Rheumatology: Hypermobility

Question 1

What is hypermobility?

Answer 1

A pain syndrome in people with joints that move beyond normal limits

It may affect any number of joints

Due to laxity of ligaments, capsules, tendons

Question 2

What are the symptoms and signs of hypermobility?

Answer 2

pain around the joints - worse after activity

soft tissue rheumatism e.g. epicondylitis

abnormal skin: papyraceous scars, hyperextensible, thin, striae

marfanoid habitus

arachnodactyly - fingers/toes abnormally long/slender

drooping eyelids, myopia

hernias and uterine/rectal prolapses

Question 3

What is the Beighton score?

Answer 3

Set of manoeuvres used to judge if there is evidence of joint hypermobility

1 point for all of the movements - L and R side

1. Can you put you hands flat on the floor with your knees straight?
2. Can you bend your elbows backward?
3. Can you bend your knee backwards?
4. Can you bend your thumb back on to the front of your forearm?
5. Can you bend your little finger up at 90 degrees to the back of your hand?

Question 4

How is hypermobility managed?

Answer 4

Strengthening exercises to reduce joint subluxation.

Work on posture and balance may also be needed.

Splinting and even surgical interventions may be needed.

Advice on pacing and goal setting may be helpful.

Specialist pain management input is often needed

Paracetamol