KALÇA AĞRISINDA LABORATUVAR BULGULARI
Hüseyin Kaplan
Erciyes Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon AD, Romatoloji BD, Kayseri, Türkiye
Kaplan H. Kalça Ağrısında Laboratuvar Bulguları. Çalış M, Talay Çalış H ed. Ağrıda Odak Noktası Kalça. 1. Baskı. Ankara: Türkiye Klinikleri; 2025. p.57-68.
ÖZET
Kalça ağrılarının ayırıcı tanısında çok sayıda hastalık yer alır. Altta yatan nedenin tespiti için farklı şekillerde sınıflandırmalar yapılarak tanıya gidilmeye çalışılır. Ayrıntılı bir öykü ve dikkatli bir fizik muayene sonrasında istenen laboratuvar ve görüntüleme testleri daha değerli olacaktır. Klinik pratikte laboratuvar testleri; tanı, monitörizasyon, tarama ve araştırma yapma gibi farklı amaçlarla istenebilmektedir. Laboratuvar testlerinin istenme gerekçesinin yanı sıra test sonuçlarının nasıl yorumlanacağı, hasta yönetimini nasıl etkileyeceği veya testin istenmemesinin olası sonuçları da hekim tarafından test istemi öncesi doğru bir şekilde değerlendirilmelidir. Kalça ağrılarının laboratuvar değerlendirmesinde ilk olarak basit testler istenir. Burada temel olarak; tam kan sayımı, akut faz reaktanları, karaciğer ve böbrek fonksiyon testleri ile beraber idrar analizleri yer alır. Gerekli durumlarda daha ileri laboratuvar testlerinden de faydalanılır. Kalça ağrılarında altta yatan hastalığa bağlı olarak laboratuvar testlerinde farklı bulgular görülebilir. Hastalıkların tanı süreçleri ve ayırıcı tanıda yer alan patolojilere göre laboratuvar testi sayısı veya tipi değişiklik gösterebilir. Örneğin; septik artrit şüphesi olan hastada sinovyal örnekleme ile enfeksiyöz ajanın tespit edilmesi esastır. Eklem aspirasyonu bu gibi tanısal rollerinin yanı sıra tedavi amaçlı da uygulanabilmektedir. Herhangi bir amaçla istenen laboratuvar panellerinde en yaygın istenen testlerden bir tanesi olan tam kan sayımının çoğunlukla tanısal yararı sınırlı iken lösemi varlığında oldukça önemli ipuçları verebilir. Gut artritinde bir biyokimyasal test olan serum ürik asit düzeyi veya kemik tutulumunda alkalen fosfataz yüksek bulunabilir. Spesifik semptomlara sahip olmayan kalça bölgesindeki tümörler gözden kaçırılmamalıdır. Dikkatli bir klinik değerlendirme, sistemik inflamasyonun laboratuvara yansımaları, bazı spesifik testler ve görüntüleme yöntemleri ile tanıya gidilmeye çalışılmalıdır. Öte yandan, birbirleriyle benzer klinik bulgulara sahip olabilen bazı otoimmün hastalıklarda otoantikorların varlığı veya yokluğu katkı sağlayabilir. Eklem problemlerinde diğer yöntemlerle altta yatan nedenin belirlenemediği nadir durumlarda sinovyal doku biyopsisi de tanıya yardımcı olabilir. Bu bölümde genel bir bilgilendirme sonrası kalça ağrısı ile prezente olabilen çeşitli inflamatuar ve inflamatuar olmayan hastalıklarda laboratuvar testlerinin yeri ve önemi ayrı baş- lıklar altında ele alınmaktadır.
Anahtar Kelimeler: Kalça; Ağrı; Laboratuvarlar; İnflamasyon; Eklemler; Ayırıcı tanı; Kan kimyası
analizi
Citation
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