Symptomatic joint hypermobility

Review written by Dr Xiaoqi Chen info

Key Points

  1. Joint hypermobility can be assessed using the Beighton scoring system which has a cut-off point of 5 out of 9. However, those who meet this cut-off point may be asymptomatic.
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BACKGROUND & OBJECTIVE

Generalized joint hypermobility (GJH) is hypermobility associated with multiple joints. The prevalence of GJH is up to 57% (1). The Beighton scoring system is the most reproducible assessment tool for hypermobility, with good inter-rater reliability (2). The original cut-off threshold for Beighton is 5 out of 9 (3), but confounding variables such as age, gender, training, injury, hormone status and ethnicity can impact the score.

Studies have tried to investigate why many people are hypermobile but asymptomatic, with minimal substantiation. In theory, a hypermobile joint is more dependent on musculotendinous function for stability, and failure of which may cause soft tissue strain/injury. Additionally, a hypermobile joint can alter the biomechanical function of the body, causing compensatory changes at other body areas and potential soft tissue irritation. Perhaps, those who are asymptomatic have adopted efficient biomechanical adaptation strategies over their lifetime. On the other hand, those who are symptomatic experience a range of symptoms of varying degrees including chronic pain, fatigue, disturbed joint proprioception, and soft tissue/joint trauma.

The prevalence of generalized joint hypermobility is up to 57%.
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Consistent physical activity is key to alleviate and/or prevent worsening of musculoskeletal symptoms.

Causes of Hypermobility and Diagnosis

The causes of joint hypermobility are multifactorial. Hypermobility can be influenced by a combination of environmental and genetic factors. It can be acquired and/or congenital. Joint hypermobility is associated with many heritable connective tissue disorders such as Ehlers-Danlos Syndrome (EDS),

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