Joint hypermobility

Hypermobility is a special condition of joints and other structures of the body, in which the amplitude of movements is much higher than normal. Usually, the flexibility and elasticity of hypermobile joints goes far beyond the natural, physiological flexibility of the body, and is considered by many specialists as an absolute pathology.

The degree of joint mobility depends on the elasticity of the joint capsule and its ability to stretch. This also applies to tendons and ligaments. Doctors do not have a single point of view on this problem. There are various numerous discussions on this matter. However, most are inclined to believe that this condition is pathological and requires treatment. The main argument in favor of this point of view is that this condition is often painful.

Joint hypermobility syndrome

The condition in which the joints are subject to excessive mobility and flexibility is called hypermobility syndrome. This condition occurs in both adults and children. It does not bypass even the elderly. At the same time, the distinctive feature is that this condition is characterized by pain and discomfort. It is on the basis of this criterion that the condition is classified as a pathological phenomenon. This condition is especially intense during physical exercise, after prolonged activity, and in young people during the period of intensive growth of bone structures. The main location of painful sensations is the legs. But often pain can also occur in the arms and even in the spine.

When it comes to joint hypermobility, we primarily mean increased mobility of the knee joint, since this is the most common pathology. However, today there are increasingly more cases of discomfort and increased mobility of the ankle joint. Doctors do not yet know how to explain such transformations.

Hypermobility syndrome is a looseness and excessive mobility syndrome.

This pathology is characterized by excessive extensibility of the ligamentous apparatus, which entails excessive mobility in the joint. Most often, this form of pathology affects the joints of the spine, which become loose. This pathology is detected quite rarely. The incidence rate does not exceed 1%. It often develops in combination with spondylolisthesis, which is accompanied by horizontal displacement of the vertebrae. It is often considered as one of the symptoms of this disease. Surgery may be required to stabilize the affected joint.

Epidemiology

It cannot be said that hypermobility is a rare condition. It occurs in about 15% of the population. At the same time, many do not even suspect that they have this condition, but consider it simply a property of the body, a naturally conditioned flexibility. Many consider this symptom to be a non-pathological separate condition, but simply weak ligaments. Indeed, it can be quite difficult to differentiate the symptoms of weak ligaments and tendons from hypermobility.

In children, the pathology is much more common than in adults and the elderly - approximately 9% of cases, while the adult population accounts for 4%. Among the elderly, this condition accounts for only 2% of cases. It is also worth noting that women are more susceptible to hypermobility than men. They have this pathology approximately 3.5 times more often than the male population. This syndrome often occurs in combination with other diseases and acts as one of the symptoms of another disease, most often related to the musculoskeletal system.

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Causes joint hypermobility

No researcher, much less a practicing physician, can give a clear answer to the question of what exactly is the cause of the pathology. The causes are still not fully understood. There are only assumptions and even individual theories that only slightly shed light on the origin and etiology of this pathology.

However, most scientists agree and tend to consider the cause at the molecular level. Thus, many experts believe that it is the excessive stretchability of collagen, which is an important component of tendons and muscles, that is the trigger in the development of such a condition. If the collagen fiber stretchability exceeds the normal values, we can say that the joint will have excessive mobility. This can provoke a large range of motion, at the same time provoking muscle weakness and disruption of the ligamentous apparatus.

According to another theory, the cause is a violation of metabolic processes in the body, and first of all, a violation of protein structures. There are suggestions that such changes are genetic in nature, or are due to the peculiarities of intrauterine development. There is also another point of view, according to which the cause of increased mobility should be considered a lack of vitamins, especially in childhood. Some believe that rapid, rapid weight gain and lagging muscle mass gain can cause excessive joint mobility. Various injuries and joint damage are also often the cause.

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Risk factors

The risk group includes people who suffer from various genetic anomalies and deviations, as well as those who are diagnosed with metabolic disorders. Protein metabolism disorders, vitamin deficiency, and protein synthesis disorders have a particularly negative effect on the condition of the joints. The risk group includes people who are quite tall, especially if their weight is insufficient. Rapid growth in childhood can also lead to hypermobility.

Excessive mobility also threatens athletes who are professional athletes, subjecting their bodies to excessive loads and constant fatigue. Taking anabolic steroids, doping, narcotic substances, and drugs intended for sports nutrition can also affect the condition of the joints and their mobility.

It is worth noting that many people involved in hand-to-hand combat, various forms of martial arts, practicing qigong, yoga, various Chinese health practices, also have excessive joint mobility. But in this regard, the question of whether such a condition is pathological remains controversial. The fact is that with such regular practice, a person does not feel pain and discomfort. Therefore, we can talk not about a pathological condition, but about the mobilization of internal reserves of the body, which allow a person to go beyond the usual capabilities of the body. When examining the joints of those who practice such practices, inflammatory and degenerative processes were not detected. On the contrary, rejuvenation and intensive tissue regeneration are noted.

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Pathogenesis

The pathogenesis is based on the disruption of natural biochemical processes in the body at the molecular level. At the same time, there is a disruption of the normal synthesis of collagen and other protein compounds. This entails a disruption of other types of metabolic processes in the body. Since it is collagen that provides mobility and extensibility of tissues, with its excessive synthesis or deposition in the body, excessive mobility and disruption of the processes of hardening and ossification are observed. Collagen can also provoke rapid aging and wear of the surface of tendons and ligaments, as a result of which they lose elasticity and resistance, and are easily subject to transformation and various types of mechanical impact.

Also, the softening of the surrounding soft tissues, which are not able to support the joint and provide it with mechanical strength, increases mobility. Swelling of soft tissues, effusion of synovial fluid, which arise for various reasons, becomes the factor that reduces strength and destroys the framework of the joint.

When conducting histological and cytological studies, it can be established that there are no inflammatory processes in the joint. However, a high level of regeneration and a condition close to post-traumatic tissue recovery are noted. The amount of collagen and elastin in the body also increases significantly. When examining the synovial fluid surrounding the joint, a reduced amount of protein and epithelial cells is noted.

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Symptoms joint hypermobility

First of all, this condition can be recognized by excessive, unnatural flexibility of the joints, which significantly exceeds the norm taking into account the age characteristics of the body, and significantly exceeds the capabilities of other people. For some people, this is simply a state of increased flexibility that does not bother a person and does not cause inconvenience. But for most, this is still a pathological condition that is accompanied by pain and discomfort.

Usually, a person has quite a lot of pain in the joint, and the pain intensifies in the evening and at night. However, many note that a slight pain syndrome is present during the day and even in the morning, after a person wakes up. With minor trauma or mechanical damage, the pain intensifies. With physical exertion, a feeling of increasing pain also occurs. Most often, the knee and ankle joints hurt. If this condition progresses and has been developing for a long time, a person's legs may twist and turn. This is especially noticeable in the morning, after sleep, and when a person is in a relaxed state.

Hypermobility can be recognized by frequent dislocations that accompany a person throughout life. At the same time, the peculiarity of many dislocations is that they are also easily and painlessly reduced, sometimes even spontaneously, when moving the joint, without outside help.

A sign that a person is developing hypermobility may also be synovitis, an inflammatory process in the joint area. The membrane lining the surface of the joint is subject to the most intense inflammation. Constant pain in the spine, especially in the thoracic region, should also cause concern.

Scoliosis, in which the spine is curved, can also be one of the signs of developing hypermobility. The distinctive feature is that a person is unable to take one position and stay in it for a long time. He is unable to control his joints. Even if he makes every effort to maintain the pose, after some time, spontaneous curvature will still occur. The appearance of muscle pain also makes it possible to suspect hypermobility in the early stages.

Hypermobility of the knee joints

This is the most common pathology that patients seek medical attention for. It occurs equally often in both children and adults. It is characterized by an increased feeling of discomfort and pain. The pain is mainly localized in the knee area, but it can also spread to the ankle joint. The pain intensifies after physical exertion. The pain is also quite severe during the period of bone growth.

In people who are professional athletes and constantly put a lot of stress on their legs, the pain is associated with swelling of soft tissues. Synovial fluid effusion is also quite common.

During histological examination, the inflammatory process is not diagnosed. The general clinical picture has many similarities with the consequences of trauma. Significant differences are also characteristic of the composition of the synovial fluid. It is possible to detect a large amount of protein. Various cells are also present, for example, epithelial. The degree of damage to tissue structures remains within the normal range, therefore, with an average degree of severity of the pathological process, a person can continue to play sports.

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Hypermobility of the patella

The main complaint is pain. This pathology can manifest itself at any age. The symptoms are quite varied and are often disguised as symptoms of another disease. Differential diagnostics with many genetic and congenital joint anomalies is almost always required. It is usually difficult for a doctor to immediately identify the pathology, so diagnosis and further treatment are most often based on the patient's initial complaints.

The interesting thing is that the "golden mean" in this pathology is extremely rare. Usually, a person either does not feel any symptoms, except for increased mobility and flexibility, or suffers from spasms and severe pain syndrome, which gives grounds to suspect a serious genetic anomaly. Therefore, in order to make a correct diagnosis, a good diagnostician is required.

The main diagnostic method is an examination, which includes a physical examination using classical clinical methods, as well as additional functional tests that allow you to assess the condition and degree of flexibility of the joints. Laboratory and instrumental methods are rarely used. Basically, they are used when there is a suspicion of inflammation or the presence of concomitant diseases. The main assessment method is the Beighton scale, which allows you to assess flexibility on a 9-point scale. In this case, the patient is asked to perform 3 simple movements for flexibility.

Hip hypermobility

This pathology is excessive flexibility and mobility of the hip joints. It is most often found in childhood. Girls are most susceptible to this pathology. The share of morbidity among girls accounts for approximately 80% of the pathology. Most researchers believe that the disease is genetically determined. Cases of familial morbidity account for approximately a third of cases. The pathogenesis is usually based on a violation of the metabolism of collagen structures.

Treatment is mainly osteopathic. Most often, 2-3 sessions are enough to eliminate the pathology. After such sessions, the range of motion returns to normal, excess muscle tension is eliminated, and metabolic processes in the surrounding tissues are normalized.

The most common complication of excessive mobility of the pelvic joints is dislocation and subluxation of the hip. This is often a congenital anomaly that is much more common in children who were born in a breech position.

Hypermobility can also be due to the bone itself, a violation of elasticity or integrity of the ligamentous apparatus, pathological phenomena. Sometimes the normal development of the bone and its location in the horizontal plane are disrupted.

It is important to detect the pathology in a timely manner and begin treatment. Then many serious complications can be avoided. At the same time, such early manifestations as shortening of one leg in a child against the background of normal sizes of the other leg are considered as the first alarming signs. The following are considered alarming signs: the appearance of an additional fold on the thigh in an infant, complete symmetry of the gluteal folds and buttocks, as well as the presence of an extraneous sound when moving the knee to the side.

Treatment is mainly limited to therapeutic exercise, the use of individual techniques of active-passive gymnastics, and timely massage. In rare cases, medication is required. It is mainly aimed at eliminating symptoms.

Hypermobility of the shoulder joint

Increased mobility of the shoulder joint is quite common. The cause is a violation of protein metabolism and a decrease in the tone of the skeletal muscles that ensure joint mobility. Weakness of the ligamentous apparatus is also noted. The anamnesis includes joint pain, increased sensitivity to physical activity, and frequent injuries. Joint dislocation is especially common. In this case, an increased amplitude of motion in the joint and excessive range of motion are noted.

In this case, there are joint manifestations of this pathology, and extra-articular ones. The first form of pathology is characterized by increased mobility of the joints.

The extra-articular form of pathology is characterized by the presence of an inflammatory process in other, nearby areas. In this case, increased mobility is often accompanied by arthralgia and myalgia. There may be a feeling of pain, heaviness, pressure in the joint area, but no other pathology is detected during palpation. In most cases, it is also impossible to visualize the pathology. A characteristic feature is that the pain intensifies during massage, but after some time after completing the full course of treatment, the condition improves. Often, the severity of the pain syndrome depends on the emotional state of a person, general well-being, and concomitant pathologies. It can occur in acute or chronic form, accompanied by frequent dislocations and subluxations.

Also, one of the signs of shoulder joint pathology is pain that occurs in the joint itself, gradually spreading to the entire shoulder, shoulder blade and sternum area. This process is accompanied by increased skin stretchability and its excessive flexibility and vulnerability. This pathology is especially dangerous for people suffering from heart problems and normal blood circulation.

Elbow hypermobility

This condition can be congenital or acquired. Most often, congenital anomalies are genetically determined or caused by pathologies of intrauterine development, birth trauma. There are cases of familial hypermobility.

Acquired ones are most often the result of trauma, injury, excessive training. This is the main professional disease for dancers, ballerinas, athletes. This pathology develops especially intensively in people who initially have high rates of natural flexibility. Also, excessive joint mobility can develop against the background of diseases of the musculoskeletal system, other diseases. Mobility increases significantly against the background of pregnancy.

The main complaint of patients, in addition to the high amplitude of movements, is pain and discomfort in the area of the damaged joint. The pathogenesis is based on a violation of metabolic processes in the joint, as well as a violation of the normal synthesis of collagen structures.

Diagnosis is most often based on the clinical picture. Laboratory and instrumental studies are also prescribed if necessary. Usually, a general physical examination and several tests for joint mobility and flexibility are sufficient to establish a diagnosis.

Treatment is mainly complex, including physiotherapy procedures, exercise therapy, massage, and drug therapy. Surgical methods are used extremely rarely, they are considered ineffective.

Hypermobility of the temporomandibular joint

Patients suffering from this disease present numerous complaints. Most of them are caused by morphological and structural changes in the joint itself. Patients often have excessive mobility in the joint area, which is accompanied by pain and discomfort. This condition is especially aggravated by talking, chewing, and swallowing. If you suspect hypermobility, you should consult a doctor. An orthopedic dentist will help. It is important to receive comprehensive treatment as soon as possible, since a dangerous complication is considered to be a violation of the normal structure and localization of the masticatory muscles. Muscle tone also decreases. The process may be accompanied by a violation of the trophism of the masticatory muscles, a violation of the functional state of the facial muscles. Inflammation and an infectious process often develop. In this case, the danger is that a joint dislocation may develop.

Complications and consequences

Hypermobility can have complications, for example, a person with such a pathology often has dislocations, subluxations, sprains of joints and ligaments. Such people are more often than others subject to sprains and injuries. With excessive mobility of the knee or ankle joint, disability can develop, since when a person leans on the leg, it twists, which can end in a dislocation, severe injury, weakening of the muscles. The extreme stage of muscle weakness is myositis, atrophy, which lead to partial or complete paralysis.

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Diagnostics joint hypermobility

In order to diagnose a condition such as hypermobility, it is necessary to contact a qualified specialist who specializes in the treatment of joints, limbs, muscles. You can contact your local therapist, who will then refer you for a consultation with the necessary specialist.

In order to make a diagnosis, anamnesis is usually enough. First, the doctor collects anamnesis of life, which can already say a lot about the person, about his lifestyle. From this, based on the analysis of data, the doctor can draw a conclusion about possible concomitant pathologies, the causes of such a condition. Often, having identified the cause, the doctor eliminates it, and this is enough to completely cure the person.

During the appointment, the doctor also collects a medical history, that is, finds out what exactly is bothering the person, receives a detailed description of the symptoms, finds out how long the disease has been bothering, what were its first signs, whether relatives and parents have a similar condition. It is also important to find out whether there are factors that increase mobility, or, on the contrary, decrease it? Is there pain, what is its nature, features of manifestation, severity.

Then, using classical research methods - palpation, percussion, the doctor conducts an examination - feels, listens to possible pathologies. Special diagnostic tests are also carried out, which help to accurately determine the cause and degree of development of the pathology. Various physical exercises are used as diagnostic tests, which demonstrate the flexibility of the joints, their mobility. Usually, based on these tests, it is possible to draw a line between the pathological and natural state, to identify existing injuries and damage.

The most common tests are: the patient is asked to touch the inside of the forearm with his thumb. If a person is flexible enough, he will not be able to do this exercise.

After this, they ask you to touch the outside of your hand with your little finger. This exercise can also only be performed by a person with excessively flexible joints.

In the third stage, the person stands up and tries to reach the floor with his hands. The knees must not be bent. And finally, the fourth test notes the condition and position of the elbows and limbs with the arms and legs fully straightened. With hypermobility, the elbows and knees will bend in the opposite direction.

Usually, such a study is sufficient to make a diagnosis. Additional methods may be required only if there is a suspicion of any additional pathology, for example, an inflammatory or degenerative process, a disorder of connective or epithelial tissue.

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Tests

First of all, clinical tests (standard) are prescribed. This is a clinical blood and urine test. They give an approximate idea of the direction of the main processes in the body, make it possible to suspect pathologies and develop the most effective program for further diagnostics, which will help to identify pathological processes and take the necessary measures.

A clinical blood test can show the presence of an inflammatory process, a viral or bacterial infection, allergic reactions. The most important diagnostic indicators are the level of leukocytes and the leukocyte formula. During an inflammatory process, ESR increases sharply, the number of lymphocytes and the total number of leukocytes increases. A shift in the leukocyte formula to the left is observed.

A urine test may also be required, since urine is a biological fluid that contains the end products of metabolism. A negative sign indicating the development of inflammatory processes in the body and inflammation of the connective and epithelial tissue is the presence of glucose or protein in the urine.

Inflammatory and degenerative processes may be accompanied by leukocyturia. This is a condition in which the number of leukocytes in the urine increases sharply.

If an inflammatory process of bacterial origin is suspected, there is a need for a bacteriological study. Standard methods of bacteriological seeding are used, in which the culture is sown, then incubated, which makes it possible to isolate the pathogen and determine its quantitative and qualitative characteristics. It is also possible to conduct an antibiotic sensitivity test, which makes it possible to select the optimal treatment and determine the most sensitive antibiotic and its required dosage. The object of the study is blood, urine, inflammatory exudate, synovial (joint) fluid.

In order to obtain synovial fluid, a puncture is performed with subsequent collection of biological material. If there is a suspicion of hyperplasia and the development of a malignant or benign neoplasm, a biopsy with tissue sampling may be required. Then a cytoscopy is performed, during which the obtained material is stained, exposed to various biochemical markers, and the morphological features and cytological structure of the cell are determined. To conduct a histological analysis, sowing is done on special nutrient media intended for tissue growth. Based on the nature and direction of growth, the main characteristics of the tumor are determined, and appropriate conclusions are made.

Additionally, an analysis of the quantitative and qualitative content of vitamins in the blood and body tissues may be required. Specialized biochemical tests may be required, in particular, a test for the content of proteins, proteins, individual amino acids, microorganisms in the blood, their quantitative, qualitative characteristics, as well as the ratio.

Often, with hypermobility, especially if it is accompanied by pain and discomfort in the joints, rheumatic tests are prescribed. In addition, it is advisable to undergo these tests for preventive purposes, at least once a year. They allow identifying many inflammatory, degenerative, necrotic, autoimmune processes at early stages. Basically, they evaluate the indicators of C-reactive protein, rheumatoid factor, antistreptolysins, seromucoids. It is important to determine not only their quantity, but also the ratio. Also, with the help of this analysis, it is possible to monitor the treatment process, if necessary, make certain adjustments to it.

Rheumatoid factor is an indicator of an acute pathological process in the body. A healthy person does not have rheumatoid factor. Its presence in the blood is a sign of an inflammatory disease of any etiology and localization. This often occurs with rheumatoid arthritis, hepatitis, mononucleosis, autoimmune diseases.

Antistreptolysin aslo is a factor aimed at lysis (elimination) of streptococcal infection. That is, its growth occurs with an increased content of streptococci. It may indicate the development of an inflammatory process in the joint capsule, soft tissues.

Determination of the level of seromucoids in hypermobility can play a very important role. The importance of this method is that it allows the disease to be detected long before it manifests itself clinically, so that measures can be taken to prevent it.

The amount of seromucoids increases against the background of inflammation. This has an important diagnostic value in many pathological conditions, sluggish inflammations that practically do not bother a person and are difficult to detect by clinical methods.

C-reactive protein is one of the indicators of an acute inflammatory process. An increase in the amount of this protein in the plasma indicates the development of inflammation. If, against the background of the treatment, the level decreases, this indicates the effectiveness of the treatment. It is necessary to take into account that the protein only shows the acute stage of the disease. If the disease has become chronic, the amount of protein becomes normal.

If it is not possible to fully establish the cause or clinical picture based on the available data, an immunogram may be additionally prescribed, which reveals the main indicators of the immune system.

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Instrumental diagnostics

It is used if the doctor was unable to establish an accurate diagnosis during the diagnostic examination, and also if the doctor suspects inflammation of soft tissues, joint capsule, or the development of other concomitant pathologies. Most often, X-ray examination, computed tomography, and magnetic resonance imaging are performed.

X-rays can be used to illuminate bones, see damage, injuries or pathologies in bones. This method is especially effective if it is necessary to visualize bone fractures, displacement and pinching of nerves, bone spurs, and even arthritis.

CT and MRI can be used to examine soft tissues. Muscles, ligaments, tendons, and even cartilage and surrounding soft tissues are well visualized.

If there is a suspicion of a violation of metabolic processes in muscles, as well as a suspicion of nerve damage, EMNG is used - the method of electromyoneurography. With the help of this method, it is possible to assess the extent to which nerve conductivity and excitability of muscle tissue are impaired. It is assessed by the indicators of nerve impulse conductivity.

Differential diagnosis

Often hypermobility has to be differentiated from natural human flexibility and other pathological conditions that have similar features. To establish a differential diagnosis, it is necessary to differentiate the condition from genetic and acquired pathologies. This is especially relevant in the case of generalized joint laxity.

The first step towards successful differentiation is the need to differentiate from connective tissue pathologies. For this, a standard clinical examination is used. The most informative method is palpation. A standard physical examination is also mandatory. Various functional tests are used.

Some congenital anomalies can be recognized by their characteristic clinical picture.

Ehlers-Danlos syndrome is a unique disease, which is a group of connective tissue diseases. Some symptoms border on connective tissue pathology and skin pathology. Skin pathology can be quite diverse. Anomalies vary widely: from excessive softness to hyperelasticity, accompanied by ruptures and bruises. Gradually, this condition leads to the formation of scars, softening and increased elasticity and mobility of ligaments, muscles and bones.

Often this condition is accompanied by pain, effusion, dislocation of joints and bone structures. The main complication is instability of the legs, in which a person cannot rely on the lower limbs. Most often it is inherited.

It is extremely important to differentiate Ehlers-Danlos syndrome stage IV from hypermobility, since this syndrome is a serious danger to the body and is a life-threatening condition. This syndrome is dangerous because it can lead to spontaneous rupture of blood vessels, in particular, arteries. Rupture of the vena cava and parenchymatous organs also occurs. This condition is especially dangerous for women during pregnancy, since uterine rupture may occur. The condition is caused by a defect in collagen synthesis.

At the second stage, it is important to differentiate from Marfan syndrome, which is a disorder characterized by increased mobility not only in the joints, but also in other organs. The person also has a peculiar appearance. A person suffering from this syndrome is abnormally tall, has long limbs that are disproportionate to the body. The body is thin, the fingers are long. Eye anomalies such as myopia and joint misalignment are also characteristic.

The disorders are caused by a disruption of fibrillin metabolism in the body. This is a special glycoprotein complex, which is the most important component of connective tissue. It is also extremely important to recognize this pathology in a timely manner, since it can act as a threat to human life. Thus, a dangerous complication is an aneurysm or dissection of the aorta, regurgitation of the aortic canal, prolapse of the mitral valve.

Basically, such pathology is detected in childhood. If this syndrome is suspected, it is necessary to undergo a comprehensive examination. A laboratory study is mandatory. It is important to analyze the amino acid composition of blood plasma. It is important to exclude homocytinuria, metabolic disorders. Marfan syndrome also requires additional differentiation. It is important to differentiate it from homocystinuria. A distinctive feature of the second pathology is mental retardation.

Differentiation with osteogenesis is carried out. A distinctive feature of this disease is the excessive thinness of the sclera, as well as the presence of a blue tint in the color of the sclera. Bones become increasingly fragile, and a person often has fractures. There are lethal and non-lethal forms of this disease. It can also be distinguished by the short stature of a person. The lethal form is associated with high bone fragility, which is incompatible with life. Non-lethal forms are characterized by a lesser severity of these symptoms, which do not pose a mortal danger. Complications to the heart and deafness may develop.

Stickler syndrome differs from hypermobility in that, against the background of increased joint mobility, a person develops peculiar facial features. The zygomatic bone undergoes changes, the bridge of the nose is depressed. Sensorineural hearing loss can also develop. Most often manifests itself in infancy. Such children also suffer from respiratory pathologies. In older children, arthritis develops as a concomitant disease, which usually tends to progress, and progresses until adolescence.

Williams syndrome is also similar to hypermobility in many ways, but differs in that it develops against the background of mental and physical developmental delay. It is also diagnosed mainly in children. Associated pathologies include heart and vascular dysfunction. Joint contracture may develop in adulthood. A distinctive feature is a rough voice and short stature. A dangerous complication is aortic stenosis, vascular stenosis, and heart disease.

Joint hypermobility test

The data are variable, and this should be taken into account when making a diagnosis. It is important to consider the anamnesis: individual characteristics of the person, age, gender, condition of the skeletal and muscular system of the person. The physiological state of the person is also important. For example, in young people the assessment on this scale will normally be much higher than in elderly people. Also, during pregnancy, the normal values can change significantly.

It is important to consider that excessive flexibility in one or two joints does not indicate pathology. The presence of the disease can be judged by the presence of generalized flexibility that occurs at the level of the entire body.

The presence of a genetic pathology can be discussed if there is a combination of several signs. This is the basis for conducting a genetic analysis, on the basis of which certain conclusions can already be made.

Beighton scale

Thanks to it, it is possible to determine the severity of hypermobility. It is used for diagnostics at the joint level. The mobility of each of them is assessed in points, then the result is summed up and compared with the scale.

The Beighton scale includes 5 criteria, based on which the condition is assessed. First, passive extension of the joints is assessed. If a person can extend it by 90 degrees, we can talk about hypermobility.

The second indicator is passive pressing of the thumb to the inner side of the forearm. Normally, hyperextension in the elbow and knee joints should not exceed 10 degrees. The downward tilt is also assessed. The legs should be straight, and the person should touch the floor with their hands. Usually, the score should not exceed 4 points. However, there are cases when girls demonstrate results above 4 points, and this is not considered a pathology. This is especially true for young girls aged 16 to 20 years who are involved in various sports.

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Treatment joint hypermobility

The treatment of hypermobility is based on pathogenetic treatment aimed at eliminating the pathological process in the body. Sometimes, at early stages, etiological treatment is used, which is based on eliminating the cause that led to the violation of normal joint mobility. Pathogenetic treatment is used if the diagnosis is accurately established and the clinical picture of the pathology is clearly visible. In this case, the course of treatment is monitored using various laboratory and instrumental research methods. A change in the results for the better indicates the effectiveness of the treatment.

Prevention

Prevention is based on a healthy lifestyle. It is necessary to maintain an optimal level of physical activity. You need to sleep on a hard surface or using special orthopedic mattresses. It is important to do physical exercises that strengthen the dorsal muscles. Swimming and tennis are good for this. It is necessary to undergo preventive massage courses. If you are prone to hypermobility, you should periodically take courses of muscle relaxants. When the first signs appear, you need to see a doctor as soon as possible and undergo symptomatic therapy.

In order to detect pathology at early stages and take timely measures, it is necessary to undergo preventive medical examinations, take laboratory tests, especially rheumatic tests. It is recommended to take them at least once a year for people over 25 years old. This is especially true for people with problems with the musculoskeletal system.

To prevent relapses, after the disease, it is necessary to strictly follow the doctor's recommendations and undergo a full course of rehabilitation. It is necessary to understand that rehabilitation is long-term. In addition, this pathology requires constant monitoring. It is necessary to take measures aimed at correcting existing deformations and preventing the formation of new ones. It is important to strengthen the muscles located along the spine.

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Forecast

For many children, the prognosis is favorable - hypermobility usually disappears in adolescence. With adults, things are different. They have hypermobility, in most cases, they need to be treated. If treatment is started in a timely manner, the prognosis can be favorable. In the absence of adequate therapy, serious complications can occur: inflammatory, degenerative processes in the joints. Complications to the heart often develop, the central nervous system is disrupted.

Joint hypermobility and the army

Hypermobility can be the basis for a deferment or unsuitability for military service only by decision of the commission examining the conscript. It is impossible to answer this question unequivocally, since the problem is approached comprehensively: the severity of the pathology, the limitation of the main functions of the body, the impact on performance, physical activity are taken into account.

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