAUMA. MRI HASA LE MAFAI GALUEGA FAʻALELEINA FAʻAALIGA O LE ALO, MA LE MAFAI ONA FAIA MO SE TATOU DX O LE ULU LOA TRAUMA.
SKULL FX E FAʻAMATALAINA ASO FXS OF SKULL VAULT, SKULL LEASE MA FAʻATASI SKELETON IA AOAO ATU MA TOTONU FAʻAMASINO MA LE FESOASOANI MO LE FAʻAMATALAINA O LE FAʻAMATALAGA.
LINEAR SKULL FX: SKULL VAULT. M / C FX. CT SCANNING O LE FAʻAALIGA E FAʻAMALUINA AI LE HEMORRHAGING MANAGERIA
X-RAY DDX: SUTURES VS. LINEAR SKull FX. FX IS THINNER, BLACKER-- IE MORE LUCENT, CROSSESSUTURES, AND VASCULAR GROOVES, LACKSSERRATIONS
RX: AFAI E LEʻI LĒ FAASOLOINA ATU I TOTONU O LE KOMISI E LE MAFAI AI. TULAGA FAʻAMASI PE A LE FAIA E LE CT SCANNING
SAUNIA SKULL FX: 75% I LE VAULT. E MAFAI ONA TATALO. ILOILOINA O SE FOTU FETU. Le tele o tulaga MANAOMIA NEUROSURGICALEXPLORATION aemaise IFFRAGMENTS mafatia> 1-CM.COMPLICATIONS: VASCULAR manua / HEMATOMAS, PNEUMOCEPHALUS, fiva, TBI, CSF mama, HERNIATION faiai ISI TULAGA FAAPENA
FAʻAALIGA: FUAFUAINA O LE TUSI PAIA O LE MAUA
BASILAR SKULL FX: MAFAI ONA MATUA. E TOE FAʻATELE I LE TASI O MEA TELE O LE PULEGA O LE PAIA MA FACIALSKELETON, E FAʻATELE MA LE TBI MA LE FAʻAMANATUINA O LE MAJORINTRACRANIAL. FAIGOFIE OCCUR AS ASI 'AOTELEGA AʻOAʻoga O Aafiaga MA METOTISI FAIGA E TUSA I LE OCCIPUT MA TEMPORAL PONI E TUSI SPHENOID MA ISI Tulaga O MATAʻOLINA. CLINICALLY: RACCOON MATA, BATTEL SAINI, CSFRHINO / OTorrHEA.
Fractures Face
NASAL BONES FX: 45% O ALLFACEFXM / C E TUSI LE LATALI (FIST BLOW ETC.) AFAI O LE UNDISPLACEDNO TREATMENT, AFAI E MAFAI ONA FAʻAMATALAINA LE AIR FLOW AND RESPIRATORY PASSAGE, E MAFAI ONA FAʻATASI ATU MA ISI FACIAL / SKULL INJURY. X-RAYS 80% SENSITIVE, NA TUSIA E CT INCOMPLEX INJURIES.
ORBITAL BLOW OUT FX: FAʻATELEGA FAʻATONU D / T AUA I LE LALOLAGI MA / PO I LE TASI IGA. FX OF ORBITAL FLOOR INTOMAXILLARY SINUS VS. UALELE FUA I TOTONU O LE ETHMOID. FAʻAMATALAGA: ENTRAPPEDINFERIOR RECTUS M, PROLAPSEORBITAL FAT, Faʻalualu Loloto Suʻega, FUAFUAGA MA OPTIC NERVE FAʻAFIAFIA. RX: O LE MANATU O LE MANATU I LE LALOLAGI E TĀUA, E MAFAI ONA E TOFIA ONA TELE FIAFIA AI FUA
TRIPOD FX: 2ND M / C FACIAL FX # AFTER NASAL (40% OF MIDFACEFX) 3-POINT FX-ZYGOMATICARCH, OROCITAL PROCESS OF ZYGOMATIC BONE & SIDE OF MAXILLARY SINUS WALL, MAXILLARY PROCESS OF ZYGOMATIC BONE.COMPLICATED INA. CT SCANNING E TELE FAʻAMATALAGA MAI X-RAYS (VAIʻA VAVE).
TUSI FX: FUAFUAGA FX ALWAYS INVOLVES PTERYGOID PLATES, FUAFUAGA MA LE SEPARATINGMIDFACE MA LE ALAVALARI ALII I LE FAAALO MAI LE SULULL. FAʻAALIGA: AIRWAYS, HEMOSTASIS, NUU I LE LOTO. E TATAU ONA TUSIA LE CT SCANNING. TUPE MAUA O BASILAR SKULL FX
PING-PONG FX: FUA MAUA I FUA TUPE MAUA. O SE FAʻATINO FAIGALUEGA FX D / T FOCALDEPRESSION: FAʻAFUAIGA FAʻAFOEINA, FAIGATA LABOR ITU. FOCALTRABECULAR MICROFRACTURIINGLEAVING DEPRESSION RESEMBLING APING-PONG. O le DX E MAUA I LE KINI ESEESEGA FAʻALELEIA - FAʻAMATALAGAINA I LE LAUOLU. TYPICALLYNEUROLOGICALLY fesoʻotaʻiga. MAFAI ONA FESOASOANI PE AFAI E FAIGALU LE MAFAI ONA. RX: OBSERVATIONAL VS. MANUIA I FAʻATINOAGA FAʻAGA. SPORTANEOUSREMODELING TUSI LIPOTI
LELEI FUAFUAINA CYST (SAUNOAINA O SKULL FX) - O SE FUAFUAINA O SKULL FRACTURE E MAʻU ATU AI I LE POSTTRAUMATIC ENCEPHALOMALACIA
E LE TATOU TAIMI, AUA O LE FAʻAALIGA O LE AOAOINA O LE ASO TAITASI O LE TUSI O LE POST-PALOSIA MA LE VAEGA SKULL FX FOLLOWEDBY FAʻAMATALAGA O LE TASI MA LE FAʻAMATALAGA MA LE FAʻAVAEINA O LE CSF. CT IS BEST ATDX THIS PATHOLOGY. FAʻAMATALAGA: TUʻUINA O LE FX MA LE FAʻAMATALAGA FAAALOALALIA ASI FOCALHYPOATTENUATING LESION.
FAʻAMATALAGA: FAʻAMATALAGA FAʻAMATALAGA FAʻAMATALAGA, PAINI, SAINI FAʻAMAITI / FILIFILI. RX: E TATAU ONA LĒ TALI LE TALOSAGA
MANDIBULAR FXS: COMMON. POTENTIALLYCONSIDEDED A OPEN FX D / T INTRA-ORALEXTENSION. 40% FOCAL BREAK DESPITEMANDIBLE I LE LUMAʻI. TULAFONO MUAMUA (ASSAULT) M / C MECHANISM
PATHOLOGICAL FX D / T BONE NEOPLASMS, INFECTION ETC. IATROGENIC I LE TULAGA O LE PALOTA (TOOTH EXTRACTION)
FAʻAALIGA: MANDIBLE X-RAYS, PANOREX, CT SCANNING ESP. I TULAGA OF ASSOCIATEDFACE / HEAD TRAUMA
FAAMATALAGA: OBSTRUCTION AIRWAYE, O HEMOSASISO O SE SUʻESUʻEGA FAʻAVAE, TAMAITI I MANDIBULAR N, OSTEOMYELITIS / CELLULITIS AND SPREAD POTENTIAL BY THE FLOOR OF THE MOUTH (LUDWIGANGINA) MA NECK FASCIAL SOFT TISSUES INTOMEDIASTINUM. E LE MAFAI ONA TALOSAINA I TOTONU O LE TOTOGI O LE TOTOGI MAUA.
RX: VAEGA FAʻAALIGA VS. FUAFUAGA
Faʻapapa Iso i totonu o le Intracranial
EPI AKA FUAFUAGA: (EDH) TRAUMATIC RAPTURE O MENINGEAL ARTERIES (MMA CLASSIC) MA LE FAʻATASI LELEI FAʻATASI HEMATOMA I LE FUA I LALOLAGI MA FUA I DURA. CT SCANNING O LE KI I DX: PERESENTS AS LENTIFORM IE BICONVEX COLLECTION OF ACute (HYPERDENSE) Toto E LE MAFAI ONA FESOASOANI MA FESOASOANI MA DDX O SE LALOLAGI HEMATOMA. CLINICALLY: HA, LUCID EPISODE INITIALLY AND DETERIORATING IN THE FATE HURS.COMPLICATIONS: BRAIN HERNIATION, CN PALSY. LE / O SE FUA TELE LELEI AFAI E VAVE FAI.
HEMATOMA SUBDURA (SDH): FUAFUAGA O BRIDGINGVEINS I Totonu o DURA MA LE ARACHNOID. LELEI AʻO FAʻALELEIA TELE TINO. MAFAI ONA AʻOAʻOINA LE AUTALAVOU MATUTUA MA TUMAU MA I TAUSAGA UMA (MVA, PAʻO ATU.) MAFAI ONA FAIA I LE 'SHAKEN BABY SYNDROME`. O LE DX E MAFAI ONA TULAFONO MA FAʻALELEIA LE FUAFUAINA MA TAMAʻI MA TAMAITI. I LE ULUAʻI O LE ULUAI O TRAUMA E MAFAI ONA MATĀʻIA PE LE MAUA. FAʻOLEFIE MA CT E FAʻAGA SAUNIGA O SE FUAFUAGA FAʻAALIGA E MAFAI ONA SOSʻIA SUTURES AE FAʻATASIINA I MANATUNATUGA LELEI. ESEESE ESEESE I luga o CT D / T ESEESE ESEESE O LE TOTO: FAʻALELELE, FAʻAFEFIAʻIA, MA FAʻAALIGA. E MAFAI ONA FAIA SE FUAFUAGA-CYSTICHYGROMA. CLINICALLY: VARIABLE PRESENTATION, 45-60% PRESENT MA LE SEVERELY DEPRESSED CNS STATUS, PUPILLARY INEQUALITY. Masani MA FUAFUAGA O LE BRAIN INITIAL, ONA O SE TUSI LELEI AUA TUA FUA SAʻITELEINA. I 30% TUPE O FATAL PAIA MAFAI ONA PAIA SA I AI SDH. RX: FAATINO NEUROSURGICAL.
FUAFUAGA FAʻAFAIGALUEGA (SAH): Toto I LE LALOLAGI O LE VAVA O SE FUA O LE TRAUMATIC PO LE FAʻAFIAFIA ETIOLOGY: BERRY ANEURYSMS I LALO O LALOLAGI O Willis.SAH 3% O MAʻAI, 5% O FAʻAFIʻAIGA FAAPITOA: Ulu na faʻamatalaina o se `` leaga HA INLIFE``. PT COLLAPSES MAY PE A LE MAFAI ONA OTI LE MAFUTAGA. PATHOGY: FESOASOANI Toto INSA SPACE 1) SUPRASELLAR CISORT WITH DIFFUSE PERIPHERAL EXTENSION, 2) IMPERIMESencesPHALIC, 3) FUA FUA FUA. TINO LE TINO I SA SPACE UNDERARTERIAL PRESSURE FAʻATELEINA LE FAʻATELEINA O LE LALOLAGI I LE FAʻATOMUAGA FAʻATUPE, O LE ISBEMIA MAUA O LE GLOBAL NA FAI E VASOSPASM MA ISI SUIGA.
DX: IMAGING: FAʻAFAIGALUEGA O LE TUSI O LE MAUAINA O LE KONAFIA, O LE TALOSAGA O LE GALUEGA E MAFAI ONA FESOASOANI IA TALA LE 99% O LE SAH. LUMBAR PUNCTUREMAY FESOASOANI I LE TUUINA ATU. PE A mavae LE TUSI FAʻAMATALAGA: MR ANGIOGRAPHY FESOASOANI I LE MAUA LE LEA MA ISI TULAGA FAATINO
FAʻAALIGA FAʻAMATALAGA: O LE NOFOAGA O LE NOFOAGA O HYPERDENSE ON CT. FAʻAMATALAGA I FESOʻOTAʻIGA: PERIMESENCEPHALIC, SUPELILE, VAEGA, VENTRICLES,
RX: TULAFONO FAATINO MEDS ANTIHYPERTENSIVE, OSMOTIC AGENTS (MANNITOL) TO DECREASEICP. NOFOAGA FAʻAMALO MA ISI TAITAIGA.
CNS Neoplasms: Benign vs. Malignant
FUAFUAGA TUSI REPRESENT 2% O KERISI UMA. LE TUSI TOLU LONA TAGATA, O LE MEA E METASTATIC FAASINO LAVA O LE TASI PAIA
SAUNIGA FAʻAMATALAGA MA FUA AʻOAʻOGA CNS LELEI, Faʻateleina ICP, INTRACEREBRAL BLEEDING isi FAMILIALSYNDROMES: VON-HIPPEL-LANDAU, TUBEROUS SCLEROSIS, TURCOT SYNDROME, NF1 & NF2 FAʻateleINA LE FAʻAFIAGA. I FANAU: M / C ASTROCYTOMAS, EPENDYMOMAS, PNETNEOPLASMS (EG MEDULLOBLASTOMA) ma isi. DX: FAʻavae I AI VASEGA.
MATUA: M / C FUAFUA NEOPLASM: MENINGIOMA. M / C PERAIMERI: GLIOBLASTOMA MULTIFORME (GBM) METSESPECIALLY MAI LUNG, MELANOMA, ANDAND BREAST.OTHERS: CNS LYMPHOMA
FAʻAALIGA O LE FAʻAMATALAGA: FAʻAMATALAGA MUAMUA E MAFAI ONA FESOASOANI ASO, ICP SIGNS HA. FAAALIA E CT MA MRI I LE IV GADOLINIUM.
FAʻAMATALAINA O TALOSAGA: INTRA-AXIAL VS. EXTRA-AXIALNEOPLASMS. METI MAI LE VAEGA MUAMUA NEOPLASMS MAYO CCUR VIA CSF MA LOTALESIA VAEGA VAEGA
FAAMATALAGA AXIAL CT SLICE OF MENINGIOMA MA AVIDCONTRAST ENGLISHMENT.
AXIAL MRI ON FLAIR PULSE SEQUENCE UA FAʻAALIA MAI LE NOFOAGA LELEI MA NA MAFAIINA CYTOTOXIC EDEMA O LE PEARI PARENCHYMA FUAFUAGA O LE GALIOMA IV GLIOMA (GBM) MA LE VAEGA LELEI MAUA. PEPA LONA TAULAGA TAULAGA: AXIAL MRI FLAIR: VAEGA METASASISI MAI LE VAEGA LELEI. O MELOMOMA E FESOASO MAI METASTASIZESTO LE VAEGA (VAAI I LE SPECIMEN PATI) MRI E MAFAI ONA TUSIA DIAGNOSTIC D / T SIGNALI I TOTONU T1 MA LE FAʻAFAIGALUEGA.
RX: NEUROSURGICAL, RADIATION, CHEMOTHERAPY, IMIMUNOTHERAPY TEECHNIQUES O LOO FAAALIA
O le tele o kamupani tausi maʻi e faʻaaogaina x-ave e avea o se diagnostic mea faigaluega e togafitia ai le tele o tagata gasegase faitioga, aofia ai ma togafiti. E mafai ona latou fesoasoani i fomaʻi e faʻailoa mai le mafuaʻaga o se faʻafitauli pe a i ai se mea e tele atu o tupu. X-ray e mafai foi ona fesoasoani i fomaʻi faʻapitoa e faʻamautinoa le ala sili ona lelei mo gaioiga. Ina ia malamalama atili, sei o tatou vaʻavaʻai vaʻavaʻai pe o a ia mea ma faʻafefea ona faʻaaogaina i le tele o faʻamalositino ofisa.
O a x-ray?
O le x-ray o se ituaiga malosiaga o electromagnetic radiation e tutusa ma leitio galu, ultraviolet radiation, microwaves, poʻo se malamalama vaʻaia e faʻaogaina e matamata ai i totonu o le tagata poʻo se mea. O le utupoto e taulaʻi i luga o se vaega faapitoa o le tino o le tagata, pei o le tua, e maua ai se ata numera o le skeletal fausaga.
O le utupoto e pasi gofie i le paʻu ma isi mea vaivai-- ae le mafai ona pasi i ponaivi ma nifo. O mea vaivai e lapopoʻa, e pei o totoga, soʻoga, ma maso, o le a vaʻaia - ae o le a puʻeina i le lanu efuefu. O vaega e pei o le manava poʻo mama e aliali mai luga o le ata e uliuli.
Le faʻaaogaina o x-ray
O faʻasologa ole laiga e maua ai se faʻamatalaga taua e mafai ona aʻafia ai le filifiliga a le fomaʻi e togafiti ai le tagata maʻi. I isi tulaga, o le togafitiga o le mafaufau poʻo le togafiti togafiti atonu e le o se talafeagai ala o gaioiga i lena taimi, ma le onosaʻi mafai ona amata i luga o se eseʻese, agamalu togafitiga.
O isi taimi, e mafai ona faʻaalia i le fomaʻi faʻapitoa auala e sili ona lelei i le togafitia o le tagata maʻi. I se faapuupuuga, tagata gasegase mafai ona maua sili atu, sili lelei-lapopoʻa tausiga e mafai sili faʻafaigofie ai latou faʻamalolo ma tiga puleaina.
Faʻailoa se tulaga poʻo ni faʻailoga, pei o le iviva tuma poʻo se papala 'o le a maua ai se fomaʻi mafuaaga e le tatau ai ona faia se faʻapitoa vasega o le tausiga.
Maua se faʻamatalaga faʻamatalaga taua e mafai ona fesoasoani i le taʻitaʻia togafitiga.
Ia tumau faʻapolokalameina ma tausia se faʻamaumauga o le onosaʻi degenerative gaioiga.
Fesoasoani i le faʻamalamalamaina o faʻalavelave i le tuila ma sooga e ono aʻafia ai togafitiga.
E mafai ai e tagata atamamai ona malamalama lelei io latou tulaga ma togafiti togafitiga, faʻatagaina i latou e faʻaaogaina le faagasologa ma sili atu ona aafia i latou togafitiga ma faʻamalologa.
O le a le mea e vaʻavaʻai e se tagata vaʻai i luga o se ata tifaga x-ray?
A. A chiropractor ave se x-ray o se tagata maʻi, o loʻo latou sailia ni mea i le tele o vaega faapitoa. Ole mea muamua latou te siakiina ia mautinoa e leai ni dislocations, gau, kanesa, faʻamaʻi, tumors, poʻo isi tulaga ono lamatia.
Ona latou vaavaai lea mo le maualuga o le maualuga ma isi faailoilo o le degeneration o le pa'ū, ponaivi o le ponaivi, ponaivi o le ponaivi, nofoaga tuufaatasi, ma le faaogaina. O lenei mea e mafai ai ei latou ona iloa tulaga e pei o le scoliosis ma isi tuutuuga atonu e manaʻomia ai ni ituaiga o togafitiga faapitoa.
Ole tele o fomaʻi faʻapitoa e mananaʻo o le tagata maʻi o loʻo iai i se tulaga mamafa peʻa ave uila vavae. E ese mai lenei mea mai le tele o falemaʻi faʻapitoa lea e taoto ai le maʻi.
O le lelei o le mamafa-aveina x-ave o se diagnostic mea faigaluega-- e mafai ai mo le fuaina, ie, vae umi le lava, scoliosis, ma le vaiti o le soʻoga avanoa. E mafai foi ona faʻaalia o nisi ponaivi, pei o le tibia ma le fibula, o loʻo vavaeʻese e mafai ona avea ma faʻailoga o le soona tendon poʻo se faʻafitauli ma le soʻoga. O le le mamafa o le aveina x-ray e le mafai ona maua ai le tutusa vaʻaiga, ma faʻailo taua i le tagata maʻi e ono misia.
IFM's Find A Practitioner mea faigaluega o le sili ona tele fesoʻotaʻiga fesoʻotaʻiga i Functional Faʻafomaʻi, fausia e fesoasoani tagata mamaʻi saili Functional Faʻafomaʻi fomaʻi soʻo se mea i le lalolagi. IFM Faʻamaonia Faʻataʻitaʻi e lisiina muamua i le sailiga iʻuga, maua a latou aʻoaʻoga tele i Functional Faʻafomaʻi
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