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Uzmanlar romatizmanın tek bir hastalık olmadığını söylüyor: Romatizmanın belirtileri nelerdir? Prof. Dr. Salih Özgöçmen, romatizmanın tek bir hastalık olmadığını söylüyor: Kas-iskelet sistemi, iskelet dışı organ ve sistemleri tutan, en az 200 farklı hastalığı içeren bir terimdir. takvim.com.tr Kaynak GAZETE Giriş Tarihi : 13 Şubat 2021
Romatizma, eklemler, kaslar ve bunları çevreleyen yumuşak dokuların ya da bağ dokusunun iltihabını ve ağrısını tanımlamaya yarayan genel bir tabirdir. İstinye Üniversite Hastanesi Medical Park Gaziosmanpaşa Hastanesi Romatoloji Uzmanı Prof. Dr. Salih Özgöçmen, sıklıkla rastlanan romatizma hastalığıyla ilgili TAKVİM'e önemli bilgiler veriyor:
HASTALIKLAR NELERDİR? En sık rastlanılan romatizmal hastalıklar arasında osteoartrit (eklem kireçlenmesi), romatoid artrit, kronik bel ve boyun ağrıları, ankilozan spondilit gibi iltihaplı omurga romatizmaları; sedef artriti, gut hastalığı ve lupus, Sjögren, skleroderma gibi bağ dokusunun iltihaplı romatizmaları sayılabilir. Ayrıca Behçet hastalığı ve Akdeniz Ateşi, ülkemizde sık rastlanılan romatizmal hastalıklardandır.
HANGİ EKLEMLERDE SIK GÖRÜLÜR? Osteoartrit (kireçlenme) yük taşıyan eklemler olan diz, ayak bileği, kalça ve bel omurlarını daha fazla etkileme eğilimindedir. Ancak kalıtsal özelliği de olan el kireçlenmesinde el parmaklarının orta ve uç oynakları daha fazla tutulur. İltihaplı eklem romatizması olarak bilinen romatoid artrit ise el, el bilek, ayak, ayak bilek eklemlerini öncelikli olarak etkiler. Sedef romatizmasında hastalık farklı eklemleri ve omurgayı etkileyebilir. En sık karşılaşılan tipinde diz, ayak ve el eklemleridir.
HANGİ YAŞLARDA GÖRÜLME SIKLIĞI ARTAR? Erişkinlerde romatizmal hastalıkların en sık görüldüğü yaşlar hastalığın çeşidine göre farklılıklar sergiler. Örneğin, osteartritin (kireçlenmenin) görülme sıklığı ilerleyen yaşla artar, romatoid artrit ise en sık 30 ile 50 yaş arasında başlar. Omurganın iltihaplı romatizmalarından ankilozan spondilit 20'li ve 30'lu yaşlarda sık görülürken, lupus 15 ve 45 yaşları arasında, Sjögren ise 40 ve 60 yaşları arasında daha sık görülebilir.
PEKİ NASIL TEŞHİS EDİLİR? Herhangi bir romatizmal hastalığın tek bir testle kesin teşhisi söz konusu değildir. Romatizmal hastalığın tanısı şikâyetleri ve hastalık belirtilerini içeren öykünün tecrübeli bir hekim tarafından değerlendirilmesiyle başlar. Örneğin, çoğunlukla başvuru şikâyeti olan ağrının, ne zaman ve nasıl başladığı, ne zaman dindiği, hangi eklem ve vücut bölgelerinde olduğu, hangi pozisyonda arttığı, gün içerisindeki değişimi, ya da bazı ilaçlarla azalışı gibi karakteristik özellikleri tanıda çok önemlidir. Geçirilmiş hastalıklar, tıbbi özgeçmiş ve soygeçmiş sorgulanır.
DETAYLAR ÖNEMLİ Genel muayene ve hareket sistemi değerlendirmesi yapılarak olası tanıya yönelik görüntüleme ve laboratuvar testleri şekillendirilir. Laboratuvar testleri iltihap belirteçlerini, bazı romatizmal hastalıklara daha özgün olan hastalık belirteçlerini ve organ fonksiyonlarına yönelik tetkikleri içerir. Bazı hastalıklarda genetik yatkınlığın aydınlatılmasına yönelik tanıya yardımcı testlerde istenebilir. Eklem zarı, tükürük bezi, damar ve kas gibi dokulardan veya böbrek, bağırsak gibi organlardan parça alınarak bunların patolojik incelemesi de gerekebilir.
TOMOGRAFİ DAHA GÜVENLİ Farklı görüntüleme metotları kullanılarak kas iskelet sisteminin ve organların görüntülenmesi tanıda oldukça önemlidir. Ayırt edici özelliği en yüksek olan metotların seçilmesine çalışılır. Örneğin, kemik yapıların görüntülenmesinde bilgisayarlı tomografi daha güvenilir görüntü sunarken, yumuşak doku ve organların görüntülenmesinde manyetik rezonans görüntüleme (MR) daha üstün özellikler gösterir.
KEMİK VE EKLEM SAĞLIĞI PROF. DR. SALİH ÖZGÖÇMEN HAZIRLAYAN: SİNEM UYSAL