Hypermobility Syndrome
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Definition/Description
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Hypermobility syndrome (HMS) is defined as the presence of musculoskeletal symptoms in subjects with Hypermobility in the absence of demonstrable systemic rheumatic disease. [1]
Excessive laxity in multiple joints is necessary to have HMS.Most common symptoms: - pain in multiple joints
- back pain
- overuse syndromes with normal levels of activity
- always being tired
Less common symptoms: - joint stiffness
- myalgia
- muscle cramps
Although women are more likely than men to have HMS and Asians and Africans are more likely to have HMS than white people, joint laxity is a consequence of a connective tissue disorder with a chance on heredity of 50%.
Clinically Relevant Anatomy[edit | edit source]
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Epidemiology /Etiology[edit | edit source]
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Characteristics/Clinical Presentation[edit | edit source]
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Differential Diagnosis[edit | edit source]
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Diagnostic Procedures[edit | edit source]
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The Beighton score measures the degree of hypermobility, the Brighton criteria is to determine the syndrome.
- Beighton score:
1. Hands flat on the floor with knees extended (1 point if positive)
2. Hyperextension of the elbow (1 point for each positive side)
3. Hyperextension of the knee (1 point for each positive side)
4. Thumb touching the forearm (1 point for each positive side)
5. Hyperextension of the 5th MCP (1 point for each positive side)
Maximum possible score: 9
Hypermobility present if total score ≥ 4
[1][2]
- Brighton criteria:
- Major criteria:
• Beighton score of ≥4
• Arthralgia for longer than 3 months in 4 or more joints
- Minor criteria:
• Beighton score of 1, 2 or 3
• Arthralgia (>3 months) in 1 to 3 joints or back pain (>3 months) or spondylosis/spondylolysis/spondylolisthesis
• Dislocation or subluxation in more than 1 joint, or in 1 joint one more than 1 occasion
• 3 or more soft tissue lesions (epicondylitis, tenosynovitis, bursitis)
• Marfanoid habitus (span: height ration >1.03 or upper segment lower segment ratio < 0.89)
• Abnormal skin: striae, hyperextensibility, papyraceous scars, thin skin
• Eye signs: drooping eye lids, myopia, or antimongoloid slant
• Varicose veins, hernia, uterine/rectal prolapse
- Requirement for diagnosis of hypermobility syndrome:
• 2 major criteria
• 1 major criteria + 2 minor criteria
• 4 minor criteria
• 2 minor criteria and unequivocally affected first-degree relative in family history [1]
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Examination[edit | edit source]
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Medical Management
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Physical Therapy Management
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The Hypermobility Syndrome can not be healed and there is not much known about an effective treatment yet.
Important is that HMS-patients have a good body conscience, to lower the risk of injuries, a good muscle balance, to support the joints, and they have to avoid excessive laxity movements.
They have to know their own body and their own limits.
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References[edit | edit source]
- ↑ 1.0 1.1 1.2 1.3 LAWRENCE A. Benign hypermobility syndrome. Indian Journal of Rheumatology 2005; 13:150-155
- ↑ 2.0 2.1 SIMPSON MR. Benign Joint Hypermobility Syndrome: Evaluation, Diagnosis, and Management. JAOA 2006;106(9):531-536
- ↑ RUSSEK LN. Examination and Treatment of a Patient With Hypermobility Syndrome. Physical Therapy 2000; 80(4):386-398
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