Contemporary approach to joint hypermobility and related disorders

被引:66
作者
Castori, Marco [1 ]
Hakim, Alan [2 ]
机构
[1] IRCCS, Casa Sollievo Sofferenza, Div Med Genet, Viale Cappuccini Snc, I-71013 San Giovanni Rotondo, Foggia, Italy
[2] Hosp St John & St Elizabeth, Hypermobil Unit, London, England
关键词
Ehlers-Danlos syndrome; international classification; joint hypermobility; management; nosology; EHLERS-DANLOS-SYNDROME; MUSCULOSKELETAL COMPLAINTS; CONNECTIVE-TISSUE; NATURAL-HISTORY; CHRONIC-FATIGUE; MANIFESTATIONS; MANAGEMENT; DIAGNOSIS; CRITERIA; ADULTS;
D O I
10.1097/MOP.0000000000000541
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Purpose of reviewJoint hypermobility is a common, although largely ignored physical sign. Joint hypermobility is often asymptomatic but may be a feature of an underlying genetic disorder with systemic manifestations. The present article presents a comprehensive approach to considering joint hypermobility and clinically related issues in children and adults.Recent findingsEhlers-Danlos syndrome (EDS) is an umbrella term for various Mendelian connective tissue disorders sharing joint hypermobility, skin hyperextensibility, and tissue fragility. Hypermobile EDS is the default diagnosis in many individuals and still lacks of any confirmatory test. There is also a continuous spectrum of phenotypes between asymptomatic, nonsyndromic joint hypermobility, and hypermobile EDS. In 2017, a new international classification of EDSs, joint hypermobility, and related disorders was published. EDSs are now classified in 13 different variants because of mutations in 19 genes. The gap between joint hypermobility and hypermobile EDS is filled by the descriptive diagnosis of hypermobility spectrum disorders'. Alongside the new criteria recommendations for the assessment and management of selected issues related to joint hypermobility such as fatigue and physical therapy have also been published by expert panels.SummaryAsymptomatic, nonsyndromic joint hypermobility, hypermobility spectrum disorders and EDS (particularly, the hypermobile type) are the most common phenotypes in children and adults with joint hypermobility. Their prompt recognition is crucial to the appropriate application of evidence-based management and the reduction in burden of ill health.
引用
收藏
页码:640 / 649
页数:10
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