{"id":5712,"date":"2020-05-11T12:22:36","date_gmt":"2020-05-11T11:22:36","guid":{"rendered":"https:\/\/euromedic.rs\/pregledi\/reumatologija-suvo-oko-syndroma-sjogre-copy\/"},"modified":"2021-03-03T10:25:49","modified_gmt":"2021-03-03T09:25:49","slug":"reumatologija-bolovi-i-ukocenost-misica-polymalgia-rheumatica","status":"publish","type":"post","link":"https:\/\/euromedic.rs\/pregledi\/specijalisticki-pregledi\/reumatologija\/reumatologija-bolovi-i-ukocenost-misica-polymalgia-rheumatica\/","title":{"rendered":"Reumatologija i fizikalna medicina – Bolovi i uko\u010denost mi\u0161i\u0107a – Polymalgia Rheumatica"},"content":{"rendered":"

Polimialgia rheumatica<\/strong> je zapaljensko, nepoznatog uzroka, oboljenje koje\u00a0 karakteri\u0161e pojava bolova i uko\u010denosti u ramenima, vratu, redje ledjima i\u00a0 butinama. Ove tegobe nastaju vrlo brzo i poja\u010dane su u jutarnjim satima. Oboljenje se \u010de\u0161\u0107e javlja kod \u017eenskih osoba starijih od 65 godina.<\/span><\/p>\n

Ovo stanje mo\u017ee biti povezano sa zapaljenjem arterija d\u017einovskih \u0107elija,naj\u010de\u0161\u0107e zapaljenje temporalnih arterije.\u00a0\u00a0<\/span><\/p>\n

Za ova oboljenja karakteristi\u010dno je\u00a0 vrlo povi\u0161ena SE i CRP, ali nema karakteristi\u010dnih\u00a0 imunolo\u0161kih pokazatelja.<\/span><\/p>\n

Klini\u010dka slika:<\/strong><\/p>\n

Tegobe na koje se bolesnik \u017eali su obostrani bolovi i ko\u010denje u\u00a0 ramenima, vratu, nadlakticama, zadnjici, butinama, ne retko bolovi u kolenima, ru\u010dnim zglobovima, ograni\u010dnost pokreta. \u010cesta je pojava op\u0161te slabosti i malaksalosti, povi\u0161ene temperature, gubitak apetita, depresivno stanje.\u00a0<\/span><\/p>\n

Ukoliko dodje i do zapaljenja arterija\u00a0 tada se tegobe pro\u0161iruju, javlja se glavobolja, ko\u010denje u vilicama, trenjenje u glavi, smetnje sa vidom. Ukoliko se ovo stanje ne le\u010di mo\u017ee imati posledice u vidu slepila i \u0161loga.<\/span><\/p>\n

Pregled\u00a0 bolesnika i potrebni nalazi:<\/strong><\/p>\n

Po\u0161to se uzme iscrpna anamneza, uradi se op\u0161ti internisti\u010dki i reumato\u0161ki pregled, uz obaveznu palpaciju temporalnih arterija.<\/span><\/p>\n

\u00a0Za postavljanje dijagnoze ovih oboljenja savetuje se laboratorija SE, CRP, urin, osnovna biohemija. Takodje se savetuje RTG plu\u0107a, Uz abdomena, pregled ginekologa ili drugih specijalnosti u vezi sa \u010desto prisutnim drugim oboljenjima, a cilj je da se isklju\u010de drugi uzroci ovih simptoma, povi\u0161ene SE i CRP.<\/span><\/p>\n

Kada postoji sumnja na arteritis d\u017einovskih \u0107elija potrebno je uraditi ultra zvuk temporalnih arterija a \u010desto i biopsija arterije sa pH nalazom, kao i pregled oftalmologa.<\/span><\/p>\n

Terapija:<\/strong><\/p>\n

Le\u010denje ovog stanja je naj\u010de\u0161\u0107e potvrda\u00a0 postavljene dijagnoze polimialgiae rheumatice, jer nakon zapo\u010dinjanja primene glikokortikoida, do pobolj\u0161anja dolazi vrlo brzo, kao i sni\u017eavanja SE i CRP. Dalju terapiju sprovodi internista reumatolog ili oftalmolog, uz redovno pra\u0107enje bolesnika i laboratorije, uz\u00a0 oprez u vezi sa ne\u017eeljenim pojavama do koje dati lekovi mogu da dovedu. Neophodna je supsitucija sa vitaminom D3. Ukoliko ova terapija ne dovede do \u017eeljenog efekta mo\u017ee se poku\u0161ati i sa primenom metotreksata, ciklofosfamida.<\/span><\/p>\n

Znaja\u010dno mesto u terapiji ima fizikalni tretman, uz odgovaraju\u0107i oprez obzirom na postojanje komorbiditeta i ne\u017eeljeih pojava primenjene\u00a0 terapije.<\/span><\/p>\n

Va\u017eno je naglasiti da i najmanje prerano smanjivanje doze leka mo\u017ee da dovede do pogor\u0161anja bolesnikovih tegoba i ponovnog porasta SE i CRP.\u00a0 Ukoliko postoji udru\u017eenost polimialgie sa zapaljenjem arterija doza glikokortikoida je znatno ve\u0107a i primena je du\u017ea, i do 2 godine.<\/span><\/p>\n

Kad je u pitanju ovo oboljenje, djagnozu treba postaviti \u0161to ranije da bi se zapo\u010dela odgovaraju\u0107a terapija.<\/span><\/p>\n

Dolaskom na pregled kod interniste reumatologa u Euromedik<\/a>, imate mogu\u0107nost da vrlo brzo uradite sve dodatne preglede u cilju isklju\u010divanja nekih drugih stanja koja se mogu manifestovati\u00a0 kao polimialgi\u010dni sindrom, kao \u0161to su pregled kardiologa, neurologa, oftalmologa, ginekologa, gastroenterologa, rentgen plu\u0107a i po potrebi ultrazvucni pregled organa, magnetna rezonanca. Euromedik je ustanova koja po\u0161tuje sve tra\u017eene <\/span><\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

Polimialgia rheumatica je zapaljensko, nepoznatog uzroka, oboljenje koje\u00a0 karakteri\u0161e pojava bolova i uko\u010denosti u ramenima,…<\/p>\n","protected":false},"author":1,"featured_media":5714,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"inline_featured_image":false,"footnotes":""},"categories":[487],"tags":[217,214,218,213],"class_list":["post-5712","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-reumatologija","tag-bolovi-i-ukocenost-misica","tag-fizijatrija","tag-polymalgia-rheumatica","tag-reumatologija"],"yoast_head":"\nReumatologija - Bolovi i uko\u010denost mi\u0161i\u0107a - Polymalgia Rheumatica<\/title>\n<meta name=\"description\" content=\"Polimialgia rheumatica je zapaljensko, nepoznatog uzroka, oboljenje koje\u00a0karakteri\u0161e pojava bolova i uko\u010denosti u ramenima, vratu, redje ledjima i\u00a0butinama.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/euromedic.rs\/pregledi\/specijalisticki-pregledi\/reumatologija\/reumatologija-bolovi-i-ukocenost-misica-polymalgia-rheumatica\/\" \/>\n<meta property=\"og:locale\" content=\"sr_RS\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Reumatologija - 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