{"id":45106,"date":"2024-01-25T04:56:47","date_gmt":"2024-01-25T03:56:47","guid":{"rendered":"https:\/\/www.invarena.cz\/?p=45106"},"modified":"2024-01-25T04:56:48","modified_gmt":"2024-01-25T03:56:48","slug":"radioporadna-klouby","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=45106","title":{"rendered":"R\u00e1dioporadna\u00a0&#8211; klouby"},"content":{"rendered":"\n<p>\u010cRo<\/p>\n\n\n\n<p>Pozv\u00e1n\u00ed \u010cesk\u00e9ho rozhlasu p\u0159ijal revmatolog ze druh\u00e9 intern\u00ed kliniky Fakultn\u00ed nemocnice Hradec Kr\u00e1lov\u00e9 pan doc. Petr Bradna. vy jste \u0159\u00edkal, \u017ee chcete za\u010d\u00edt artritidou, tak poj\u010fme na ni.<br \/><br \/>Petr Bradna<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>Asi bych to tro\u0161i\u010dku up\u0159esnil, co to vlastn\u011b takov\u00e1 artritida je Artritida je v podstat\u011b z\u00e1n\u011bt kloubu, kter\u00fd se m\u016f\u017ee projevovat nej\u010dast\u011bji otokem, bolest\u00ed, omezen\u00fdm pohybem a artritida m\u016f\u017ee b\u00fdt p\u0159\u00edznakem nejr\u016fzn\u011bj\u0161\u00edch onemocn\u011bn\u00ed, mimo jin\u00e9 taky t\u00e9 artr\u00f3zy, ale cel\u00e9 \u0159ady z\u00e1n\u011btliv\u00fdch revmatick\u00fdch onemocn\u011bn\u00ed, kter\u00e9 se v\u011bt\u0161inou jmenuj\u00ed artritida, k tomu maj\u00ed je\u0161t\u011b n\u011bjak\u00e9 dal\u0161\u00ed slov\u00ed\u010dko jako revmatoidn\u00ed, psoriatick\u00e1, \u0159ada dal\u0161\u00edch<br \/><br \/>moder\u00e1torka<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>Jak\u00fd je ten z\u00e1sadn\u00ed rozd\u00edl mezi artritidou a artr\u00f3zou?<br \/><br \/>Petr Bradna<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>Artritida m\u016f\u017ee b\u00fdt projevem artr\u00f3zy, artritida je v podstat\u011b stav, v jak\u00e9m se ten kloub nach\u00e1z\u00ed, zat\u00edmco artr\u00f3za je jednou z mo\u017en\u00fdch p\u0159\u00ed\u010din, artr\u00f3za je kloubn\u00ed onemocn\u011bn\u00ed, kter\u00e9 je chronick\u00e9, kter\u00e9 se postupn\u011b vyv\u00edj\u00ed, a pokud to hodn\u011b zjednodu\u0161\u00edm, tak artr\u00f3za je takov\u00fd typ kloubn\u00edho\u00a0<strong>posti\u017een\u00ed<\/strong>, kter\u00e9 se projevuje zv\u00fd\u0161en\u00edm zn\u00e1mek z\u00e1n\u011btu, jako je t\u0159eba zv\u00fd\u0161en\u00e1 sedimentace nebo c reaktivn\u00ed protein, p\u0159esto\u017ee v tom chorobn\u00e9m procesu hraje z\u00e1n\u011bt ur\u010ditou \u00falohu a je to z\u00e1n\u011bt, kter\u00fd je omezen\u00fd na ten prostor toho kloubu a nep\u0159ech\u00e1z\u00ed do celkov\u00fdch syst\u00e9mov\u00fdch projev\u016f.<br \/><br \/>moder\u00e1torka<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>J\u00e1 jsem n\u011bkdy \u010detla, \u017ee r\u00e1d \u010dtete detektivky. Plat\u00ed to st\u00e1le.<br \/><br \/>Petr Bradna,<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>No, teoreticky ano, ale prakticky na to nen\u00ed moc \u010dasu.<br \/><br \/> moder\u00e1torka<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>J\u00e1 jsem si \u0159\u00edkala, \u017ee k tomu va\u0161emu oboru se to mo\u017en\u00e1 hod\u00ed, proto\u017ee to b\u00fdv\u00e1 detektivn\u00ed pr\u00e1ce, zjistit, co se v tom t\u011ble a z jak\u00e9ho d\u016fvodu d\u011bje.<br \/><br \/>Petr Bradna,<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>Tak to do jist\u00e9 m\u00edry uspokojuje m\u016fj z\u00e1jem o detektivky, proto\u017ee jich m\u00e1m plnou pracovn\u00ed dobu.<br \/><br \/> moder\u00e1torka<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>Trp\u00ed t\u011bmito obt\u00ed\u017eemi i mlad\u00ed lid\u00e9? Pokud je artr\u00f3za degenerativn\u00ed onemocn\u011bn\u00ed, zat\u00edmco artritida z\u00e1n\u011btliv\u00e9, znamen\u00e1 to, \u017ee u t\u011bch mlad\u0161\u00edch lid\u00ed je \u010dast\u011bj\u0161\u00ed asi ta artritida.<br \/><br \/>Petr Bradna<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>Ano, nicm\u00e9n\u011b k v\u00fdvoji artr\u00f3zy m\u016f\u017ee doj\u00edt i v pom\u011brn\u011b \u010dasn\u00e9m v\u011bku, pokud tam jsou n\u011bjak\u00e9 p\u0159isp\u00edvaj\u00edc\u00ed situace, jako jsou t\u0159eba opakovan\u00e1 traumata nebo n\u011bjak\u00e1 nespr\u00e1vn\u00e9 uspo\u0159\u00e1d\u00e1n\u00ed nebo nespr\u00e1vn\u00e1 poloha kloubu, jako t\u0159eba p\u0159i zn\u00e1m\u00e9 dysplazii ky\u010dle. Tam potom se mohou ty artrotick\u00e9 zm\u011bny vyvinout relativn\u011b \u010dasto u\u017e ve t\u0159et\u00edm, ve \u010dtvrt\u00e9m deceniu, ale m\u00e1te pravdu, v\u00fdskyt artr\u00f3zy rychle nar\u016fst\u00e1 s v\u011bkem, tak\u017ee pacienti v sedm\u00e9m, osm\u00e9m deceniu maj\u00ed n\u011bjak\u00e9 projevy artr\u00f3zy, dokonce ve v\u011bt\u0161in\u011b p\u0159\u00edpad\u016f.<br \/><br \/>moder\u00e1torka<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>Deceniu, to znamen\u00e1, \u017ee po 70, 80 letech.<br \/><br \/>Petr Bradna,<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>\u0158\u00edk\u00e1 se, \u017ee tak 70, 80 % pacient\u016f u\u017e m\u00e1 s projevy artr\u00f3zy svoje zku\u0161enosti. V tomto v\u011bku.<br \/><br \/>Pavla Kindernayov\u00e1, moder\u00e1torka<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>Co tato kloubn\u00ed onemocn\u011bn\u00ed zp\u016fsobuje, m\u00e1 na to vliv d\u011bdi\u010dnost.<br \/><br \/>mluv\u010d\u00ed 2,<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>R\u016fzn\u011b, v r\u016fzn\u00fdch lokalizac\u00edch na kloubech, je spo\u010d\u00edt\u00e1no, \u017ee nap\u0159\u00edklad artr\u00f3za drobn\u00fdch ru\u010dn\u00edch kloub\u016f, kter\u00e1 postihuje ty kone\u010dn\u00e9 klouby nejbl\u00ed\u017ee u nehtu, a prost\u0159edn\u00ed m\u00e1 genetick\u00fd p\u016fvod tak asi v 60 % t\u011bch vyvol\u00e1vaj\u00edc\u00edch p\u0159\u00ed\u010din, a tak se taky \u010dasto setk\u00e1v\u00e1me s t\u00edm, \u017ee takov\u00e9to artrotick\u00e9 zm\u011bny se vyskytuj\u00ed u v\u00edce \u010dlen\u016f rodiny, typicky na t\u011bch ruk\u00e1ch to b\u00fdv\u00e1, tak\u017ee maminka nebo babi\u010dka pacientky, kter\u00e1 za n\u00e1ma s t\u011bmito pot\u00ed\u017eemi p\u0159ich\u00e1z\u00ed, m\u011bla tak\u00e9 n\u011bjak\u00e9 zm\u011bny.<br \/><br \/>Pavla Kindernayov\u00e1, moder\u00e1torka<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>Takov\u00e9 ty zn\u00e1mky, co po\u010das\u00ed, pane docente, te\u010f t\u011bch probl\u00e9m\u016f s klouby je to tak, \u017ee je jich v\u00edc a \u017ee jsou bolestiv\u011bj\u0161\u00ed. Jak se \u0159\u00edk\u00e1.<br \/><br \/>mluv\u010d\u00ed 2,<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>Po\u010das\u00ed m\u00e1 vliv, nejhor\u0161\u00ed ro\u010dn\u00ed obdob\u00ed jsou ty, kdy se \u010dasto po\u010das\u00ed m\u011bn\u00ed, typick\u00e9 jsou jaro, podzim, kdy v\u011bt\u0161ina na\u0161ich pacient\u016f ty pot\u00ed\u017ee m\u00e1 v\u011bt\u0161\u00ed, nicm\u00e9n\u011b po\u010das\u00ed m\u016f\u017ee pot\u00ed\u017ee zhor\u0161it nebo zlep\u0161it, ale nen\u00ed jist\u011b d\u016fvodem k t\u011bm pot\u00ed\u017e\u00edm.<br \/><br \/>mluv\u010d\u00ed 3,<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>Dobr\u00e9 dopoledne v\u0161em. Mysl\u00edm si, \u017ee to je probl\u00e9m dost velk\u00e9 populace. To, co j\u00e1 m\u00e1m od ml\u00e1d\u00ed, jsem si sna\u017eila hl\u00eddat klouby, a tak jsem zav\u010dasu \u0161la pan\u00ed doktorce, ta mn\u011b \u0159ekla, ma\u017ete si to. V l\u00e9k\u00e1rn\u011b si n\u011bco kupte, pan\u00ed ml. L\u00e9k\u00e1rn\u00edka mn\u011b \u0159\u00edkala, no, v tomhle stavu, kdy\u017e u\u017e to m\u00e1te, tak v\u00e1m stejn\u011b maz\u00e1n\u00ed nepom\u016f\u017ee. V\u00edte, p\u0159i\u0161lo mn\u011b to, j\u00e1 u\u017e jsem nev\u011bd\u011bla, co m\u00e1m na ty klouby si d\u00e1vat v\u0161echny mo\u017en\u00fd bylinky, ale nikde jsem pomoct nena\u0161la. To mn\u011b vad\u00ed.<br \/><br \/>moder\u00e1torka<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>Kolik let je to zp\u00e1tky? Kdy v\u00e1m za\u010daly ty obt\u00ed\u017ee.<br \/><br \/>mluv\u010d\u00ed 3,<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>No, p\u0159es 20.<br \/><br \/>Pavla Kindernayov\u00e1, moder\u00e1torka<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>P\u0159es 20 let. Pokus\u00edme se zareagovat, pokus\u00edme se zareagovat, na shledanou. pane docente, co vy na to?<br \/><br \/>mluv\u010d\u00ed 2,<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>Do zna\u010dn\u00e9 m\u00edry na tom, co zp\u016fsobilo pot\u00ed\u017ee, kter\u00e9 na\u0161i pacientku su\u017euj\u00ed&#8230; Samoz\u0159ejm\u011b tro\u0161ku slo\u017eit\u011bj\u0161\u00ed je situace u t\u011bch degenerativn\u00edch onemocn\u011bn\u00ed, \u010dili u t\u00e9 artr\u00f3zy. To, co l\u00ed\u010d\u00ed, by se mohlo do tohoto obrazu vej\u00edt, tam vysloven\u011b postup, kter\u00fd by upravil u\u017e vznikl\u00e9 pot\u00ed\u017ee, skute\u010dn\u011b nen\u00ed to, co pan\u00ed sly\u0161ela od sv\u00e9ho l\u00e9ka\u0159e, v podstat\u011b je postup, kter\u00fd m\u00edrn\u00ed pot\u00ed\u017ee, kter\u00e9 to jej\u00ed onemocn\u011bn\u00ed zp\u016fsobilo. V sou\u010dasn\u00e9 dob\u011b existuj\u00ed ji\u017e ur\u010dit\u00e9 prepar\u00e1ty, kter\u00e9 dok\u00e1\u017eou zpomalit pr\u016fb\u011bh artr\u00f3zy, zejm\u00e9na na, jak se domn\u00edv\u00e1m, \u017ee jsem to pochopil, na drobn\u00fdch kloubech, rukou, nohou, tyto l\u00e9ky jsou tzv. chondoprotektiva. Dneska nelze v podstat\u011b sledovat televizi, ani\u017e by tam nebylo n\u011bkolik reklam na r\u016fzn\u00e9 prepar\u00e1ty tohoto typu, ale faktem je, \u017ee n\u011bkter\u00e9 z nich maj\u00ed skute\u010dn\u011b pr\u016fkazn\u00e1 data o tom, \u017ee dok\u00e1\u017eou ten proces zpomalit a ty potom se poznaj\u00ed podle toho, \u017ee jsou na l\u00e9ka\u0159sk\u00fd p\u0159edpis a \u017ee z\u010d\u00e1sti poji\u0161\u0165ovna hrad\u00ed samoz\u0159ejm\u011b to, co \u0159\u00edk\u00e1m, \u017ee to zpomal\u00ed pr\u016fb\u011bh onemocn\u011bn\u00ed. Skute\u010dn\u011b plat\u00ed v tuto chv\u00edli, \u017ee nem\u00e1me k dispozici zp\u016fsob, jak\u00fdm ten u\u017e vznikl\u00fd probl\u00e9m vy\u0159e\u0161it, vyjma chirurgick\u00e9ho v\u00fdkonu.<br \/><br \/>Pavla Kindernayov\u00e1, moder\u00e1torka<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>Je to n\u00e1ro\u010dn\u00e9. Pak \u017eivot s t\u00edmto posti\u017een\u00edm, v\u00edte, tak\u017ee ty masti\u010dky, bylinky, \u010dlov\u011bk se asi opravdu sna\u017e\u00ed naj\u00edt cokoliv, co ulev\u00ed.<br \/><br \/>mluv\u010d\u00ed 2,<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>Krom\u011b masti\u010dky, co\u017e jsou zpravidla protiz\u00e1n\u011btliv\u00e9 a protibolestiv\u00e9 prepar\u00e1ty v n\u011bjak\u00e9m mas\u0165ov\u00e9m nebo gelov\u00e9m z\u00e1kladu, tak lze tu terapii pod\u00e1vat i celkov\u011b v podob\u011b tablet, eventu\u00e1ln\u011b injekc\u00ed a tam je v\u00fdhoda zpravidla vy\u0161\u0161\u00edho \u00fa\u010dinku. Naproti tomu nev\u00fdhoda v rizic\u00edch vedlej\u0161\u00edch projev\u016f, tak\u017ee se mus\u00ed dob\u0159e v\u00e1\u017eit.<br \/><br \/>Pavla Kindernayov\u00e1, moder\u00e1torka<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>Popros\u00edm, nasa\u010fte si op\u011bt sluch\u00e1tka, m\u00e1me tady dal\u0161\u00ed telefonick\u00fd dotaz. Dobr\u00e9 dopoledne, jste v radioporadn\u011b.<br \/><br \/>mluv\u010d\u00ed 3,<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>Dobr\u00e9 dopoledne. Pros\u00edm v\u00e1s, j\u00e1 jsem se cht\u011bla pana doktora zeptat. M\u011b. Nebolej kolena ani klouby, ale od kolene nahoru, ale to je tak hrozn\u00e1 bolest, \u017ee maz\u00e1n\u00ed a pr\u00e1\u0161ky na to beru, m\u011b pan doktor p\u0159edepisuje injekce m\u011b d\u00e1v\u00e1 r\u016fzn\u00fd, jo, ale v\u016fbec nic m\u011b nepom\u00e1h\u00e1, tak jsem se cht\u011bla zeptat, jestli by pan doktor m\u011b ne\u0159ekl, co na to.<br \/><br \/>mluv\u010d\u00ed 2,<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>To je jedna z v\u011bc\u00ed, kter\u00e1 bude vy\u017eadovat, aby se rozhodlo, co je p\u0159\u00ed\u010dinou, proto\u017ee takov\u00e9to pot\u00ed\u017ee vyza\u0159uj\u00edc\u00ed zejm\u00e9na z oblasti doln\u00edch zad do oblasti stehen mohou b\u00fdt zp\u016fsobeny zm\u011bnami kupodivu nikoliv v t\u011bch m\u00edstech, kde to bol\u00ed, ale t\u0159eba v oblasti doln\u00edch zad, kde mohou b\u00fdt jak degenerativn\u00ed, tak z\u00e1n\u011btliv\u00e9 zm\u011bny, to vy\u017eaduje sv\u016fj postup l\u00e9\u010debny, m\u016f\u017ee b\u00fdt i z\u00e1n\u011btliv\u00e1 p\u0159\u00ed\u010dina takov\u00e9ho stavu, \u0159\u00edk\u00e1 se tomu polymyalgie, a to vy\u017eaduje dal\u0161\u00ed diagnostiku s pou\u017eit\u00edm laboratorn\u00edch metod.<br \/><br \/>Pavla Kindernayov\u00e1, moder\u00e1torka<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>To znamen\u00e1 k l\u00e9ka\u0159i op\u011bt zaj\u00edt a pt\u00e1t se, ano? Pt\u00e1t se, vy\u017eadovat dal\u0161\u00ed reakci, <br \/><br \/>mluv\u010d\u00ed 5,<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>J\u00e1 v\u00e1m dobr\u00fd den. Osm rok\u016f, dva m\u011bs\u00edce zp\u00e1tky jsem m\u011bl hrozn\u00e9 k\u0159e\u010de do svalu. Mezi t\u0159\u00edslem a klanem, \u017e\u00e1dn\u00e9 probl\u00e9my jsem nem\u011bl. A te\u010f jsem, te\u010f m\u011b bylo \u0159e\u010deno, \u017ee m\u00e1m rozsypanou t\u0159et\u00ed stupe\u0148 ky\u010del, je to mo\u017en\u00e9 za dva m\u011bs\u00edce? Takhle m\u011b to bol\u00ed, \u017ee chod\u00edm, kulh\u00e1m. Anebo toho je EF tady kolega n\u011bco podobn\u00fdho, sk\u0159\u00edpa od p\u00e1te\u0159e?<br \/><br \/>Pavla Kindernayov\u00e1, moder\u00e1torka<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>Pokus\u00edme se zareagovat,  m\u011bjte se hezky, \u00fasm\u011bv, a\u0165 v\u00e1m vydr\u017e\u00ed i p\u0159es ty bolesti, na shledanou.<br \/><br \/>mluv\u010d\u00ed 2,<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>No, \u0159\u00edk\u00e1te to dob\u0159e, ob\u011b ty varianty jsou mo\u017en\u00e9, ur\u010dit\u011b to nen\u00ed v\u011bc, kter\u00e1 by b\u011bhem t\u00fddn\u016f nebo m\u011bs\u00edc\u016f vznikla, nicm\u00e9n\u011b fakt, \u017ee ty zm\u011bny mohou prob\u00edhat i dlouh\u00e1 l\u00e9ta, ani\u017e by se n\u011bjak v\u00fdrazn\u011b projevovaly a projev\u00ed se, a\u017e dostoup\u00ed ur\u010dit\u00e9ho momentu a pak to m\u016f\u017ee skute\u010dn\u011b b\u00fdt pom\u011brn\u011b kr\u00e1tk\u00e1 doba. Je pot\u0159eba zase bli\u017e\u0161\u00ed vy\u0161et\u0159en\u00ed, zpravidla v\u010detn\u011b rentgenov\u00fdch zn\u00e1mek a laboratorn\u00edch test\u016f a ty pot\u00ed\u017ee z oblasti doln\u00ed p\u00e1te\u0159e mohou b\u00fdt \u0159e\u0161iteln\u00e9 jak l\u00e9ky, tak chirurgick\u00fdm z\u00e1krokem. Z\u00e1le\u017e\u00ed na tom, co je p\u0159\u00ed\u010dinou a rozli\u0161en\u00ed mezi t\u00edm, jestli to je z oblasti ky\u010dl\u00ed, anebo z oblasti bedro, k\u0159\u00ed\u017eov\u00e9ho kloubu, to je to es\u00ed\u010dko tzv., p\u0159inese zpravidla rentgenov\u00e9 vy\u0161et\u0159en\u00ed.<br \/><br \/>Pavla Kindernayov\u00e1, moder\u00e1torka<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>Asi ka\u017ed\u00e9ho, pane docente, n\u011bkdy, ob\u010das n\u011bco bol\u00ed, ale pozn\u00e1me, \u017ee u\u017e je to revmatick\u00e9 onemocn\u011bn\u00ed, jakou bolest\u00ed se to projevuje, pokud v\u016fbec n\u011bjakou bychom v\u011bd\u011bli, kdy za v\u00e1mi m\u00e1me p\u0159ij\u00edt.<br \/><br \/>mluv\u010d\u00ed 2,<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>\u0158\u00edk\u00e1te to zcela p\u0159esn\u011b. Skoro ka\u017ed\u00fd dosp\u011bl\u00fd \u010dlov\u011bk m\u00e1 n\u011bjakou zku\u0161enost s bolav\u00fdm kloubem, ta \u010dastost z toho p\u0159\u00edznak\u016f nebo prakticky zcela obecn\u00e1 p\u0159\u00edtomnost toho p\u0159\u00edznaku n\u011bkdy v pr\u016fb\u011bhu \u017eivota znamen\u00e1, \u017ee ho nelze \u00fapln\u011b pou\u017e\u00edt jako ten d\u016fvod. A tak. Celosv\u011btov\u011b se m\u00e1 za to, \u017ee dobr\u00e1 p\u0159\u00ed\u010dina k tomu, aby \u010dlov\u011bk nav\u0161t\u00edvil sv\u00e9ho l\u00e9ka\u0159e. Otok, jakmile vznikne otok kloubu, tak je ta spr\u00e1vn\u00e1 chv\u00edle, kdy vyhledat sv\u00e9ho l\u00e9ka\u0159e, proto\u017ee potom u\u017e ty dom\u00e1ck\u00e9 recepty zpravidla nesta\u010d\u00ed a taky to vy\u017eaduje dal\u0161\u00ed vy\u0161et\u0159en\u00ed a laboratorn\u00ed testy, rentgenov\u00e1 vy\u0161et\u0159en\u00ed atd.<br \/><br \/>Pavla Kindernayov\u00e1, moder\u00e1torka<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>Hodn\u011b lid\u00ed m\u00e1 i sedav\u00e9 zam\u011bstn\u00e1n\u00ed, tr\u00e1v\u00ed \u010das u po\u010d\u00edta\u010d\u016f. Kdy\u017e n\u00e1s za\u010dnou bolet mal\u00e9 klouby u prst\u016f, i to m\u016f\u017ee b\u00fdt sign\u00e1l nebo v\u00fdstraha. Odpo\u010dinci, jak k tomu p\u0159istupovat.<br \/><br \/>mluv\u010d\u00ed 2,<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>Bolesti jsou pom\u011brn\u011b \u010dastou z\u00e1le\u017eitost\u00ed, m\u016f\u017ee to b\u00fdt jak p\u0159\u00edznak vyv\u00edjej\u00edc\u00edch se artrotick\u00fdch zm\u011bn, tak to m\u016f\u017ee b\u00fdt prvn\u00ed projev z\u00e1n\u011btu kloubu z toho celkov\u00e9ho autoimunitn\u00edho d\u016fvodu. Nej\u010dast\u011bj\u0161\u00ed takovou p\u0159\u00ed\u010dinou je nemoc, kter\u00e1 se jmenuje revmatoidn\u00ed artritida. A to u\u017e je situace, kter\u00e1 nejenom, \u017ee vy\u017eaduje n\u00e1v\u0161t\u011bvu l\u00e9ka\u0159e kv\u016fli tomu, aby n\u00e1m pomohl a ulevil zejm\u00e9na i proto, \u017ee \u0161ance na \u00fasp\u011b\u0161nou l\u00e9\u010dbu se v\u00fdrazn\u011b a rychle zhor\u0161uje s t\u00edm, jak dlouho ty pot\u00ed\u017ee trvaj\u00ed. \u010cili pokud m\u00e1me pot\u00ed\u017ee v ru\u010dn\u00edch kloubech, zejm\u00e9na to jsou ty klouby, kde vlastn\u011b za\u010d\u00ednaj\u00ed prsty, mezi prsty a dorzalem ruky, tak tam je pot\u0159eba to nepodcenit, nav\u0161t\u00edvit sv\u00e9ho doktora. Zpravidla v\u00e1s bu\u010fto vy\u0161et\u0159\u00ed s\u00e1m, nebo v\u00e1s po\u0161le do p\u0159\u00edslu\u0161n\u00e9 poradny revmatologick\u00e9, proto\u017ee tam je p\u0159ece jenom pom\u011brn\u011b v\u00fdznamn\u00e9 riziko, aby neza\u010d\u00ednalo n\u011bco jako revmatoidn\u00ed nebo jin\u00e1 z\u00e1n\u011btliv\u00e1 artritida a tam u\u017e to chce pom\u011brn\u011b intenzivn\u00ed l\u00e9\u010dbu. \u010c\u00edm d\u0159\u00edv, t\u00edm lep\u0161\u00ed.<br \/><br \/>mluv\u010d\u00ed 8,<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>Dobr\u00fd den, pros\u00edm v\u00e1s p\u011bkn\u011b, j\u00e1 bych se cht\u011bla zeptat. M\u00e1m revmatoidn\u00ed artritidu, ale u\u017e asi t\u0159i roky m\u011b hrozn\u011b bolej nohy od kolen ke kotn\u00edk\u016fm, nem\u016f\u017eu to vydr\u017eet, nem\u016f\u017eu st\u00e1t. U\u017e je to t\u0159i roky a reumatolog s n\u00ed nic ned\u011bl\u00e1. Beru teda ale flunom. A ani obvodn\u00ed l\u00e9ka\u0159, nikdo, nikdo m\u011b nic. Chodit m\u016f\u017eu jakoby, ale kdy\u017e si zastav\u00edm, tak to je konec, pros\u00edm, mus\u00edm okam\u017eit\u011b sednout.<br \/><br \/>Pavla Kindernayov\u00e1, moder\u00e1torka<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>Tak mus\u00edme se zareagovat. D\u011bkujeme, na shledanou.<br \/><br \/>mluv\u010d\u00ed 2,<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>Na\u0161e poslucha\u010dka trp\u00ed jednou z t\u011bch z\u00e1n\u011btliv\u00fdch celkov\u00fdch onemocn\u011bn\u00ed, tedy revmatoidn\u00ed artritidou. J\u00e1 bych \u00fapln\u011b nesouhlasil s t\u00edm, \u017ee revmatolog nic ned\u011bl\u00e1, proto\u017ee ty l\u00e9ky, kter\u00e9 jmenovala, jsou skute\u010dn\u011b jedn\u011bmi z t\u011bch, kter\u00e9 p\u0159ipadaj\u00ed do \u00favahy. P\u0159i terapii toho onemocn\u011bn\u00ed, o tom, jak z\u00e1va\u017en\u00fd je ten z\u00e1n\u011bt, informuje jednak celkov\u00fd fyzick\u00fd n\u00e1lez, jednak laboratorn\u00ed testy, to je pot\u0159eba vyhodnotit a na z\u00e1klad\u011b toho potom vyplyne, nakolik je ta l\u00e9\u010dba dostate\u010dn\u00e1, nebo by se m\u011bla zm\u011bnit Nicm\u00e9n\u011b toto onemocn\u011bn\u00ed m\u016f\u017ee zp\u016fsobovat v\u00fdrazn\u00e9 bolesti a v\u00fdrazn\u00e9 pot\u00ed\u017ee.<br \/><br \/>Pavla Kindernayov\u00e1, moder\u00e1torka<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>Asi ch\u00e1pe, \u017ee s t\u00edm se je\u0161t\u011b t\u011b\u017eko smi\u0159uje, \u017ee \u010dlov\u011bk se zapojovat d\u011btem n\u011bjak\u00fd skv\u011bl\u00fd tunell, \u017ee by to mohlo zlep\u0161it.<br \/><br \/>mluv\u010d\u00ed 2,<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>Tam jin\u00e1 mo\u017enost, ne\u017e se domluvit se sv\u00fdm o\u0161et\u0159uj\u00edc\u00edm l\u00e9ka\u0159em nen\u00ed.<br \/><br \/>Pavla Kindernayov\u00e1, moder\u00e1torka<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>M\u00e1me tady dal\u0161\u00ed telefon\u00e1t, pros\u00edm sluch\u00e1tka. Dobr\u00fd den.<br \/><br \/>mluv\u010d\u00ed 8,<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>Dobr\u00fd den, tady je poslucha\u010dka z Hradce Kr\u00e1lov\u00e9, j\u00e1 bych m\u011bla dv\u011b ot\u00e1zky na pana doktora, jestli je lep\u0161\u00ed operovat d\u0159\u00edv koleno nebo ky\u010del, to by byla jedna, ob\u011b jsou na tom, koleno je t\u0159i, ky\u010del \u010dty\u0159i a druh\u00e1 ot\u00e1zka by byla, jestli, kdy\u017e takhle bol\u00ed to koleno a doktor navrhne, navrhne tam p\u00edchnout n\u011bjakou injekci, kterou jako jsou ty, j\u00e1 nev\u00edm, injekce t\u0159eba, nap\u0159\u00edklad depo, meddrol a takov\u00fd, jestli mi to sp\u00ed\u0161 neubl\u00ed\u017e\u00ed, proto\u017ee to jsou vlastn\u011b kortikoidy a tak, jestli na tom nebudu h\u016f\u0159 ne\u017e&#8230;<br \/><br \/>mluv\u010d\u00ed 2,<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>Z\u00e1le\u017e\u00ed na stavu t\u011bch jednotliv\u00fdch kloub\u016f. Z toho, co pacientka l\u00ed\u010dila, bych asi volil ten kloub kter\u00fd \u010din\u00ed v\u011bt\u0161\u00ed pot\u00ed\u017ee, na kter\u00e9m je pokro\u010dilej\u0161\u00ed stav, ale nicm\u00e9n\u011b t\u00edm zab\u00edh\u00e1m tro\u0161ku do rozhodov\u00e1n\u00ed, kter\u00e9 provede kolega ortoped, proto\u017ee v jeho kompetenci je ta opera\u010dn\u00ed l\u00e9\u010dba, \u010dili v\u00e1\u0161 ortoped je to.<br \/><br \/>Pavla Kindernayov\u00e1, moder\u00e1torka<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>A ned\u00e1 se \u0159\u00edct, co je lep\u0161\u00ed ud\u011blat d\u0159\u00edv, co je v\u00edc zat\u011b\u017eovan\u00e9.<br \/><br \/>mluv\u010d\u00ed 2,<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>Co pom\u016f\u017ee, se to \u0159\u00edct ned\u00e1, to, co d\u011bl\u00e1 v\u011bt\u0161\u00ed pot\u00ed\u017ee nebo kde je hor\u0161\u00ed n\u00e1lez.<br \/><br \/>Pavla Kindernayov\u00e1, moder\u00e1torka<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>Tak a ty injekce kurtikoidov\u00e9 nemohou ubl\u00ed\u017eit.<br \/><br \/>mluv\u010d\u00ed 2,<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>Kortikoidov\u00e9 injekce jsou dobr\u00e1 mo\u017enost p\u0159i zvl\u00e1d\u00e1n\u00ed z\u00e1n\u011btliv\u00e9 aktivity v tom p\u0159\u00edslu\u0161n\u00e9m kloubu je to samoz\u0159ejm\u011b kr\u00e1tkodob\u00e9 zklidn\u011bn\u00ed toho z\u00e1n\u011btu, tak\u017ee ve v\u011bt\u0161in\u011b p\u0159\u00edpad\u016f by to nem\u011blo t\u00edmto kr\u00e1tkodob\u00fdm zp\u016fsobem skon\u010dit, ale to onemocn\u011bn\u00ed by se m\u011blo l\u00e9\u010dit celkov\u011b, faktem je, \u017ee ve v\u011bt\u0161in\u011b p\u0159\u00edpad\u016f ty kortikoidy mohou b\u00fdt pou\u017eity nap\u0159\u00edklad i p\u0159i zhor\u0161en\u00ed nebo p\u0159i artritid\u011b v r\u00e1mci celkov\u00e9ho onemocn\u011bn\u00ed <\/p>\n\n\n\n<p> moder\u00e1torka<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>Ale neb\u00e1l byste se toho? <br \/><br \/>mluv\u010d\u00ed 2,<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>Asi l\u00e9ka\u0159 do toho nep\u016fjde, pokud nebude c\u00edtit nutnost tohoto stavu.<br \/><br \/>Pavla Kindernayov\u00e1, moder\u00e1torka<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>P\u00ed\u0161e n\u00e1m pan Luk\u00e1\u0161. N\u011bkdy c\u00edt\u00edm v kolenech a jin\u00fdch kloubech p\u0159i pohybu mal\u00e9 lup\u00e1n\u00ed, m\u011bl bych to n\u011bjak \u0159e\u0161it? \u017diju aktivn\u011b, sna\u017e\u00edm se po pr\u00e1ci b\u011bhat, jezdit na kole, je mi 54 let, u\u017e\u00edv\u00e1m i dopl\u0148ky s kolagenem, to lup\u00e1n\u00ed je ale bohu\u017eel \u010d\u00edm d\u00e1l \u010dast\u011bj\u0161\u00ed, m\u016f\u017ee to znamenat zv\u00fd\u0161en\u00e9 riziko rozvoje artritidy, d\u011bkuji za odpov\u011b\u010f.<br \/><br \/>mluv\u010d\u00ed 2,<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>Rozvoje artritidy pravd\u011bpodobn\u011b ne. Tam bychom sp\u00ed\u0161 dali na to, kdy\u017e by se objevil otok toho kloubu, co se t\u00fd\u010de zm\u011bn artrotick\u00fdch, tedy degenerativn\u00edch, tam samoz\u0159ejm\u011b ty zvukov\u00e9 efekty mohou b\u00fdt jedn\u00edm z pr\u016fvodn\u00edch z\u00e1le\u017eitost\u00ed, ale o tom, jak ten kloub vypad\u00e1, sp\u00ed\u0161 informuje rentgenov\u00fd n\u00e1lez.<br \/><br \/> moder\u00e1torka<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>Zaj\u00edmav\u00fd dotaz i od pan\u00ed Terezy. P\u0159ekvapiv\u00fd pom\u011brn\u011b. Je pravda, \u017ee nadm\u011brn\u00e1 konzumace raj\u010dat nebo paprik m\u016f\u017ee zhor\u0161it stav na\u0161ich kloub\u016f?<br \/><br \/>mluv\u010d\u00ed 2,<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>Nem\u011bla by.<br \/><br \/>moder\u00e1torka<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>V\u00e1s ten dotaz ale nep\u0159ekvapil? Asi se o tom hodn\u011b.<br \/><br \/>mluv\u010d\u00ed 2,<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>Mluv\u00ed, o dietn\u00edch r\u016fzn\u00fdch manipulac\u00edch se toho mluv\u00ed pom\u011brn\u011b hodn\u011b, nicm\u00e9n\u011b z\u00e1sadn\u00ed vliv na kloubn\u00ed onemocn\u011bn\u00ed nebyl pro ty dietn\u00ed manipulace prok\u00e1z\u00e1n, snad s v\u00fdjimkou situace, kdy se \u010dlov\u011bk p\u0159ej\u00edd\u00e1 a nar\u016fst\u00e1 mu nadv\u00e1ha, pochopiteln\u011b v\u0161echny kloubn\u00ed pot\u00ed\u017ee jsou t\u00edm zhor\u0161ov\u00e1ny, tak\u017ee pokud byste cht\u011bla n\u011bco prov\u00e9st se svoj\u00ed dietou, tak m\u016f\u017eu doporu\u010dit to, co b\u011b\u017en\u011b doporu\u010dujeme, jako zdravou stravu, tedy n\u011bco, \u010demu se \u0159\u00edk\u00e1 st\u0159edomo\u0159sk\u00e1 dieta.<br \/><br \/>Pavla Kindernayov\u00e1, moder\u00e1torka<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>No, vy jste, pane docente, v oboru ur\u010dit\u011b hodn\u011b dlouho, vid\u00edte ur\u010dit\u00e9 pokroky a nov\u00e9 mo\u017enosti. J\u00e1 jsem \u010detla, \u017ee v t\u00e9 regenerativn\u00ed medic\u00edn\u011b se te\u010f experimentuje nap\u0159\u00edklad i s chrupav\u010dit\u00fdmi \u0161t\u011bpy z nosn\u00ed chrupavky, \u017ee u\u017e byli dokonce operov\u00e1ni prvn\u00ed lid\u00e9 a \u00fasp\u011b\u0161n\u011b v Basileji. Tak mysl\u00edte si, \u017ee by to mohla b\u00fdt i alternativa k protetice, \u017ee ten obor opravdu jde d\u00e1l a d\u00e1l a ty mo\u017enosti jsou tady nov\u00e9.<br \/><br \/>mluv\u010d\u00ed 2,<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>Ten rozvoj je obrovsk\u00fd. Znovu. Tohle je ot\u00e1zka sp\u00ed\u0161e oboru ortoped\u016f, nicm\u00e9n\u011b ty zpr\u00e1vy vypadaj\u00ed nad\u011bjn\u011b, ale v t\u00e9to chv\u00edli jsou to zat\u00edm sp\u00ed\u0161e ojedin\u011ble ne\u017e rutinn\u011b pou\u017e\u00edvan\u00e9 metody, ale i v t\u00e9 na\u0161\u00ed \u010d\u00e1sti, tedy neoperativn\u00ed, se ten pokrok na\u0161t\u011bst\u00ed a\u017e p\u0159ekotn\u011b \u0159\u00edt\u00ed dop\u0159edu a pomalu ka\u017ed\u00fd rok p\u0159in\u00e1\u0161\u00ed n\u011bjak\u00e9 nov\u00e9 z\u00e1sadn\u00ed mo\u017enosti v l\u00e9\u010db\u011b t\u011bch z\u00e1n\u011btliv\u00fdch onemocn\u011bn\u00ed, kter\u00fdmi se revmatolog hlavn\u011b zab\u00fdv\u00e1.<br \/><br \/>Pavla Kindernayov\u00e1, moder\u00e1torka<br \/>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8211;<br \/>Dobrou zpr\u00e1vou skon\u010d\u00edme, \u017ee je tady nad\u011bje na ten \u017eivot s co nejmen\u0161\u00ed bolest\u00ed pro v\u011bt\u0161inu lid\u00ed. Petr doc. Petr Bradna byl dnes na\u0161\u00edm hostem, d\u011bkuju za to a budu se t\u011b\u0161it brzy zase na shledanou.<br \/><br \/><\/p>\n","protected":false},"excerpt":{"rendered":"<div class=\"mh-excerpt\"><p>\u010cRo Pozv\u00e1n\u00ed \u010cesk\u00e9ho rozhlasu p\u0159ijal revmatolog ze druh\u00e9 intern\u00ed kliniky Fakultn\u00ed nemocnice Hradec Kr\u00e1lov\u00e9 pan doc. Petr Bradna. vy jste \u0159\u00edkal, \u017ee chcete za\u010d\u00edt artritidou, <a class=\"mh-excerpt-more\" href=\"https:\/\/www.invarena.cz\/?p=45106\" title=\"R\u00e1dioporadna\u00a0&#8211; klouby\">[&#8230;]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":22862,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-45106","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zdravi"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/45106","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=45106"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/45106\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/22862"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=45106"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=45106"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=45106"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}