Obrazov\u00e9 diagnostick\u00e9 metody jsou d\u016fle\u017eitou sou\u010d\u00e1st\u00ed objas\u0148ov\u00e1n\u00ed lokace a typu onemocn\u011bn\u00ed kloub\u016f a \u010dasto jsou pro stanoven\u00ed spr\u00e1vn\u00e9 diagn\u00f3zy nepostradateln\u00e9. P\u0159i posuzov\u00e1n\u00ed b\u011b\u017en\u00fdch ortopedick\u00fdch pacient\u016f se v prvn\u00ed f\u00e1zi pou\u017e\u00edv\u00e1 rentgen, p\u0159\u00edpadn\u011b ultrazvuk, kter\u00e9 veterin\u00e1\u0159i m\u00edvaj\u00ed i v poj\u00edzdn\u00fdch veterin\u00e1rn\u00edch prax\u00edch. Naopak v p\u0159\u00edpad\u011b, \u017ee se posuzuje n\u00e1lez na velk\u00fdch kloubech, jako nap\u0159\u00edklad ramenn\u00edm nebo kolenn\u00edm kloubu, na p\u00e1te\u0159i \u010di jinak \u0161patn\u011b p\u0159\u00edstupn\u00e9m m\u00edst\u011b ko\u0148sk\u00e9ho t\u011bla, mus\u00ed se \u010dasto volit ne tolik b\u011b\u017en\u00e9 diagnostick\u00e9 metody jako jsou CT, MRT a scintigrafie. Tyto p\u0159\u00edstroje se ov\u0161em nach\u00e1z\u00ed pouze na vybran\u00fdch klinik\u00e1ch.<\/p>\n\n\n\n
Ne\u017e veterin\u00e1\u0159 zvol\u00ed adekv\u00e1tn\u00ed metodu diagnostiky, prohl\u00e9dne si kon\u011b nejprve ve stoje (adspekce), dlan\u00ed ohmat\u00e1 dle podez\u0159en\u00ed pat\u0159i\u010dn\u00e9 \u010d\u00e1sti t\u011bla kon\u011b (palpace) a n\u00e1sledn\u011b si kon\u011b prohl\u00e9dne v pohybu \u2013 pokud to samoz\u0159ejm\u011b zdravotn\u00ed stav kon\u011b dovol\u00ed a nen\u00ed podez\u0159en\u00ed na fisuru \u010di frakturu. P\u0159i anal\u00fdze pohybu se v optim\u00e1ln\u00edm p\u0159\u00edpad\u011b lokalizuje m\u00edsto p\u0159\u00ed\u010diny obt\u00ed\u017e\u00ed, a to skrze kulh\u00e1n\u00ed a jin\u00e9 nefyziologick\u00e9 vzorce pohybu. Pokud je kulh\u00e1n\u00ed v\u00fdrazn\u00e9, vol\u00ed se v\u011bt\u0161inou postup anestezie (lok\u00e1ln\u00ed znecitliv\u011bn\u00ed) dan\u00e9ho kloubu s n\u00e1sledn\u00fdm op\u011btovn\u00fdm opohybov\u00e1n\u00edm. C\u00edlem tohoto vy\u0161et\u0159en\u00ed je zjistit, zda skrze zac\u00edlen\u00e9 umrtven\u00ed p\u0159estane k\u016f\u0148 vykazovat zn\u00e1mky bolesti a diskomfortu, a t\u00edm p\u00e1dem p\u0159estane kulhat. Pokud se takov\u00e1to zkou\u0161ka prok\u00e1\u017ee jako pozitivn\u00ed (tzn. \u017ee anestezie zafunguje a k\u016f\u0148 p\u0159estane kulhat), p\u0159ech\u00e1z\u00ed se nej\u010dast\u011bji k rentgenov\u00e9mu vy\u0161et\u0159en\u00ed. P\u0159\u00edpadn\u011b, pokud je podez\u0159en\u00ed na po\u0161kozen\u00ed m\u011bkk\u00fdch tk\u00e1n\u00ed jako \u0161lach, pouzder a vaz\u016f, tak k ultrazvuku. U m\u00edrn\u00e9ho kulh\u00e1n\u00ed nebo pouze ne\u010dist\u00e9ho pohybu se p\u0159ed obrazovou diagnostikou prov\u00e1d\u00ed ohybov\u00e9 zkou\u0161ky, kter\u00e9 p\u0159i pozitivn\u00edm testu dok\u00e1\u017eou nasm\u011b\u0159ovat k pravd\u011bpodobn\u00e9 lokalizaci probl\u00e9mu.<\/p>\n\n\n\n
Rentgen je nej\u010dast\u011bji pou\u017e\u00edvan\u00fdm diagnostick\u00fdm p\u0159\u00edstrojem v p\u0159\u00edpad\u011b ortopedick\u00fdch pot\u00ed\u017e\u00ed a funguje na principu rentgenov\u00e9ho z\u00e1\u0159en\u00ed, kter\u00e9 prostupuje tk\u00e1n\u011bmi a vytv\u00e1\u0159\u00ed tak optick\u00fd obraz. D\u00edky rozd\u00edln\u00e9 propustnosti jednotliv\u00fdch struktur se kosti a m\u011bkk\u00e9 tk\u00e1n\u011b zobrazuj\u00ed rozd\u00edln\u011b \u2013 tzn. kosti b\u00edle a svaly, \u0161lachy, vazy, kloubn\u00ed tekutina apod. \u010dern\u011b. Pokud veterin\u00e1\u0159 pot\u0159ebuje opravdu v\u00fdrazn\u00fd kontrast mezi jednotliv\u00fdmi strukturami, m\u016f\u017ee si dopomoci opichem m\u011bkk\u00fdch tk\u00e1n\u00ed kontrastn\u00ed l\u00e1tkou. Tento zp\u016fsob vy\u0161et\u0159en\u00ed se pou\u017e\u00edv\u00e1 hlavn\u011b pro diagnostiku onemocn\u011bn\u00ed\/\u00faraz\u016f kost\u00ed a kloub\u016f, a tak\u00e9 p\u0159i p\u0159edprodejn\u00edm vy\u0161et\u0159en\u00ed. V\u00fdhodami rentgenu jsou dobr\u00e1 dostupnost, relativn\u011b n\u00edzk\u00e9 n\u00e1klady na diagnostiku a dobr\u00e9 zobrazen\u00ed patologi\u00ed tvrd\u00fdch struktur. Naopak negativy jsou nemo\u017enost rozpozn\u00e1n\u00ed probl\u00e9m\u016f m\u011bkk\u00fdch tk\u00e1n\u00ed, rozezn\u00e1n\u00ed akutn\u00edch z\u00e1n\u011btliv\u00fdch proces\u016f od t\u011bch chronick\u00fdch, a vystaven\u00ed radiaci.<\/p>\n\n\n\n
Druh\u00fdm z\u00e1kladn\u00edm p\u0159\u00edstrojem pro stanoven\u00ed diagn\u00f3zy p\u0159i kulh\u00e1n\u00ed je vy\u0161et\u0159en\u00ed ultrazvukem, kter\u00e9 je stejn\u011b jako rentgenov\u00e9 pom\u011brn\u011b dob\u0159e dostupn\u00e9, a i cenov\u011b p\u0159ijateln\u00e9. Jeho syst\u00e9m spo\u010d\u00edv\u00e1 na vys\u00edl\u00e1n\u00ed ultrazvukov\u00fdch vln (v tomto p\u0159\u00edpad\u011b bez neblah\u00e9ho dopadu na organismus), kter\u00e9 dob\u0159e zachycuj\u00ed stav m\u011bkk\u00fdch tk\u00e1n\u00ed \u2013 v p\u0159\u00edpad\u011b kloub\u016f tedy nepostradateln\u00fdch \u0161lach a vaz\u016f. Tato diagnostika se pou\u017e\u00edv\u00e1 zejm\u00e9na u kulh\u00e1n\u00ed jdouc\u00edho od kolene, pro kter\u00e9 je nezbytn\u00e9 zkontrolovat i kloubn\u00ed pouzdro, k\u0159\u00ed\u017eov\u00e9 vazy, menisky a kloubn\u00ed \u010d\u00e9\u0161ku, nebo u ramenn\u00edho \u010di sp\u011bnkov\u00e9ho kloubu. V hlavn\u00edm nasazen\u00ed v ortopedii je ale ultrazvuk v prv\u00e9 \u0159ad\u011b p\u0159i \u00farazech \u0161lach, kdy dok\u00e1\u017ee zobrazit i sebemen\u0161\u00ed natr\u017een\u00ed, zm\u011bny ve struktu\u0159e \u010di z\u00e1n\u011btliv\u00e9 zv\u011bt\u0161en\u00ed.<\/p>\n\n\n\n
U komplikovan\u011bj\u0161\u00edch \u010di nejasn\u00fdch p\u0159\u00edpad\u016f se mus\u00ed nez\u0159\u00eddka kdy s\u00e1hnout po k v ko\u0148sk\u00e9 medic\u00edn\u011b ne tolik zn\u00e1m\u00fdch a pou\u017e\u00edvan\u00fdch diagnostick\u00fdch technik\u00e1ch. Jednou z nich je CT \u2013 po\u010d\u00edta\u010dov\u00e1 tomografie, kter\u00e1 se prov\u00e1d\u00ed bu\u010f v pln\u00e9 nark\u00f3ze nebo ve stoje v sedaci \u2013 z\u00e1le\u017e\u00ed, kter\u00e1 \u010d\u00e1st t\u011bla kon\u011b se vy\u0161et\u0159uje. Samotn\u00e9 vy\u0161et\u0159en\u00ed tak trv\u00e1 n\u011bkolik minut, pokud ale prob\u00edh\u00e1 pod nark\u00f3zou, trv\u00e1 i s p\u0159\u00edpravou a probuzen\u00edm v\u00edce ne\u017e hodinu. Tato diagnostick\u00e1 metoda zprost\u0159edkov\u00e1v\u00e1 3D obraz, slo\u017een\u00fd z n\u011bkolika sn\u00edmk\u016f z r\u016fzn\u00fdch \u00fahl\u016f a po\u0159\u00edzen\u00fdch v diverzn\u00edch vrstv\u00e1ch tk\u00e1n\u00ed a zprost\u0159edkov\u00e1v\u00e1 tak detailn\u011bj\u0161\u00ed a kontrastn\u011bj\u0161\u00ed zobrazen\u00ed. Po\u010d\u00edta\u010dov\u00e1 tomografie je skv\u011bl\u00fdm pomocn\u00edkem p\u0159edev\u0161\u00edm p\u0159i diagnostice patologick\u00fdch zm\u011bn p\u00e1te\u0159e, velk\u00fdch kloub\u016f, kloubn\u00ed chrupavky, kopytn\u00edho kloubu, zub\u016f a hlavy. Jeho v\u00fdhodou je p\u0159esnost, rychlost vy\u0161et\u0159en\u00ed a mo\u017enost v p\u0159\u00edpad\u011b patologick\u00e9ho n\u00e1lezu ji\u017e p\u0159i CT vy\u0161et\u0159en\u00ed v nark\u00f3ze okam\u017eit\u011b operovat. Naopak nev\u00fdhodou je vy\u0161\u0161\u00ed cena vy\u0161et\u0159en\u00ed, nutnost p\u0159evozu kon\u011b do kliniky a vystaven\u00ed kon\u011b rentgenov\u00e9mu z\u00e1\u0159en\u00ed.<\/p>\n\n\n\n
Dal\u0161\u00ed ne zcela obvyklou diagnostikou je MRT, funguj\u00edc\u00ed na b\u00e1zi magnetov\u00e9 rezonance a t\u00edm p\u00e1dem protonov\u00e9m proud\u011bn\u00ed. Tato metoda se vol\u00ed vzhledem k n\u00e1kladnosti vy\u0161et\u0159en\u00ed p\u0159edev\u0161\u00edm p\u0159i vy\u0161et\u0159en\u00ed v\u0161ech tk\u00e1n\u00ed ulo\u017een\u00fdch v kopytn\u00edm pouzdru (kter\u00e9 jsou jin\u00fdmi p\u0159\u00edstroji t\u00e9m\u011b\u0159 nedosa\u017eiteln\u00e9), d\u00e1le p\u0159i degenerativn\u00edch zm\u011bn\u00e1ch kost\u00ed, jejich z\u00e1n\u011btech, fisur\u00e1ch a zlomenin\u00e1ch. Magnetickou resonanci lze takt\u00e9\u017e prov\u00e1d\u011bt v pln\u00e9 nark\u00f3ze, stejn\u011b jako v sedaci ve st\u00e1n\u00ed \u2013 ov\u0161em je dobr\u00e9 m\u00edt na pam\u011bti, \u017ee vy\u0161et\u0159en\u00ed trv\u00e1 dle n\u00e1ro\u010dnosti 1-3 hodiny a mus\u00ed na n\u011bj b\u00fdt odstran\u011bny v\u0161echny podkovy. Velkou p\u0159ednost\u00ed MRT jsou v\u00fdborn\u00e9 rozli\u0161en\u00ed m\u011bkk\u00fdch i tvrd\u00fdch tk\u00e1n\u00ed, jeho \u0161irok\u00e9 spektrum vyu\u017eit\u00ed a bezpe\u010dnost magnetismu. Asi nejv\u011bt\u0161\u00edmi z\u00e1pory jsou pouze mal\u00e1 dostupnost a vy\u0161\u0161\u00ed finan\u010dn\u00ed n\u00e1klady.<\/p>\n\n\n\n
Tou posledn\u00ed a asi i tou nejm\u00e9n\u011b zn\u00e1mou vy\u0161et\u0159ovac\u00ed technologi\u00ed je scintigrafie. Jedn\u00e1 se o skv\u011blou metodu obrazov\u00e9 diagnostiky, kter\u00e1 se uplat\u0148uje p\u0159i nejasn\u00e9m kulh\u00e1n\u00ed (nap\u0159\u00edklad n\u011bkolik kon\u010detin z\u00e1rove\u0148), n\u00e1hl\u00fdch a neopodstatn\u011bn\u00fdch probl\u00e9mech s jezditelnost\u00ed kon\u011b, u nekooperativn\u00edch kon\u00ed \u010di v p\u0159\u00edpad\u011b podez\u0159en\u00ed na z\u00e1n\u011bty v oblasti p\u00e1te\u0159e, ale i m\u011bkk\u00fdch tk\u00e1n\u00ed. Unik\u00e1tn\u00ed na t\u00e9to technologii je mo\u017enost rozli\u0161en\u00ed akutn\u00edch z\u00e1n\u011bt\u016f od chronick\u00fdch obt\u00ed\u017e\u00ed. Skrze injektovan\u00ed lehce radioaktivn\u00ed l\u00e1tky do krevn\u00edho ob\u011bhu doch\u00e1z\u00ed p\u0159\u00edmo v ko\u0148sk\u00e9m t\u011ble k vyza\u0159ov\u00e1n\u00ed gama z\u00e1\u0159en\u00ed, kter\u00e9 prob\u00edh\u00e1 obzvl\u00e1\u0161t\u011b koncentrovan\u011b v m\u00edstech se zv\u00fd\u0161enou l\u00e1tkovou v\u00fdm\u011bnou. Tu n\u00e1sledn\u011b zaznamen\u00e1vaj\u00ed kamery do po\u010d\u00edta\u010dov\u00e9ho syst\u00e9mu. Obavu z negativn\u00edho vlivu scintigrafie m\u00edt nemus\u00edte, jednak se nejedn\u00e1 o silnou radiaci a jednak mus\u00ed k\u016f\u0148 b\u00fdt pro vy\u0161et\u0159en\u00ed hospitalizov\u00e1n v klinice, kdy jsou v pobytu zapo\u010d\u00edt\u00e1ny i 2 dny karant\u00e9ny po vy\u0161et\u0159en\u00ed. I p\u0159es nesporn\u00e1 pozitiva, kter\u00e9 scintigrafie p\u0159in\u00e1\u0161\u00ed, si majitel kon\u011b mus\u00ed promyslet, zda se tato n\u00e1ro\u010dn\u00e1 diagnostika vyplat\u00ed \u2013 je toti\u017e velmi n\u00e1kladn\u00e1, jen m\u00e1lokter\u00e1 klinika ji nab\u00edz\u00ed a b\u00fdvaj\u00ed na ni dlouh\u00e9 \u010dekac\u00ed lh\u016fty.<\/p>\n\n\n\n
Ne\u017e se spole\u010dn\u011b s veterin\u00e1\u0159em rozhodnete pro konkr\u00e9tn\u00ed diagnostickou metodu, je d\u016fle\u017eit\u00e9 si polo\u017eit ot\u00e1zku, co chcete zjistit a \u010deho chcete vy\u0161et\u0159en\u00edm dos\u00e1hnout. Ve v\u011bt\u0161in\u011b p\u0159\u00edpad\u016f je d\u016fkladn\u00e9 vy\u0161et\u0159en\u00ed v pohybu s ohybov\u00fdmi zkou\u0161kami a p\u0159\u00edpadnou punktac\u00ed \u010di anestezi\u00ed kloub\u016f dosta\u010duj\u00edc\u00ed, a ji\u017e sta\u010d\u00ed si diagn\u00f3zu konkretizovat pouze rentgenov\u00fdm sn\u00edmkem \u010di ultrazvukem.<\/p>\n\n\n\n
Ne\u017e seri\u00e1l o kloubech ukon\u010d\u00edm, cht\u011bla bych v\u00e1m d\u00e1t je\u0161t\u011b p\u00e1r tip\u016f na v\u00fd\u017eivov\u00e9 dopl\u0148ky kloub\u016f. Jak\u00e9 v\u00fd\u017eivov\u00e9 dopl\u0148ky maj\u00ed tedy na klouby pozitivn\u00ed \u00fa\u010dinek? Aby se zabr\u00e1nilo p\u0159ed\u010dasn\u00e9mu opot\u0159eben\u00ed kloub\u016f, je vhodn\u00e9 kon\u00edm pravideln\u011b dod\u00e1vat kloubn\u00ed v\u00fd\u017eivu p\u0159izp\u016fsobenou krmn\u00e9 d\u00e1vce. Pr\u00e9miov\u00e9 kloubn\u00ed p\u0159\u00edpravky obsahuj\u00ed \u017eiviny, kter\u00e9 podporuj\u00ed tvorbu kloubn\u00ed tekutiny, ale tak\u00e9 p\u0159isp\u00edvaj\u00ed k vy\u017eiven\u00ed \u0161lach, vaz\u016f a chrupavky. Pat\u0159\u00ed mezi n\u011b glukosamin, chondroitin, MSM (methylsulfonylmethan) a kyselina hyaluronov\u00e1. Glukosamin sulf\u00e1t je sulf\u00e1tovan\u00fd glykosaminoglykan, kter\u00fd se nach\u00e1z\u00ed p\u0159ev\u00e1\u017en\u011b v hyalinn\u00ed chrupavce a kter\u00fd je d\u016fle\u017eitou \u017eivinou pro jej\u00ed tk\u00e1\u0148 a kloubn\u00ed tekutinu. Obsahuj\u00ed jej i b\u011b\u017en\u011b dostupn\u00e9 plody jako \u010f\u00e1bl\u016fv ko\u0159en, z\u00e1zvor \u010di avok\u00e1do a podle nejnov\u011bj\u0161\u00edch v\u011bdeck\u00fdch poznatk\u016f glukosamin podporuje tak\u00e9 udr\u017eov\u00e1n\u00ed zdrav\u00fdch \u0161lach. Chondroitin sulf\u00e1t p\u016fsob\u00ed nejl\u00e9pe spole\u010dn\u011b pr\u00e1v\u011b s glukosaminem a aktivn\u011b podporuje v\u00fd\u017eivu kloubn\u00ed chrupavky kon\u011b.<\/p>\n\n\n\n
Dal\u0161\u00edm velmi pozitivn\u011b p\u016fsob\u00edc\u00edm krmn\u00fdm dopl\u0148kem, hlavn\u011b v kombinaci s dal\u0161\u00edmi kloubn\u00edmi \u017eivinami, je MSM, zn\u00e1m\u00fdm hlavn\u011b jako \u00fa\u010dinn\u00fd organick\u00fd zdroj s\u00edry. A pro\u010d je zrovna s\u00edra pro klouby d\u016fle\u017eit\u00e1? Proto\u017ee je stavebn\u00edm prvkem mnoha tk\u00e1\u0148ov\u00fdch struktur v t\u011ble \u2013 MSM tak hraje d\u016fle\u017eitou roli p\u0159i synt\u00e9ze v\u0161ech pojivov\u00fdch tk\u00e1n\u00ed. Posledn\u00edm pomocn\u00edkem, kter\u00fd zm\u00edn\u00edm v r\u00e1mci pravideln\u00e9 v\u00fd\u017eivy, je kyselina hyaluronov\u00e1, kter\u00e1 je v ko\u0148sk\u00e9m t\u011ble velmi roz\u0161\u00ed\u0159en\u00e1 \u2013 a samoz\u0159ejm\u011b p\u0159edev\u0161\u00edm v kloubech. Jej\u00edm p\u0159id\u00e1v\u00e1n\u00edm do krmn\u00e9 d\u00e1vky podpo\u0159\u00edte kvalitu chrupavky a tvorbu kloubn\u00ed tekutiny.<\/p>\n","protected":false},"excerpt":{"rendered":"
Obrazov\u00e9 diagnostick\u00e9 metody jsou d\u016fle\u017eitou sou\u010d\u00e1st\u00ed objas\u0148ov\u00e1n\u00ed lokace a typu onemocn\u011bn\u00ed kloub\u016f a \u010dasto jsou pro stanoven\u00ed spr\u00e1vn\u00e9 diagn\u00f3zy nepostradateln\u00e9. P\u0159i posuzov\u00e1n\u00ed b\u011b\u017en\u00fdch ortopedick\u00fdch pacient\u016f se v prvn\u00ed f\u00e1zi pou\u017e\u00edv\u00e1 rentgen, p\u0159\u00edpadn\u011b ultrazvuk, kter\u00e9 veterin\u00e1\u0159i m\u00edvaj\u00ed i v poj\u00edzdn\u00fdch veterin\u00e1rn\u00edch prax\u00edch.<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_mi_skip_tracking":false},"categories":[4],"tags":[],"_links":{"self":[{"href":"https:\/\/rehaequus.cz\/index.php?rest_route=\/wp\/v2\/posts\/422"}],"collection":[{"href":"https:\/\/rehaequus.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/rehaequus.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/rehaequus.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/rehaequus.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=422"}],"version-history":[{"count":1,"href":"https:\/\/rehaequus.cz\/index.php?rest_route=\/wp\/v2\/posts\/422\/revisions"}],"predecessor-version":[{"id":423,"href":"https:\/\/rehaequus.cz\/index.php?rest_route=\/wp\/v2\/posts\/422\/revisions\/423"}],"wp:attachment":[{"href":"https:\/\/rehaequus.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=422"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/rehaequus.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=422"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/rehaequus.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=422"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}