I ka jargon lapaʻau, pili ka ʻōhū i ka pehu o kahi aʻa, nā ʻola a ʻāpana paha o ke kino. Hiki ke hoʻopili ʻia kēia i ka mumū, edema, kahi hematoma post-traumatic, kahi abscess a i ʻole kahi tumo. He kumu pinepine ia no ke kūkākūkā ʻana me ke kauka. Hoʻololi nā ʻōuli i ke ʻano a me ka wahi o ka pehu. ʻO ka pehu kahi hōʻailona hōʻailona, ​​ʻaʻole kahi ʻōuli. E hoʻāla ʻia ka hōʻailona e like me ka pōʻaiapili a e kākoʻo ʻia e nā hoʻokolohua hou (x-ray, ultrasounds, MRI, scanner). E hilinaʻi ka lāʻau i ke ʻano o ka pehu, a ʻo ke kumu hoʻi ia.

Inā hoʻohana iki ʻia ka huaʻōlelo "puʻupuʻu iwi", me ka ʻōlelo pololei ʻana, i ka honua olakino, hiki ke hele pū kekahi mau ʻōpū e hōʻino ana i ka ʻili o ka iwi me kahi ʻōhū e ʻike ʻia ma ka palpation. ʻO ka iwi iwi ka ulu ʻana o nā mea pathological i loko o ka iwi. ʻO ka hapa nui o nā puʻupuʻu iwi he benign (non-cancerous) i hoʻohālikelike ʻia me nā tumors malignant (cancerous). ʻO ka hoʻokaʻawale nui ʻelua e hoʻokaʻawale i nā tumors "primite", pinepine pinepine ʻia, mai ke kula kiʻekiʻe (metastatic) mau mainoino mau.

ʻO ka tumign iwi ʻino (non-cancerous) ka puʻupuʻu ʻaʻole pālahalaha aku i nā ʻāpana ʻē aʻe o ke kino (ʻaʻole metastasize). ʻAʻole maʻamau ka hoʻoweliweli o ka tumoma benign. ʻO ka hapa nui o nā puʻupuʻu iwi maʻi ʻole i hemo ʻia e ka ʻoki ʻana a i ʻole curettage, a ʻaʻole hoʻi lākou i hoʻi maʻamau (recur).

Hoʻomaka nā tumors mua i ka iwi a hiki ke kino a i ʻole, ʻoi aku ka liʻiliʻi, malignant. ʻAʻohe kumu a predisposing factor wehewehe paha i ke kumu a pehea e ʻike ai. Ke ola lākou, ʻike pinepine ʻia nā ʻōuli ma ka iwi kākoʻo, hohonu a paʻa ʻole, ʻokoʻa ka osteoarthritis, ʻaʻole e emi ke hoʻomaha. ʻO nā mea ʻē aʻe, ka tumo hoʻonāwaliwali i ka iwi o ka iwi i hōʻike ʻia e kahi haʻihaʻi "kahaha" no ka mea kū ia ma hope o ka trauma liʻiliʻi.

Nui a hewahewa nā ʻano like ʻole o ka tumign benign e pili ana i nā ʻano ʻokoʻa o nā hunaola e hoʻoliʻiliʻi ai: fibroma non-ossifying, osteoid osteoma, tumo pūnaewele nui, osteochondroma, chondroma. Hoʻololi nui lākou i nā ʻōpio a me nā ʻōpio ʻōpio, akā ʻo nā keiki pū kekahi. Hoʻohālikelike ʻia ko lākou maikaʻi e ko lākou lohi o ka evolution a me ka ʻole o kahi diffusion mamao. ʻO ko lākou wahi maʻamau ka wahi kokoke i ke kuli, pelvis, a me ka ʻāpana poʻohiwi.

Ma ke ʻano he rula laulā, koe wale nō kekahi o nā tumors (non-ossifying fibroma), ua manaʻo ʻia e hemo i ka tumo e hoʻoneʻe ai i ka hōʻoluʻolu a i ʻole ka ʻeha, e hōʻemi ai i ka hopena o ka haki a, ʻoi aku ka liʻiliʻi, e pale iā ia mai ka loli. i ka puʻuwai malignant. Aia ka hana i ka hana ʻana i kahi excision (ablasi) o ka ʻāpana i hoʻopili ʻia o ka iwi, i ka uku ʻana i ka wahi i hoʻoneʻe ʻia a me ka hoʻoikaika ʻana paha i ka iwi me nā mea ʻoki lāʻau metallic a i ʻole osteosynthesis. Hiki ke hoʻopiha i ka nui o ka tumo i lawe ʻia me ka iwi mai ka mea maʻi (autograft) a i ʻole ka iwi mai kekahi mea maʻi (allograft).

ʻAʻohe hōʻailona a ʻeha paha kekahi o nā tumors maikaʻi. ʻO ia i kekahi manawa he ʻike radiological fortuitous. I kekahi manawa ʻo ia ka ʻeha o ka iwi i hoʻopilikia ʻia e koi ai i kahi hoʻokolohua radiological piha (X-ray, CT scan, a me MRI). I ka hapanui o nā hihia, hiki i nā kiʻi olakino ke ʻike kikoʻī a wehewehe pono hoʻi i ke ʻano o ka tumo, ma muli o kāna ʻano radiographic kikoʻī. I kekahi mau hihia kahi hiki ʻole ke hana i ka ʻike definitive, kahi biopsy iwi wale nō e hōʻoia i ke kuhi a kāpae i nā kānalua no kahi tumo malignant. E nānā ʻia ka laʻana iwi e kahi pathologist.

E hoʻomaopopo i ka hihia kūikawā o ka osteoid osteoma, kahi tumo liʻiliʻi i kekahi mau mika ma ke anawaena, pinepine ʻeha, kahi e hana ʻole ʻia ai ka hana e kahi kauka lāʻau akā na kahi radiologist. Luku wela ʻia ke tumo e ʻelua mau uila i hoʻolauna ʻia i loko ona, ma lalo o ka kaohi scanner.

ʻAʻohe laha nā tumors iwi malignant mua e pili nui i nā ʻōpio a me nā ʻōpio ʻōpio. ʻO nā ʻano nui ʻelua o ka iwi ʻōiwi malignant i kēia pae makahiki (90% o nā iwi malignancies iwi):

• osteosarcoma, ka mea maʻamau o nā maʻi ʻaʻai iwi, 100 a 150 mau hihia hou i kēlā me kēia makahiki, ke kāne nui;
• ʻO ka sarcoma a Ewing, kahi tumo laha ʻole e hoʻopili ana iā 3 i hoʻokahi miliona mau kānaka i kēlā me kēia makahiki ma Palani.

ʻO Pain ka hōʻailona kāhea nui. ʻO ia ka hana hou ʻana a me ka hoʻomau ʻana o kēia mau ʻeha, ka mea e pale ai i ka hiamoe a ʻano ʻē paha, a laila ke ʻano o ka ʻōhū e alakaʻi i nā noi noi (X-ray, scanner, MRI) e kānalua ai ka ʻike. Kākaʻikahi kēia mau tumors a pono e mālama ʻia i nā kikowaena loea.

ʻO ke kaha keʻehi ke kihi o ka mālama curative o nā sarcomas, ke hiki a ʻaʻole metastatic ka maʻi. Hiki ke hoʻohui ʻia me radiotherapy a me chemotherapy. Hana ʻia ke koho therapeutic i kahi ala like ma waena o nā loea mai nā ʻano ʻokoʻa (ʻoki kino, radiotherapy, oncology, kiʻi, anatomopathology) a noʻonoʻo mau i ke kū hoʻokahi o kēlā me kēia mea maʻi.

ʻO nā tumors nui i hiki ke kumu i nā metastases iwi (nā tumors ʻelua) ʻo ka umauma, nā hakuʻala, prostate, thyroid a me nā maʻi ʻākala. ʻO ka mālama ʻana i kēia mau metastases ka manaʻo e hoʻomaikaʻi i ke ola o ka mea maʻi, ma o ka hoʻomaha ʻana i ka ʻeha a me ka hōʻemi ʻana i ka maka o ka haki. Hoʻoholo ʻia a nānā ʻia e kahi hui multidisciplinary (oncologist, surgeon, radiotherapist, etc.).