Abstract | Stopalo je kompleksan dio ljudskog tijela koji sadrži veliki broj kostiju, zglobova i mišića. Dva najvažnija zgloba su gornji i donji nožni zglob, a donji se dijeli na subtalarni i talokalkaneonavikularni. Osim zglobova, koji omogućuju razne vrste pokreta, ligamenti i mišići pomažu i sudjeluju u stabilizaciji tih zglobova. Mišići, koje dijelimo na mišiće gornje strane stopala i mišiće tabana, sudjeluju u aktivnom izvođenju pokreta. Dorzalna i plantarna fleksija te everzija i inverzija su mogući pokreti u području stopala. Izvanzglobni reumatizam odnosi se na skup upalnih i degenerativnih stanja mišićno-koštanog sustava koja uzrokuju bol u mekim tkivima oko zglobova. Ova stanja mogu zahvatiti tetive, hvatišta tetiva, mišiće, fascije, burze i zglobnu čahuru. Izvanzglobni reumatizam može biti primaran (sindromi prenaprezanja) ili sekundaran (uzrokovan reumatskim bolestima, endokrinološkim poremećajima, infekcijama, tumorima ili lijekovima). U izvanzglobni reumatizam stopala spadaju sljedeća stanja: plantarni fasciitis, Ahilova tendinopatija, tibialis posterior tendinopatija, peronealna tendinoza, Haglundov sindrom i Ahilova entezopatija. Bol različitog stupnja je dominantan simptom kojeg prati ograničenje opsega pokreta zahvaćenih struktura. Dijagnostički najbitnije je detaljno uzimanje anamneze i fizikalni pregled. Na temelju kliničke slike postavlja se dijagnoza koja se po potrebi potvrđuje slikovnim metodama ako postoje nedoumice. Liječenje uključuje fizikalnu terapiju i primjenu lijekova, a u krajnjem slučaju potreban je operativni zahvat. |
Abstract (english) | The foot is a complex part of the human body that contains a large number of bones, joints, and muscles. The two most important joints are the upper and lower ankle joints, with the lower joint further divided into the subtalar and talocalcaneonavicular joints. In addition to the joints, which enable various types of movement, ligaments and muscles assist in stabilizing these joints. The muscles, which are divided into the muscles of the upper side of the foot and the muscles of the sole, actively participate in movement execution. Dorsal and plantar flexion, as well as eversion and inversion, are the possible movements in the foot area. Extraarticular rheumatism refers to a group of inflammatory and degenerative musculoskeletal conditions that cause pain in the soft tissues around the joints. These conditions can affect tendons, tendon attachments, muscles, fascia, bursae, and the joint capsule. Extraarticular rheumatism can be primary (overuse syndromes) or secondary (caused by rheumatic diseases, endocrine disorders, infections, tumors, or medications). Extraarticular rheumatism of the foot includes the following conditions: plantar fasciitis, Achilles tendinopathy, tibialis posterior tendinopathy, peroneal tendinosis, Haglund's syndrome, and Achilles enthesopathy. Pain of varying character is the dominant symptom, accompanied by a restriction in the range of motion of the affected structures. The most important diagnostic step is a thorough history and physical examination. Based on the clinical picture, a diagnosis is made, which can be confirmed by imaging methods if there are uncertainties. Treatment includes physical therapy and medication, and in extreme cases, surgical intervention is required. |