Hypermobility Syndromes

Question 1

Hypermobility Syndromes:
How it may present?

Answer 1

Presentation types:
-gastric upset, nausea, diarrhoea, constipation
-debilitating fatigue atypical for the child
-postural intolerances
-allergies and food chemical insensitivities

MOST COMMON
-joint sprains, subluxations, dislocations, persistent musculoskeletal pain
-functional gastrointestinal disorders
-urinary incontinence
-anxiety

*Can be associated with delayed motor milestones

Question 2

Hypermobility Syndromes:
How to diagnose?

Answer 2

Diagnosis is clinical

Beighton scoring of hypermobility

1 point for
-each hyperextending knee beyond 10 degrees
-each hyperextending elbow beyond 10 degrees
-each thumb that can touch forearm
-each fifth digit hyperextending beyond 90degrees at MCP joint
-if whole palm can be placed flat on the floor with straight legs

Maximum score of 9

Question 3

Hypermobility Syndromes:
Terminology?

Answer 3

Terminology
Generalised joint hypermobility (GJH)
Ehlers-Danlos Syndrome (EDS)

There are 13 forms of EDS
12 are rare
The most common if hypermobility EDS (hEDS)

Question 4

Hypermobility Syndromes:
Indications for specialist input?

Answer 4

-FHx of sudden death, cardiac disease, vascular issues, low force fractures or recurrent pneumothoracies
-wide atrophic scars, poor wound healing, recurrent hernias/pneumothoracies, severe scoliosis
-blue sclera, disabilities, dysmorphia, lens issues, skin fragility