Hypermobility, overstreched joints 4.25/5 (12)

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Hypermobility. CC BY SA 3.0
Hypermobility / Hypermobile joints. Magnolia Dysnomia / Wikipedia. CC BY SA 3.0

Definition

Hypermobility is excessively mobile joints and back without another explanatory disease, i.e. absence of the syndromes Marfan's-, Ehlers-Danlos, Loeys-Dietz- og Osteogenesis imperfecta. The hypermobility syndrome is also characterized by Pain in joints og muscles. The condition is often genetic and not one autoimmune systemic connective tissue disease.

Occurrence

Common occurrence. Most women. One study showed a degree of hypermobility in as many as 17,6-21,2% in European populations using the Beighton score (see below) (reference: Mulvey MR, 2013).

Symptoms

over Movement
Hypermobile fingers. Czaprowski D, 2011. CC BY 2.0

Over-movable, unstable joints that easily come "out of joint" (luxates): "Stepping over" with ankle, kneecap out of joint, shoulder out of joint, jaw out of joint, whip lash (neck pain after injury). Someone with hypermobility reports Pain in joints og muscles or backache, but repeated episodes of "out of joint" dispose too soon  Osteoarthrtitis which can be painful.

Beighton's hypermobility score

To determine hypermobility is often used Beighton hypermobility score (reference: B Juul-Kristensen, 2007). 4 / 9 points indicate generalized hypermobility:

  • Little finger can be stretched (extension) to more than 90 degrees (2 points if present in both arms)
  • Opposes thumbs against the forearm (2 points if both sides)
  • Elbow more than 10 degrees overextension (2 points if both)
  • Knee more than 10 degrees overextension (2 points if both)
  • Palms against the floor (standing with straight knees) 1 points

The The hypermobility syndrome in addition to hypermobility it should be symptoms such as pain in joints or muscles or sensible skin.

There are several diagnostic criteria for hypermobility syndrome. A set of current criteria here (Reference: Graham R, 2000)

Diagnostic criteria for hypermobility syndrome (Brighton 1998) for EDS (Grahame R, Bird HA, Child A 2000)

Major criteriaMinor criteria
Beighton score ≥4/9Beighton scores 1–3/9
Joint pain >3 months in >4 jointsJoint pain in 1–3 joints
Medical history of "out of joint" / dislocations
>3 soft tissue injuries
Marfanoid Habitus
Skin stretch marks () striae, stretchable, thin skin, abnormal scars
Eye symptoms: drooping eyelids, myopia, anti-mongoloid droop. Varicose veins, pelvic prolapse or hernia in the abdominal area (abdominal hernias)
For the diagnosis of EDS, both major criteria or one major and at least two minors or four minors or two minors combined with a family history of EDS type II are required.

Causes of hypermobility

Usually there are no signs of disease (idiopathic), but is a normal variant which is then often seen when other close relatives have the same. Listed below are rare associated conditions:

Treatment

Interdisciplinary treatment with physical treatment, initial instruction by a physiotherapist may be applicable (reference: Simmonds JV, Keer RJ Man Ther. 2007). It is important to maintain physical strength and form to reduce the risk of injury. Regular exercise, possibly under the guidance of a physiotherapist. Avoid maximum range of motion and overstretching. Adapted to everyday life and work that does not overload joints, back and muscles. No effective drug treatment, diet/dietary supplement or gene therapy is known.

Literature


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