Joint Hypermobility Syndrome
Tongue to nose(Gorlins Sign)Tongue to nose(Gorlins Sign) Hypermobility-2
Joint laxity, hypermobility or supple (loose) joints is a very common condition affecting 10-25% people. The joints move beyond normal range and hence cause recurrent minor injuries to joints and adjacent structures (muscles, ligaments, etc). This leads to chronic pain at various sites which is usually mild and does not require treatment. Hypermobile joints can be an asset to some people such as dancers, musicians (particularly instrumentalists), gymnasts and yoga practitioners. It is neither arthritis nor any other disease, but is a natural variation in composition and flexibility of body tissues. Females are usually suppler than male counterparts

Features: Pain at various joints particularly hands, hips and knees after unusual activity is a common complaint of hypermobile people. Pain can disturb sleep at night and is relieved by morning. Sprains are frequent in ankle and other joints. Muscles and ligaments are prone to tear and joints can swell due to fluid. More laxity can lead to unstable joints and recurrent dislocations. Back pain and soft tissue rheumatism can also occur. Repetitive trauma and recurrent dislocations lead to joint damage and consequent degenerative arthritis. Some of these patients are very tall and slim with long and slender fingers. Skin can be thin and stretchy with scarring from minor cut injuries. Drooping eyelids, slanting eyes, short sightedness, varicose veins, hernia and prolapse of rectum or uterus are some other features that can be associated with this condition. You can find out whether you are hypermobile from Beighton Score (5 or more out of 9 points). You can still be hypermobile if you have less than 5 points along with some of the features mentioned above.

Genetic Causes: HypermobilityJoint hypermobility is called benign if the joints are not unstable. In rare cases joint hypermobility can indicate a more generalised and usually inherited disease such as Marfan’s syndrome (tall stature, long slender limbs, deformed spine and thoracic bones, problems of eyes and blood vessels, etc), Osteogenesis imperfecta (fragile bones) and Ehlers-Danlos syndrome (many subtypes). Many patients of these disorders have soft skin, easy bruising, dental crowding, high arched palate, hernias, and early osteoarthritis. Other organs such as eye, ears, large blood vessels and heart can also be involved. There are no confirmatory laboratory tests and genetic testing is very expensive. Avoidance of high impact joint activity and regular exercise are important in management of these diseases. Treatment: The pain due to hypermobile joints can be reduced with gentle strengthening exercises and pain killers like paracetamol. Stronger painkillers may be required if pain is more severe. Surgical stabilization of joints provides only temporary and partial improvement in most cases
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