Hypermobility Spectrum Disorder

Question 1

What is hypermobility spectrum disorder?

Answer 1

Pain syndrome in people with joints that move beyond normal limits (often referred to as being double jointed).

Question 2

Why does hypermobility spectrum disorder occur (sort of acting pathophysiology)?

Answer 2

• Laxity of ligaments, capsules and tendons
• Thought that microtrauma is the origin of the pain

Question 3

State some potential causes of hypermobility spectrum disoder

Answer 3

• Inheritance
• Injury to joints or ligaments
• Overuse
• Surgery
• MSK malformations

Question 4

Discuss the prevelance of hypermobility spectrum disorder, include:

• How common it is
• If there is familial link
• Who it commonly prsents in: gender & ethnicity
• Age it presents

Answer 4

• 10% population
• Often familial
• Females, asian people
• Childhood or young adulthood

Question 5

Discuss the signs & symptoms of hypermobility spectrum disorder

Answer 5

Symptoms

• Painful joints
• Worse after activity (but may be generalised also)
• Fatigue
• Epicondylitis
• Frequent injuries: subluxation, dislocation, strains

Signs

• Abnormal skin: papyraeous scars, hyperextensible, thin, striae
• Marfanoid habitus
• Arachnodactyly
• Droop eyelids
• Myopia
• Hernias and uterine/rectal prolapses

Question 6

What scoring system can be used to asses hypermobility?

Answer 6

Beighton score

Question 7

Discuss the treatment of hypermobility spectrum disorder, include:

• Aims of treatment
• Treatments offered

Answer 7

Aim of treatment is to improve pain & reduce disability:

• Conservative (mainstay of treatment)
  
  • Strengthening exercises (reduce subluxation)
  • Posture & balance
  • Splinting
  • Psychological support
• Pharmacological
  
  • Paracetamol