[Ortho] Стопы при псориатическом артрите

[cishaifa]

OK. I decided to answer since by now it looks clearer than on the first post. The clinical picture looks like a Rheumatoid Arthritis, rather then psoriatic which is assymmetrical. I would cite a Fowlers procedure as a choice. I do them from a dorsal approach, while Dr. Mazalov suggest plantar like Fowler described. Mayo procedure is now not in favor for Rigidus, but in rheumatoid patient Fowlers would be a good choice. I would prefer to see the plantar surface and an X-Ray including Cervical Flexion-Extention. I woul think of severe rigidus according to the picture. Will she be able to carry herself on her upper extremities?
Are there signs of active inflammatio in blood tests?б═
Remember to explain that her foot will be smaller, but fit for shoes.б═
RA are good patients, Goodluck. AL


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п═п╣п╥п╣п╨я├п╦я▐ пЁп╬п╩п╬п╡п╬п╨ 2-4 п╩я┐я┤п╣п╧ п╪п╬п╤п╣я┌ п╠я▀я┌я▄ п╬п©я─п╟п╡п╢п╟п╫п╟ п©я─п╦ п©п╬п╢я┌п╡п╣я─п╤п╢п╣п╫п╦п╦ п©я│п╬я─п╦п╟я┌п╦я┤п╣я│п╨п╬пЁп╬ я┘п╟я─п╟п╨я┌п╣я─п╟ п╟я─я┌я─п╦я┌п╟. п╖я┌п╬ п╨п╟я│п╟п╣я┌я│я▐ я─п╣я┬п╣п╫п╦я▐ п╬ 1 п©п╩я▌я│п╫п╣-я└п╟п╩п╟п╫пЁп╬п╡п╬п╪ я│я┐я│я┌п╟п╡п╣, я┌п╬ я▐ п╠я▀ п╢п╬п╤п╢п╟п╩я│я▐ п╠я▀ п╢п╟п╫п╫я▀я┘ п©п╬ п╣пЁп╬ я└я┐п╫п╨я├п╦п╦, п╟ п©п╬я┌п╬п╪ п©я─п╦п╫п╦п╪п╟п╩ п╠я▀ я─п╣я┬п╣п╫п╦п╣.

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9 п╬п╨я┌я▐п╠я─я▐ 2014 пЁ., 0:52 п©п╬п╩я▄п╥п╬п╡п╟я┌п╣п╩я▄ п▒п╣я─п╣п╤п╫п╬п╧ п║п╣я─пЁп╣п╧ <orthoforum на weborto.net> п╫п╟п©п╦я│п╟п╩:
п▓я│п╣-я┌п╟п╨п╦ п╡я▀ п╫п╣ п╫п╟п©п╦я│п╟п╩п╦ п╨п╬пЁп╢п╟ п©п╬я▐п╡п╦п╩п╟я│я▄ п╢п╣я└п╬я─п╪п╟я├п╦я▐. п·я┤п╣п╫я▄ п©п╬я┘п╬п╤п╟ п╫п╟
п╡я─п╬п╤п╢п╣п╫п╫я┐я▌ п╦п╩п╦ п©я─п╦п╬п╠я─п╣я┌п╣п╫п╫я┐я▌ п╡ я─п╟п╫п╫п╣п╪ п╡п╬п╥я─п╟я│я┌п╣.
пёя┤п╦я┌я▀п╡п╟я▐ п╫п╬я─п╪п╟п╩я▄п╫я▀п╧ п©п╣я─п╡я▀п╧ п╪п╣п╤п©п╩я▌я│п╫п╣п╡я▀п╧ я┐пЁп╬п╩, я▐ п╠я▀ я─п╣п╨п╬п╪п╣п╫п╢п╬п╡п╟п╩ я│п╢п╣п╩п╟я┌я▄
п╬п©п╣я─п╟я├п╦я▌ п╗п╣п╢п╣, п╢п╦я│я┌п╟п╩я▄п╫я┐я▌ п╨п╩п╦п╫п╬п╡п╦п╢п╫я┐я▌ п╬я│я┌п╣п╬я┌п╬п╪п╦я▌ п©п╣я─п╡п╬п╧ п©п╩я▌я│п╫п╣п╡п╬п╧ п©п╬
п═п╣п╡п╣я─п╢п╦п╫я┐, я┤я┌п╬п╠я▀ я┐я│я┌я─п╟п╫п╦я┌я▄ п╫п╟п╨п╩п╬п╫ п╨п╫п╟я─я┐п╤п╦ я│я┐я│я┌п╟п╡п╫п╬п╧ п©п╩п╬я┴п╟п╢п╨п╦ п°1. п╜я┌п╟
п╬я│я┌п╣п╬я┌п╬п╪п╦я▐ п╪п╬п╤п╣я┌ п╡я▀п©п╬п╩п╫я▐я┌я▄я│я▐ я│ я│п╬я┘я─п╟п╫п╣п╫п╦п╣п╪ п╩п╟я┌п╣я─п╟п╩я▄п╫п╬пЁп╬ п╨п╬я─п╨п╬п╡п╬пЁп╬ я│п╩п╬я▐
п╠п╣п╥ п╡п╫я┐я┌я─п╣п╫п╫п╣п╧ я└п╦п╨я│п╟я├п╦п╦. п≤ п╬я│я┌п╣п╬я┌п╬п╪п╦я▌б═ п╬я│п╫п╬п╡п╫п╬п╧ я└п╟п╩п╟п╫пЁп╦ п©п╬ п░п╧п╨п╦п╫. п░ п╡п╬я┌
я│ п╩п╟я┌п╣я─п╟п╩я▄п╫я▀п╪п╦ п╩я┐я┤п╟п╪п╦ я│п╩п╬п╤п╫п╣п╣. п▓ я│п╩я┐я┤п╟п╣ я─п╣п╥п╣п╨я├п╦п╦ пЁп╬п╩п╬п╡п╬п╨ п╩п╟я┌п╣я─п╟п╩я▄п╫я▀я┘
п©п╩я▌я│п╫п╣п╡я▀я┘ п╨п╬я│я┌п╣п╧ я┤я┌п╬ п©п╬п╪п╣я┬п╟п╣я┌ "п╠п╬п╩я┌п╟я▌я┴п╦п╪я│я▐" 2-4 п©п╟п╩я▄я├п╟п╪ я│п╫п╬п╡п╟
п╬я┌п╨п╩п╬п╫п╦я┌я▄я│я▐ п╡ я│я┌п╬я─п╬п╫я┐? п■п╟п╤п╣ п╡ я│п╩я┐я┤п╟п╣ 4-6 п╫п╣п╢п╣п╩я▄п╫п╬п╧ я└п╦п╨я│п╟я├п╦п╦ я│п©п╦я├п╟п╪п╦. п╞
п╠я▀ п╬п╠п╢я┐п╪п╟п╩ п╡п╟я─п╦п╟п╫я┌ п╟я─я┌я─п╬п╢п╣п╥п╟ п©п╩я▌я│п╫п╣я└п╟п╩п╟п╫пЁп╬п╡я▀я┘ я│я┐я│я┌п╟п╡п╬п╡. п≤ я─п╣п╨п╬п╪п╣п╫п╢я┐я▌
п╬п©п╣я─п╦я─п╬п╡п╟я┌я▄ п©п╬ п╬п╢п╫п╬п╧ я│я┌п╬п©п╣. п▓ я█я┌п╬п╪ я│п╩я┐я┤п╟п╣ п▓я▀ я┐п╡п╦п╢п╦я┌п╣, п╨п╟п╨ п©п╬п╡п╣п╢п╣я┌ я│п╣п╠я▐
я│я┌п╬п©п╟ п©п╬я│п╩п╣ п╬п©п╣я─п╟я├п╦п╦ п╦ я│п╪п╬п╤п╣я┌п╣ я┐я┤п╣я│я┌я▄ я█я┌п╬я┌ п╬п©я▀я┌, п╬п©п╣я─п╦я─я┐я▌ п╡я┌п╬я─я┐я▌ я│я┌п╬п©я┐.
п░ п╥п╟п╬п╢п╫п╬ п╦ п╦я│п©я─п╟п╡п╦я┌я▄ я┤я┌п╬-п╫п╦п╠я┐п╢я▄ п╟ п©п╣я─п╡п╬п╧ я│я┌п╬п©п╣, п╣я│п╩п╦ п╠я┐п╢п╣я┌ п╫я┐п╤п╢п╟.
п▒п╣я─п╣п╤п╫п╬п╧ п║п╣я─пЁп╣п╧


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