Artritis septik vs Gout Flare: Ko waɗi jokkondire goote ɓuuɓɗe, ɓuuɓɗe e nguleeki ko 24 hojom¶

Jokkondire goote gulɗe, boɗeeje, ɓuuɓɗe, mettuɗe no feewi (acute monoarthritis), ɓurɗe heewde heɓtaade koppi, wuttulo, wuttulo, junngo, walla wuttulo, ina jeyaa e caɗeele ɓurɗe teeŋtude e safaara. So tawii ɓuuɓri gonndi e kiristaal (gout akut ummoriiɗo e kiristaal urate monosodium walla pseudogout / CPPD ummoraade e kiristaal pirofosfaat kalsiyum) ina addana ɓuuɓri gonndi e ɓalndu, ndi jaabotoo ko leɗɗe kaɓtooje ɓuuɓri, **artritis acute bacterial se emergency orthopedique e safaara ɗo bakteriiji guurɗi e nder ɓuuɓri sinoviyal udditiindi ina njaltina enzim proteolitik (metalloproteinaseeji matriks e elastaas neutrophil) ɗi mbaɗtata ɓuuɓde e halkude kartilage hyaline artikulaar avaskulaar e nder waktuuji 24 haa 48 hopitaal e nder waktuuji 24 haa 48 rate gila e yahrude yeeso jaawɗo haa sepsis e ɓuuɓri septik. Ko ɓuri bonde nii, gout e septik ina mbaawi wuurdude e sahaa gooto e nder jokkondire goote, tee ɓuuɓri kiriis tan ina heewi saabaade nguleeki ɓalndu haa 38,9 degere Celsius (102 degere Fahrenheit). Sabu hay ƴeewndo ƴiiƴam, walla ƴeewndo ɓanndu, walla ƴeewndo ɓanndu gooto waawaa safrude ñawu nguu e hoore mum, kala jokkondire goote ɓuuɓɗe, ɓuuɓɗe ɗe nganndaaka, ina poti waɗde aspiraasiyoŋ steril (artrosentesis) ko yaawi hade dose gooto antibiotik walla steroid administeroid waɗde. So tawii neɗɗo oo ina wondi e nguleeki mawki e ɓuuɓri, jiiɓru, foofaango yaawngo, ɓuuɓri, ɓuuɓri ɓalndu, walla waasde ummitaade, noddu ɗoon e ɗoon limoore emergency nokku maa (911 to Amerik e Kanadaa, 112 e nder Dental Orop, 999 to Angalteer) walla ƴeewto regginorde amen of limooje caɗtuɗe. Ngam emergency infection e musculoskeletal jokkondirɗo e mum, janngu binndanɗe amen e... sepsis e anndinde soklaaji septik, sellulit, erisipela, limfangitis ɓuuɓɗo, e ɓeydagol ɓuuɓri, e ɓuuɓri ɓalndu, koppi, e ɓuuɓri jokkondire.

Waɗde ɗum jooni¶

1. Yah to suudu safrirdu ɗoon e ɗoon so tawii jokkol gootol ina ɓuuɓna ɗoon e ɗoon, ina wuli, ina ɓuuɓtoo e kala dille: Woto ɗaɓɓu jamma ngam ƴeewde so tawii goddol, hip, koyngal, junngo, walla koyngal ɓuuɓngal kesal ina moƴƴi e hoore mum, haa teeŋti noon so tawii neɗɗo oo ina jogii feso rhiumath, chiriumath ar, immunosuppression, injection jokkondire ɓooyɗe, walla lomtinande jokkondire artificielle (jokkondire prosthetique). E nder mboros septik bakteriiji, halkaare kartilage duumiinde fuɗɗotoo ko e nder waktuuji 24 caggal nde maale ɗee puɗɗii.
2. Ƴeewndo seerndi leeso tiiɗngo : ƴeewto e nofru so tawii jokkondire ɗee ina mbaawi muñde hay degereeji 5 dille (mikromotion) : So ñawɗo oo ina ɓuuɓna ƴiye mum haa laaɓa, eto no feewi ɓuuɓnude walla yirlaade jokkondire gonɗe heen ɗee e degereeji 5 haa 10 tan. E nder ñawuuji ɓalndu toowɗi (bursitis prepatellar walla cellulitis dow jokkere), dille ɓuuɓɗe tokoose ɗe jokkere ndee e hoore mum ina metti no feewi haa ɓalndu nduu ɓuuɓtoo no feewi. E nder artritis septik intra-artikulaire goonga (e ɓuuɓri kiristaal tiiɗndi), kapsul jokkondire ɗee fof ina ɓuuɓtoo e les ɓuuɓri ndiyam mawndi : ñawɗo oo ina jogoo jokkondire ɗee no feewi e nder position maximum flexion capsulaire (ngam goddol, 15 haa 30 degereeji ; yaajde yirlaade) e wulla walla haɗa ma diwde jokkondire ɗee hay degereeji 5.
3. Woto meeɗ ƴettude antibiotikuuji heddiiɗi e hunuko hade safrirde ndee waɗde tappirde (arthrocentesis) : So wonaa tawa ñawɗo oo ina wondi e caɗeele nguurndam ɓuuɓri septik waktuuji 10 e nder safrirde, woto meeɗ muñde antibiotik galle hade doktoor aspirde ndiyam e jokkere ɓuuɓnde ndee. Dose gooto amoksisiliin, sefaleksin, doksisiklin, walla siprofloksasin, waawataa naatde e nokku jokkondirɗo keewɗo pus e nder ɓuuɓri toowndi ngam hisnude kartilaj, kono ina sterilize pinal ndiyam sinovial, ina maska bakteriiji caabotooɗi ɗii, ina ɗacca safrooɓe ɓee ina njiɗi safrooɓe ɓee antibiotik e lootgol seppooji walla safaara gout koyɗol.
4. Woto meeɗ accude safrirde ina waɗa kortison (kortikosteroid) e nder jokkondire ɓuuɓɗe, ɓuuɓɗe hade mum limteede e ƴiiƴam sinovial e stain Gram ina haɗa ñawu nguu: So tawii ñawɗo mo taariindi mum woni e mum ko osteoartritis walla gout naamndii safrirde toppitiinde ko yaawi "kortison ɓuuɓɗo" e nder jokkere enɗam hesere analis ko adii, e jokkondire ɗee ina njogii tigi rigi bakteriiji Staphylococcus aureus, sterooji nder jokkondire ina ustoo ƴiiƴam ɓalejam nokku oo, ina addana halkaare jokkondire fulminant, osteomielitis, e bakteriiji baawɗi warde e nder balɗe seeɗa.
5. Doole NPO tiiɗɗo (alaa ko woni e hunuko, tawa alaa ko ñaametee, ndiyam, walla pillitol ñawu nguu) nde njahataa e departemaa emergency: So tawii artrosentesis ina hollita ɓuuɓri bakteriiji e nder jokkondire mawɗe (haa teeŋti e hip, ɓalndu, walla goddol/hip prosthetic), ñawɗo oo ina foti ƴettude operaasiyoŋ to artroskopi walla artrotomi udditirɗo seppooji ndiyam e debridement (loowdi jokkondire) e nder anestesi kuuɓtodinɗo walla anestetik ɓalndu. Reento rokkude AINE (ibuprofen, naproxen) walla asetaminofen (paracetamol) ko adii ɗuum, ngam haɗde reedu nduu ɓuuɓde ngam anestetik e waasde maskude nguleeki e sahaa triage.
6. Splint e immobilize jokkondire e nder mbaydi mum fooftere e ustude teddeendi kala: Woto doole goddol ɓuuɓngol, ɓuuɓngol walla hip ina tiiɗi. Wallitde goddol walla koyngal mettungal e dow pillow e dow ŋoral walla e jolngo ngam zero teddeendi ɓanndu ina toɓɓa laabi kartilage artikulaar softuɗi ɗii, e wallitde ɓalndu walla junngo mettungo e nder ŋoral welngal.

Lekki kuulal : triage ɓuuɓɗo, ɓuuɓɗo e jokkondire goote (monoartrite).¶

flowchart TD
    Start["Jokkondire goote ɓuuɓɗe, boɗeeje, ɓuuɓɗe, walla mettuɗe (Goddol, Hip, Baagal, Ankle, Wrist, walla Toe)"] --> CheckSepsis{"1. Kala Banndiraaɓe Boɗeeji Sepsis : Jiiɓru, Rigor, Ɓooygol BP, Ɓooygol Ɓernde >110, walla Fooftere Jaawnde ?"}

    CheckSepsis -->|"EEY: Sepsis sistemik walla shok septik"| Call911["ƊOONI 911 / 112 / 999 PROTOKOL SEPSIS: 1. Noddu Ambulance ɗoon e ɗoon ngam yahdu yaawndu e opitaal 2. Ƴettu pine ƴiiƴam + Waɗde aspiraasiyoŋ jokkere enɗam e nder leeso 3. Fuɗɗoraade Antibiyotik IV mo mbaydi mum yaajndi e nder Triage1"]

    CheckSepsis -->|"NO: Hemodinamik ina woodi"| CheckChildHip{"2. Mbele ñawɗo oo ko cukalel ngel salii ɗoon e ɗoon jogaade teddeendi e koyngal gootal walla diwde hip mum?"}

    CheckChildHip -->|"EEY: Hip Irritable sukaaɓe"| KocherCheck["ƊEMNGAL KOCHER ƁIƁƁE : 1. Yah to nokku ɓuuɓɗo sukaaɓe (Keep Child UPO) 2. Ƴeewto 4 Teskagol Kocher : Teddungal ngal alaa teddungal, nguleeki >38,5 C (101,3 F), ESR >40 mm/hr, WBC03 Aspiration ngam haɗde nekrosis hoore femoral e nder waktuuji seeɗa"]

    CheckChildHip -->|"NO: Koolol mawɓe"| CheckBursaVsJoint{"3. Mbele ɓuuɓri ina tiiɗi e yaasi koppi/tippirde koppi e Micromotion 10-Degree mo alaa ko nafata, WALLA e nder kapsul jokkondire luggiɗe?"}

    CheckBursaVsJoint -->|"Ko ɓuri heewde e koppi/Olekranon; Mikromosiyoŋ mo alaa nafoore"| SepticBursitis["BURSITIS SEPTIK TUUMAA WALLA SELLULITIS ƁURƊO : 1. Hoto meeɗ waɗde ƴiiƴam e nder ɓalndu boɗeeru ɓuuɓndu e nder jokkere luggiɗnde nde ɓuuɓnaaka 2. Ƴeewndo safaara jaawɗo ngam aspiraasiyoŋ bursal walla antibiyotikuuji sistemik"]

    CheckBursaVsJoint -->|"Jokkondire luggiɗe ndartinaaɗe e dille 5-degereeji"| UrgentTap["ARTROSENTESIS DO DEPARTEMENT EMERGENSI WONI : 1. Jogaade NPO ñawɗo ; WOTO ƴettu antibiyotik walla kortison e hunuko hade maa tappude 2. Aspire ndiyam sinovial ngam limde WBC, % PMNs, mbaydi Gram, pinal, e ƴeewndo kiristaal lewño polarize 3. Siftor: Wondude e kiristaal Gout/CPPD haɗataa Arpxitis CoE"]

Ko waɗi ɓuuɓri bakteriiji ina halka jokkondire e nder waktuuji 24 haa 48¶

Nandugol e ɓalndu, e ƴiye, walla e ƴiye, kartilaj hyaline artikulaar (kuɗol ɓuuɓngol no gilaas nii, ngol ɓuuɓri mum famɗi, ngol suddata ko jokkere ƴiye nder jokkondire sinovial) ina jogii ɓiɗɓe ƴiiƴam, ƴiye, e ɓuuɓri limfatik. So karte mawɗe ɗee mbonnaama, ɗe mbaawataa wuurde.

1. No bakteriiji naatirta e nder ɓuuɓri jokkondire udditiinde¶

Membrane sinovial gonɗo e nder kapsul jokkondire ina heewi ƴiiƴam, ko ɗum waɗi ɗum ko filtirde mawnde wonande bakteriiji cirƴattooɗi e nder ƴiiƴam, kono ko ɓuri haawnaade heen alaa ko woni e mum so wonaa membrane basement reenoowo. Bakteriiji ina naata e nokku jokkondirɗo oo e laabi tati : 1. Aawdi hematogenic (70 haa 80 e nder teemedere e ñawɓe): E nder ɓuuɓri ƴiiƴam juutndi walla feeñndi (bakteriemi) ummoriindi e ɓuuɓri ɓalndu woɗɗundi, ɓuuɓri ƴiiƴam, ɓuuɓri ƴiiƴam, ɓuuɓri ƴiiƴam, ɓuuɓri ƴiiƴam, kuutoragol leɗɗe e nder ƴiiƴam, endokarditis, walla dental/kateter travel, rewrude e laawol dental/kateter sinoviyum mo alaa membrane les oo e nder ndiyam jokkondire. 2. Inokulaasiyoŋ toowɗo (15 haa 20 e nder teemedere): Bakteriiji ina njuutee e nder ɓuuɓri jokkondire tawa ko e ɓuuɓri naatndi (ɓuuɓri, ɓuuɓri, ɓuuɓri pusi, walla "ɓuuɓri hare" ɓuuɓndi e junngo ɓuuɓngo, ɓuuɓngo e dow ŋoral), ɓuuɓri ndi alaa ɓiɗɓe **intra-centrique corticoroïde in or articulaire corticoroïde opereeji artroskopi walla lomtingol jokkondire. 3. Yaajde jokkondirɗe (5 haa 10 e nder teemedere): Infection bone adjacent (osteomyelitis acute) ina ɓuuɓtoo e nder ɓalndu, ina naata e nokku jokkondirɗo, ɓuri anndeede ko e cukalel tokosel e sukaaɓe tokosɓe, ɗo ƴiiƴam taƴata e ɓalndu mawnugol (physis) e nder hip, e ɓalndu, e koyngal, e

2. Kaskaade ɓuuɓɗo karte enzimatik¶

So tawii ko bakteriiji ko wayi no Stafilokokus (ina heen MRSA, baawɗo saabaade ko ina ɓura 50% e ñawɓe mawɓe), Streptokokus sifaaji, Neisseria gonorrhoeae (e sukaaɓe mawɓe wonɓe e jokkondire), walla **Bacilli Gram-no*Pseumona, Escherichia coli e nder mawɓe, ñawɓe ɓe cellal mum en ŋakki, walla huutortooɓe leɗɗe IV) ina naata e ndiyam sinovial keewɗam ñamri : - Waktu 0 haa 12 (Invasion des Neutrophiles & Pressure Surge): Ɓoornugol sinoviyal ina ɓuuɓna ɓuuɓri jokkondire, ina waɗi ujunnaaje ujunnaaje neutrophiles polimorfonukleer (ƴiiƴam ɓalejam) e ndiyam. Sabu kapsul jokkondire fibrous waawaa yaajde e no feewi, ɓuuɓol hidrostatik nder ƴiye ina ɓeydoo heewde, pinndingol ina uddita ƴiye epifisiyeeje tokoose ɗe ina ndokka ƴiye les ɗee (haa teeŋti noon e nder ƴiye bal-e-socket jokkondiral hip, ina addana nekrosis avaskulaar ore moral necrose of the**). - **Waktu 12 haa 24 (Maayde Glosaminoglikan Proteolitik): Bakteriijiii fof (rewrude e Kondroitinaas bakteriiji e tooke) e ƴiiƴam ɓalejam ñawɗo oo e hoore mum ina njaltina proteaseeji lisosomal, kolagenaseeji, e metallo matriks (MPMkeewɗi. E nder waktuuji **, ɗeen enzim ina njuppa haa **40 e nder teemedere (40%) e ƴiiƴam ɓalndu (glikosaminoglikan) **. - Waktu 24 haa 48+ (Collagen Scaffolds Collagen Irreversible): So kuɗol proteoglycan ngol fusii, mbaydi kolagen mbaydi II gonndi e ɓuuɓri kartilaj e les ɓuuɓri jokkondire mekanik. Hay so tawii caggal ɗuum antibiotik ina wara kala bakteri ñalnde 4, kartilage oo ina ɓuuɓtoo haa abada haa laaɓa, ina addana ñawɗo oo won’de ñawu nguu ina wondi e ɓuuɓri gonndi e ƴiiƴam, walla ɓuuɓri gonndi e ƴiiƴam (ankylosis).

Njiylawu bannge-bannge : Artritis septik vs Gout Akut vs Pseudogout (CPPD) vs Bursitis septik¶

Ƴeewndo ndiyam sinoviyal : firtude tappirde njuumri (artrosentesis)¶

Sabu ƴeewndo ɓanndu e ƴeewndo ƴiiƴam (asid urik serum, limto ƴiiƴam ɓalejam, ESR, e CRP) ina kawri no feewi hakkunde ɓuuɓri septik e ɓuuɓri kiristaal, safrooɓe urgence tuugnii ko e analis ndiyam sinovial ƴettaa e laawol steril gocent as sterile arth

Artritis septik sukaaɓe e hip : emergency Criteria Kocher¶

E nder sukaaɓe tokosɓe, sukaaɓe tokosɓe, e sukaaɓe tokosɓe, artrite septique bactérienne aiguë de l’hip ina jeyaa e caɗeele ɓurɗe yaawde e nder safaara sukaaɓe. Sabu ƴiiƴam gonɗam e hoore feso cukalel ngel ina mawna (ƴiiƴam retinakulaar de l'arterie épiphyseale latérale) ina doga e nder kapsul jokkere enɗam tiiɗnde, pus ina moofta e les ɓuuɓri nder reedu cukalel ngel **ina ɓuuɓna ƴiiƴam ɗam to dow feɗeendu to,6u1 ɓuuɓgol jokkere hippoode, ŋakkeende njuuteendi terɗe, e ŋakkeende nguurndam.

1. No cukalel walla cukalel gonngel e hip septik jogori jogaade koyngal mum ("La posture Fabere")¶

Cukalel tokosel walla cukalel gonngel e ɓuuɓri hippoode ɗoon e ɗoon jaɓa daraade, yahde, walla jogaade teddeendi e koyngal gootal (walla cukalel ina woya tawa ina weltii e kala mbayliigu paɗe). Ƴeewee no cukalel ngel jogori jogaade koyngal gonngal e ñawu nguu tawa ina lelii e dow koyɗe maɓɓe : - Hip ina jogaa Flexed (ɓuuɓɗo dow), Abducted (ɓuuɓɗo yaasi to bannge no koyngal paabi nii), e Externally Rotated (koyngal ɓuuɓngal dow). - Koni? Sabu ngool Darnde FABERE ina ɓeyda ɓuuɓri nder kapsul jokkondire hippoode, ina usta ɓuuɓri nder ɓalndu. Kala etaade feewnude koyngal cukalel ngel walla ɓuuɓnude koyngal ngal e nder mum ina addana ngel wullude ɗoon e ɗoon.

2. Laabi Kocher 4 : seerndude Hip Septik e "Sinovitis Transient" moƴƴo.¶

Sabu ɓuuɓri mboros bonndi, ɓuuɓndi hoore mum, ina wiyee sinovitis gonɗo e ɓalndu ("sinovitis tooke") ina heewi addande sukaaɓe yahrooɓe e duuɓi 3 haa 8 ɓuuɓde balɗe seeɗa caggal nde ɓe keɓi ɓuuɓri, safrooɓe sukaaɓe e safrooɓe ɓalli ina kuutoroo **a Kocher C- septik bakteriiji goonga:

Feereeji keertiiɗi ɓurɗi heewde baasal : Infeksiyoŋ Gonokok diisneteeɗo, Artritis Lyme, e Sepsis Sternoklavikulaar¶

Wonaa kala jokkondire gonɗe e ñawu nguu ina njiyloo no sepsis koppi Staphylococcus aureus ɓooyɗo nii. Jeertoɗee e ñawuuji tati ceertuɗi, ɗaɓɓuɗi ƴeewndo keeriiɗo :

1. Nguurndam gonokok (DGI / Sindrom artrite gonokok-dermatitis) :
2. Mo ɗum fiyi: Sabaabu #1 gonɗo e ñawu nguu e nder sukaaɓe mawɓe e sukaaɓe rewɓe (haa teeŋti e sukaaɓe rewɓe e nder lewru walla e nder reedu).
3. Triad Classic: Ko adii nde jooɗotoo e jokkondire goote walla ɗiɗi (ko ɓuri heewde ko goddol, junngo, walla koyngal), DGI ina hollira (1) poliartraljiiji eggotooɗi (nafoore diwtunde gila e koppi haa e junngo haa e koyngal), (2) tenosynovitis (nafoore juutnde, boɗeere the junngo, walla koyngal), e (3) ɓuuɓri ɓalndu ɓuuɓndi walla ƴiiƴam ndi alaa nafoore (ɓuuɓri 5 haa 20 ɓuuɓri tokosiri gunmetal-gray e dow base boɗeejo dow koppi, paɗe, juuɗe, walla koyɗe).
4. Nanngugol ñawbuuli: Pine ndiyam sinovial gonɗe e mbaydi kuuɓtodinndi ina mawna Neisseria gonorrhoeae ko famɗi fof 50 e nder teemedere, tawa kadi limoore WBC sinovial ina waawi wonde tan 20 000 haa 40 000 cellal/uL. Safrooɓe ina poti mooftude teskuyaaji ƴellitaare asid nukleik (NAAT / PCR swabs) e nder ƴiiƴam/reedu, e reedu, e daande (farinks) e saraaji pine ƴiiƴam e jokkondire, e safrude e ceftriaxone nder ƴiiƴam.
5. Nyawu Lyme, ɓuuɓri ƴiiƴam (Borreliya burgdorferi):
6. Hollitoore: Yontereeji haa lebbi caggal nde mboros oo anndaaka e nder nokkuuji ɗo mboros oo woni ɗoo (Fuɗnaange-rewo, Caka-Atlantik, e Toownde-Hirnaange-rewo Amerik; Orop hakkundeejo e Fuɗnaange-rewo), ñawɗo oo ina heɓa koppi ɓuuɓɗi no feewi ("wo"balloon knee isllen than ina metti**. Nanduɗo e Staph septic arthritis, ñawɗo mo Lyme knee arthritis ina heewi alaa ɓuuɓri kadi ina waawi yahde haa jooni e nder safrirde ina jogii teddeendi hay so tawii koppi mum ina ɓuuɓi no feewi. Ko ɗum anndiraa e ELISA/Western blot mo ƴiiƴam mum tolnii e PCR mo ƴiiƴam sinoviyal ; safretee ko e doksisiklin walla amoksisiliin balɗe 28 tawa alaa ko haani lootde jokkondire e seppo.
7. Artritis septik gonɗo e ɓalndu sternoklavikulaar e sakroiliak:
8. So tawii ko ɗoon e ɗoon, ɓuuɓri mawndi, ɓuuɓri, e ɓuuɓri ƴiye peeñii e jokkondiral sternoklavikulaar (to ƴiye ndernderiije ɗee kawri e dow ƴiye ɓalndu to les daande), ina sikkaa ko ɓuuɓri septik hematogen (ko heewi saabaade ɗum ko Staphylococcus ve.P central with Staphylococcus ve.P central walla kateteruuji, laabi hemodiyaaliis, jabet, walla kuutoragol geɗe IV). Sabu jokkondire sternoklavikulaare ina njooɗii yeeso ƴiiƴam les, ƴiiƴam brakiyosefali, e mediastinum toowɗo, ɓuuɓri jokkere sternoklavikulaar nde safraaka ina rutta caggal e nder reedu (mediastinitis nekrotisant descendant) ina ɗaɓɓi ƴeewndo CT/MRI e yaawngo.

Limooje emergency diiwaan e porotokolle agence¶

• Leyɗeele dentuɗe Amerik e Kanadaa: Noddu 911 so tawii jokkere enɗam ina wondi e nguleeki mawki, ɓuuɓri, jiiɓru, ɓuuɓri, walla waasde daraade. So wonaa ɗuum, yah to Departemaa Emergency Hospital (wonaa kilinik farmasii retail walla walk-in urgent care mo alaa ko woni e mum so wonaa kaɓirɗe artrosentesis sterile, mikroskopi polarisé, e opereeji ortopedik e noddaango).
• Dental Dowlaaji Dentuɗi: Noddu 999 ngam tuumeede sepsis walla yah to suudu safrirdu ɓurndu ɓadaade ma departemaa A&E. E nder **Fedde Angalteer ngam Reumatoloji (BSR) e Fedde Angalteer ngam Ortopedi (BOA) , kala monoartritis ɓuuɓɗo ina foti waɗde aspiraasiyoŋ jokkondire ngam ƴeewndaade mikroskopi, limde cellal sinovial, e pinal ko adii nde antibiotik waɗata, tawa ina yahdi e reshout orthopedic urgent.
• Dental Orop: Noddu 112 ngam yahdu e ambulance e nder safaara walla yahde e departemaa safaara e nder safrirde caggal Fedde Orop ngam Fedde Reumatologie (EULAR) laabi monoartritis ɓuuɓɗo.
• Ostraali e Nuwel Selannde: Noddu 000 to Ostarali walla 111 to Nuwel Selannde, walla hollir ɗoon e ɗoon to Departemaa Emergency to opitaal laamu walla keeriiɗo ngam waɗde artrosentesis e ƴeewndo ortopedi ko yaawi.
• Inndo e Asii-Pacifik: Noddu 112 walla 108 to Inndo, 995 to Singapuur, 119 to Japon e Koree worgo, walla 999 to Hong Kong e Malesi.

Naamne keewɗe naamneede¶

Hol ko waɗi goddol walla hippoode ɓuuɓnde, ɓuuɓnde ina hiisee wonde emergency safaara waktuuji 24 ?¶

Nandugol e ɓalndu walla e ɓalndu, kartilage hyaline ɓuuɓɗo, ɓuuɓnoowo jokkere enɗam nder ɓalndu, alaa ƴiiƴam, waawaa kadi wuurde so bonnii. So bakteriiji njippiima e nokku udditirɗo jokkondire (artritis septik), tooke bakteriiji e enzim proteolitik mo ƴiiƴam ɗam ɓuuɓɗam yaltinta, puɗɗotoo ko ɓuuɓnude ƴiiƴam ɗam, ɓuuɓɗam ɗam, e nder waktuuji 24 haa 48. So tawii ko ɓuuɓri ƴiiƴam yaawndi, lootgol jokkere enɗam, e antibiotikuuji nder ƴiiƴam, bonnugol jokkere enɗam duumotoonde walla sepsis baawɗo warde ina waawi waɗde e nder balɗe ɗiɗi.

Hol ko waɗi mi meeɗaa ƴettude antibiotik heddii e galle am hade am yahde safrirde ngam ɓuuɓri ƴiiƴam?¶

Ƴettude hay pillol antibiotik gooto walla ɗiɗi e nder hunuko hade cafroowo oo ɓuuɓnude ndiyam e nder jokkere maa e ƴiiƴam (arthrocentesis) ina heewi haɗde laboratuwaar mikroo-biyoloji mawnude bakteriiji e nder pinal ("pinal fenaande-negatif"), tawa e goonga safraani ñawu jokkere luggiɗngu nguu. So tawii pinal ndiyam jokkondire sterilisee ko e pillol gonngol e sahaa, safrooɓe mbaawataa anndude so tawii aɗa jogii infection jokkondire bakteriiji baawɗe warde nguurndam, ina ɗaɓɓi lootgol seppooji e jonte 4 antibiotik e nder ƴiiƴam walla ɓuuɓri gout steril, doole juutɗe e nder safrirde e dow leɗɗe empirik yaajɗe.

Mbele ɓuuɓri gout ina waawi saabaade nguleeki, kadi mbele aɗa waawi heɓde gout e ɓuuɓri jokkondire bakteriiji e sahaa gooto ?¶

Eey e ɗiɗo fof. Gout ɓuuɓɗo walla pseudogout flare, haa teeŋti noon e jokkondire mawɗe hono koppi walla e nder jokkondire keewɗe, ina yaltina ɓuuɓri keewndi e nder ƴiiƴam, tawi noon ina heewi saabaade nguleeki ɓalndu haa 38,9 degere Celsius (102 degere ƴiiƴam Fahren). E ko refti heen, haa 5 e nder teemedere ñawɓe wonduɓe e jokkondire septik bakteriiji ina njogii kadi kiristaal gout walla pseudogout yiyteteeɗo e nder sample ndiyam gootol tigi rigi sabu enzim bakteriiji ɓuuɓnooji kartilage ina njirloo kiristaal gonɗo ko adii ɗuum. Ko limre cellal ndiyam sinovial timmungal, mbaydi Gram, e pinal tan mbaawi seerndude ɗi ɗiɗi.

Hol ko waɗi ina bonna heɓde kortison e nder goddol ɓuuɓngol kesol tawa ƴeewndaaki ndiyam jokkondire ko adii ?¶

Kortikosteroid (hono triamcinolone walla metilprednisolone) ina gollira e doole ngam haɗde ƴiiƴam ɓalejam e golle reenngo ɓalndu nder ɓalndu. So tawii noon injection steroid ina yaawi safrude osteoartritis sterile walla gout flare, injection kortison e nder jokkondire gonɗe e sirlu bakteriiji ina momta reentaare ɓanndu nokkuure, ina addana bakteriiji ɗii ɓeydaade heewde tawa ƴeewtaaka, ina halka denndaangal jokkondire triyelidesteom the fatal), e nder sokla.

Hol no safrooɓe nganndirta seerndi hip septik e "sinovitis transient" mo alaa ko bonnata e cukalel ngel salii yahde ɗoon e ɗoon ?¶

Cafrooɓe sukaaɓe ina ƴeewtoo sifaaji Kocher nay ɗii : (1) salaade jogaade teddeendi e koyngal, (2) nguleeki ɓurtuki 38,5 degere Celsius (101,3 degere Fahrenheit), (3) ɓuuɓri ƴiiƴam (ESR) ɓurndi 40 mm/hr (walla ƴiiƴam ɗam ina tolnoo e 12 000 ƴiiƴam e nder mikroo-liiteer gooto. Cukalel gonngel e zero walla gootol, ko famɗi fof ina jogii sinovitis transient viral benign, kono cukalel ngel 3 walla 4 ina jogii ko ɓuri 93% e mboros septik bakteriiji, ina ɗaɓɓi ko yaawi aspiraasiyoŋ hip guided e ultrasound e drainage surgical e nder suudu safrirdu.

Hol ko limtetee e emergency so tawii miɗo jogii goddol artificiel walla lomtinande hip (joint prosthetique) ?¶

Kala puɗɗagol ɗoon e ɗoon nafoore hesere, nguleeki, ɓuuɓri, ɓuuɓri, ɓuuɓri ƴiiƴam, walla ɓuuɓri ndi alaa ko firti e ñawɗo mo koppi mum, koppi mum, walla koppi mum fof lomtii, ko huunde nde opereeji ɗii mbaɗi, so tawii ko yontereeji 2 jooni walla duuɓi 10 jooni. Bakteriiji jahrooji e ƴiiƴam ummoraade e laɓɓingol dental, taƴgol ɓalndu, walla ɓuuɓri ƴiiƴam ina mbaawi aawde njamndi mboɗeeri, mahde biofilm mo safaara mum waawataa safrude e nder balɗe seeɗa. Yah to departemaa emergency opitaal mo coverage opereeji orthopedique e woto meeɗ ɗaccude kilinik toppitiiɗo ko yaawi tappude jokkondire prosthese yaasi ngonkaaji ortopediiji sterile.

Ardiiɓe jokkondirɓe¶

• Sepsis e septik shock anndinde e jaabawol e nder sahaa
• Sellulit, erisipela, limfangitis ɓuuɓɗo, e ɓeydagol ɓuuɓri
• Dislocated ɓalndu, koppi, e immobilisation jokkondire
• Kosam ɓuuɓɗam, ɓuuɓɗam, e ɓuuɓri tiiɗndi ballal gadanal

Fuɗɗoode e ardorde laawɗunde¶

• Fedde Angalteer ngam Ɓoornugol (BSR), Fedde Angalteer ngam Ɓoornugol (BOA), e Koldaa Laamɗo ngam Ɓoornugol (Royaume-Uni): Laabi ngam ƴellitde jokkondire ɓuuɓɗe e nder mawɓe (Artrosentesis, Analyse de fluide synovial) e Washout Stards Surgical.
• Fedde Fedde Oropnaare ngam Ɓooygol (EULAR): Wasiyaaji EULAR ngam haɓaade ñawu nguu e nder ɓalndu, e ñawu nguu, e ñawu nguu, e ñawu nguu, e ñawu nguu (CPPD).
• Fedde ñawuuji mborosaaji Amerik (IDSA, Amerik): Laabi gollorɗi e nder safaara ngam ƴeewde e ƴellitde ñawuuji mborosaaji gonɗi e nder reedu, artritis septik gonɗo e nder reedu, e mborosaaji gonɗi e nder reedu (PJI).
• Akademi Ameriknaajo toppitiiɗo ko faati e ƴiye (AAOS) e Fedde toppitiinde ko faati e ƴiye sukaaɓe to Amerik worgo (POSNA): Laabi gollorɗi safaara ko faati e ñawu nguu e nder sukaaɓe (Kocher Criteria) e ñawu nguu e nder sukaaɓe mawɓe.
• Koldaa Ameriknaajo ko faati e ƴiiƴam (ACR, Amerik): Laabi njuɓɓudi ñawu nguu (Kolkisiin/AINE/Steroid ɓuuɓɗo e ittugol ñawu nguu e nder sahaa gooto).