Beighton Criteria Research Articles

Abstract WP187: Diagnostic Significance of Connective Tissue Dysplasia Signs in Patients With Cervical Artery Dissection

Introduction: Cervical artery dissection (CeAD) is the most frequent cause of ischemic stroke in young adults. It is suggested that connective tissue dysplasia (CTD) underlies in the arterial wall weakness predisposing to dissection. The aim : to elucidate CTD signs that have prognostic and diagnostic significance for CeAD. Methods: We examined 80 patients (mean age 38,5±13,5; 49 females, 61,2%) with CeAD, verified by MRI/MRA and 20 healthy volunteers (mean age 30,3±6,7; 12 females 60%). We assessed 48 signs selected from criteria of the vascular type of Ehlers-Danlos syndrome, Marfan syndrome, Beighton criteria of joint hypermobility and other. In addition we estimated arterial hypotension (≤100/70 mm Hg), and headache in the past history. Each sign was counted as present or absent, resulting in an individual CTD score. On the basis of linear regression analysis these signs were divided into major and minor signs. Results: CTD signs were found more frequently in CeAD patients than in the control (mean score 7,9 ± 3,6 vs 4,6 ± 2,5; p<0.0039). The following CTD signs were significantly more often in patients than in control: arterial hypotension (51% vs 20%, Р=0,018), extensive bruising (40% vs 10%, Р=0,016), widened atrophic scars (23% vs 0%, Р=0,02), headache in the past history (60% vs 35%, p=0,027) - major signs; translucent skin (29% vs 5%, Р=0,037), hight palate (20% vs 0%, Р=0,037), nasal bleeding (34% vs 15%, Р=0,044), blue sclera (20% vs 5%, Р=0,05), propensity to constipation (30% vs 0%, Р=0,05) - minor signs. If there were 4 major and 2 small signs logistic regression model gave 75% predictive value of dissection. The reliability of these signs was confirmed by ROC analysis (AUC 0,90 [95% CI 0,84-0,96], sensitivity - 86%, specificity - 85%). Conclusion: CTD signs are highly prevalent in patients with CeAD that is in accordance with our morphological data that arterial wall dysplasia is a main cause of spontaneous dissection. The presence of 4 major and 2 minor signs may be used to estimate the predisposition to CeAD and in some cases as additional argument at clinical diagnosis.

Markers of connective tissue dysplasia in cervical artery dissection and its predisposing factors

Introduction . C ervical artery dissection (CeAD) is the most frequent cause of ischemic stroke in young adults. Arterial wall dysplasia underlies its weakness and predisposes to dissection. Objective . To assess clinical signs of connective tissue dysplasia (CTD) in patients with CeAD using special criteria of CTD, and to evaluate predisposing factors for the CeAD development. Materials and methods. We examined 80 patients (mean age 38,5±13,5; 49 females) with CeAD, verified by MRI/MRA and20 healthy volunteers . We estimated 48 signs of CTD included in the Villefranche diagnostic criteria for the vascular type of Ehlers – Danlos syndrome, the Ghent criteria for Marfan syndrome, the Beighton criteria of joint hypermobility and some others, as well as history of headache. Each sign was counted as present or absent, yielding the individual and mean CTD group scores. Results. Clinical CTD signs were more frequently detected in patients with CeAD than in controls (mean score 7.9 ± 3.6 vs. 4.6 ± 2.5; p < 0.0039). Significant signs (more than 8 points) were present in 53% of patients. Regression analysis was performed to determine diagnostic-prognostic value of CTD signs. The main diagnostic criteria included history of headache (p=0.022), arterial hypotension (р=0.012), extensive bruising (р=0.011), and widened atrophic scars (р=0.019). The additional diagnostic criteria included translucent skin (р=0.034), high palate (р=0.034), predisposition to constipation (р=0.050), nasal bleeding (р=0.043), and blue sclera (р=0.050). In the presence of the 4 main and 2 additional criteria, the predictive value of dissection according to regression model is 75 – 77% (ROC analysis: AUC 0.90, 95% CI, 0.84–0.96). Most patients 97% had various predisposing factors of CeAD development, either isolated 47% or combined 50% . Conclusions. The presence of the 4 main and 2 additional diagnostic criteria of CTD has a high predictive value of CeAD and can be used as its diagnostic-prognostic criteria. Dissection of the arterial wall with signs of dysplasia is provoked by various additional factors.

Aetiopathogenesis of cuff-tear arthropathy: Could juvenile joint laxity be considered a predisposing factor?

Although many hypotheses have been formulated, aetiopathogenesis of cuff-tear arthropathy (CTA) is still motive for discussion. Since prevalence of CTA is notoriously higher in women, as is joint hypermobility, we hypothesised a possible correlation between the two conditions. One hundred thirty-three (n = 133) consecutive patients with glenohumeral osteoarthritis [48men, 85 women; mean age (SD) 72.32 (7.05)] were divided into two groups: Groups 1 (CTA) and 2 (concentric shoulder arthropathy) comprised 71 (22men, 49 women) and 62 (26men, 36 women), respectively. The presence of current or previous joint hypermobility was assessed using two standardised methodologies: the Beighton criteria score, and a five-item self-report questionnaire. Data were submitted to statistical analysis. A moderate association between Beighton criteria and the five-item self-report (φ = 0.481, p < 0.001) was detected. Beighton criteria led to a diagnosis of joint hypermobility in 16 patients (22.5%) in Group 1 and 15 (24.2%) in Group 2. According to five-item self-report questionnaire, juvenile joint laxity was diagnosed in 11 (15.5%) and 12 (19.4%) patients in Groups 1 and 2, respectively. No significant association between groups and the Beighton criteria [χ2(1) = 0.051, p = 0.82] and five-item self-report questionnaire [χ2(1) = 0.67, p = 0.41] was found. Juvenile joint hyperlaxity is not a predisposing factor for cuff arthropathy. Further studies will be needed to explain CTA aetiopathogenesis. III.

Generalized Hypermobility, Knee Hyperextension, and Outcomes After Anterior Cruciate Ligament Reconstruction: Prospective, Case-Control Study With Mean 6 Years Follow-up

To determine whether generalized hypermobility and contralateral knee hyperextension affect failure rates and patient-related outcomes after anterior cruciate ligament reconstruction (ACLR). A total of 226 consecutive patients presenting with acute ACL tears were prospectively evaluated for generalized hypermobility by a modified Beighton criteria. Minimum 2-year follow-up was achieved for 183 knees (81%). Patients underwent ACLR with either bone-patellar-tendon (BPTB) autograft (n= 46), quadrupled hamstring (HT) autograft (n= 85), or allograft tissue (n=52). KT-1000 measurements, International Knee Documentation Committee (IKDC), Cincinnati, and Lysholm scores were obtained. Forty-one of 183 consecutive patients were categorized as hypermobile. At mean 6years' follow-up (range 2-12.5years), IKDC (P= .003), Cincinnati (P= .001), and Lysholm scores (P < .001) were significantly better in the Non-Hypermobile group for patients with an intact graft. The failure rate was higher in the Hypermobile group (10knees, 24.4% failure rate) compared with the Nonhypermobile group (11 knees, 7.7% failure rate) (P= .006). The overall ACL injury rate (ACL graft injury, excessive graft laxity, plus contralateral ACL tear) was higher in the Hypermobile group (34.1%) compared with the Nonhypermobile group (12.0%) (P= .002). Heel height >5cm(P= .009) and fifth metacarpophalangeal (MCP) extension >90° (P= .006) were independently predictive of failure for the entire study population. Graft failure rates were higher and inferior subjective outcomes were observed after ACLR in patients with generalized hypermobility. Heel height and fifth MCP hyperextension were most predictive of ACL injury/reinjury and poorer outcome scores. Nearly one-third of hypermobile patients sustained a contralateral ACL tear, ipsilateral graft failure, or had excessive graft laxity. Level III, case control study.

Utility of Dynamic Sonographic Evaluation of Left Knee Pain &amp; Locking in a Softball Catcher

HISTORY: An 18 year-old softball catcher presenting with a 3 year history of left progressive postero-lateral knee discomfort with associated knee locking when squatting or deep knee flexion. Onset was 3 years ago when she was in a squat position during a softball game. She had been avoiding aggravating activities and initially sought medical care 3 months ago, presenting to an orthopedic specialist’s clinic. Following a negative MRI, she was referred to our clinic for diagnostic ultrasound of the knee. She reported no reliable way to reproduce locking, but, when locking does occur, she must manually unlock herself. Previous treatment included 8 weeks of physical therapy without benefit. PHYSICAL EXAMINATION: No discoloration or swelling of the left knee. Non-antalgic gait. Valgus alignment with dynamic valgus on single leg squat. Posterior lateral joint line tenderness. No other focal tenderness. Full and symmetric bilateral knee active range of motion without pain, except in terminal flexion. Negative McMurray’s, cruciate and collateral ligament testing and dial test. 9/9 Beighton criteria. DIFFERENTIAL DIAGNOSIS: 1. Meniscocapsular separation 2. Lateral meniscus injury 3. Proximal tibiofibular ligament injury 4. Popliteus muscle/tendon injury 5. Anteriolateral complex sprain 6. PFL injury TEST AND RESULTS: MRI: Subtle irregularity of posterior superior meniscocapsular fascicle deemed secondary to volume-averaging artifact. Otherwise, no discrete pathology was noted. Ultrasound: No discrete lesion of entirety of lateral meniscus on static exam. Development of a separation (3.1mm) between posterior knee capsular tissue and posterior outermost fiber of left lateral meniscus when knee is in near full flexion. FINAL WORKING DIAGNOSIS: left postero-lateral meniscocapsular separation TREATMENT AND OUTCOMES: Management options (expectant management, injection options to mitigate pain, and a surgery) were discussed. Patient elected surgical fixation of lateral meniscus. Arthroscopic fixation of lateral meniscus with 2 vertical mattress sutures using a FasTFix device was performed. After 4 weeks of bracing to allow proper surgical healing, she was able to start using an elliptical at 6 weeks and jogging at 9 weeks. She remains void of pre-surgical pain and locking at 16 weeks post-operatively.

Investigation of joint hypermobility in individuals with hyperbilirubinemia.

Benign joint hypermobility syndrome refers to hypermobile individuals with musculoskeletal symptoms in the absence of any systemic rheumatic disease; its prevalence is approximately 0.5%. In animal studies, bilirubin has been shown to reduce fibrosis induced by bleomycin. It has been suggested that bilirubin leads to hypermobility that affects the structure or function of collagen. In addition, our observation is that hypermobility occurs more often in patients with indirect hyperbilirubinemia. In this study, we aimed to evaluate hypermobility in patients with indirect hyperbilirubinemia. We recruited 120 consecutive patients with indirect hyperbilirubinemia from a tertiary gastroenterology outpatient clinic and examined them for hypermobility. Hypermobility was evaluated using the Beighton criteria, and other relevant clinical findings were recorded. In addition, a group of healthy individuals (n=107) without hyperbilirubinemia were included as controls. The mean ages of the patients and controls were 33.4±12.9 and 36.2±11.2 years, respectively (p=0.09). In total, 100 (83%) patients and 78 (73%) controls were male (p=0.075). The mean indirect bilirubin levels were 1.44±0.66 mg/dL in the patient group and 0.37±0.18 mg/dL in the control group. Based on the Beighton score, 23 patients (19.2%) in the patient group and 3 (2.8%) individuals in the control group had joint hypermobility. The difference between the groups was statistically significant (p<0.001). According to the results of our study, findings of joint hypermobility are more frequent in patients with indirect hyperbilirubinemia than in controls.

Modified Broström Procedure for Chronic Lateral Ankle Instability in Patients With Generalized Joint Laxity

Background: Generalized joint laxity (GJL) has been considered a risk factor for late failure of ligament reconstruction in the knee; however, it is not known whether GJL is the cause of recurrent instability after the modified Broström procedure for chronic lateral ankle instability. Purpose: To compare the clinical results of the modified Broström procedure for chronic lateral ankle instability in patients with or without GJL. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 100 patients (100 ankles) who underwent the modified Broström procedure were divided into 2 groups, with or without GJL, according to the Beighton criteria. Age and body mass index were matched between the 2 groups. The mean follow-up duration was 43.3 months in the laxity group (44 ankles; Beighton score ≥5) and 42.9 months in the nonlaxity group (56 ankles). Results: The mean preoperative Karlsson and American Orthopaedic Foot and Ankle Society (AOFAS) scores were a respective 53.2 and 60.9 in the laxity group and 53.9 and 62.6 in the nonlaxity group, and these scores improved to 87.4 and 89.5, respectively, in the laxity group and to 94.1 and 94.8, respectively, in the nonlaxity group at final follow-up. The mean preoperative talar tilt angle and anterior talar translation were a respective 12.5° and 8.8 mm in the laxity group and 10.8° and 8.5 mm in the nonlaxity group, and these values improved to 7.3° and 6.0 mm, respectively, in the laxity group and to 5.2° and 5.0 mm, respectively, in the nonlaxity group at final follow-up. Failure rates were 11.4% (5 patients) in the laxity group and 1.8% (1 patient) in the nonlaxity group. Significant differences were found between the 2 groups in terms of the Karlsson score, AOFAS score, talar tilt angle, anterior talar translation, and failure rate at final follow-up (P < .05). Conclusion: Patients with GJL showed inferior outcomes and a higher failure rate compared with patients without GJL. Therefore, GJL appears to be a risk factor associated with recurrent instability after the modified Broström procedure.

Proposed modifications to Beighton criteria for the diagnosis of joint hypermobility in children

ObjectiveBenign joint hypermobility (BJH) is a clinical condition characterized by an increased ability of joints during passive and dynamic movements. In this study a new diagnostic criteria for generalized hypermobility in children has been proposed and compared with the Beighton criteria. MethodTwo hundred children from 3 to 16 years of age were included. 100 children with BJH (according to Beighton criteria) were compared with and equal number of age and sex matched controls. The children were separately examined by two qualified pediatric rheumatologists and the Beighton score for hypermobility was calculated twice. Then examinations were performed based on the new criteria and the questionnaires were filled out. ResultsData analysis revealed significant correlation between Beighton and the new criteria in which sensitivity, specificity, positive and negative predictive values were 100%, 98%, 100%, 98%, respectively. Accuracy was 99% and balanced accuracy was 99%. The area under the ROC curve was 0.99. ConclusionOn the basis of pediatrics physiological and mechanical characteristics, it appears that the Shiari–Javadi criteria are able to detect hypermobile children more accurately. Also, the new criteria appears to be more practical, faster and easier.

The effect of hypermobility on the incidence of injury in professional football: A multi-site cohort study

BackgroundA recent study demonstrated joint hypermobility increased the incidence of injury in an elite football team utilising a univariate statistical model. ObjectivesTo compare injury incidence between hypermobile and non-hypermobile elite football players incorporating a multi-site design and multivariate inferential statistics. Methods80 players comprising 3 English Championship football teams were followed prospectively during the 2012–2013 season. Joint hypermobility was assessed according to the 9-point Beighton Criteria at the start of the study period. A cut-off score of ≥4 categorised a participant as hypermobile. Player exposure and time-loss injuries were recorded throughout. ResultsMean ± standard deviation incidence of injuries was 9.2 ± 10.8 injuries/1000 h. The prevalence of hypermobility was 8.8%. Hypermobiles had a tendency for higher injury incidence (mean [95% confidence interval] difference, 5.2 [0.9–2.7] injuries/1000 h; p = 0.06). Cox regression analyses found training exposure to be highly significant in terms of injury risk (p < 0.001) for all participants. Non-hypermobiles had a lower injury risk (p = 0.11), according to the Cox model, which is suggestive but not conclusive that hypermobility predisposes injury risk. ConclusionsHypermobility showed a trend towards increased risk of injury. Training exposure is a significant injury risk factor in elite football.

Relación entre hipermovilidad articular generalizada y dolor articular en niños de 4 a 17 años en Pasto, Colombia

IntroductionGeneralised joint hypermobility (GJH) and its association with joint pain in children is controversial. So far, there are no publications from Colombia in the literature reviewed. ObjectivesThe main objective of this study was to identify the association between GJH and joint pain in children aged 4-17 years in Pasto, Colombia. Materials and methodsDescriptive, analytical type, case-control study of children from a school in Pasto, Colombia. GJH was defined using Beighton criteria, considering 5 or more criteria as positive. A questionnaire on joint pain was completed. ResultsA total of 576 children, with a mean age of 9.7 years (SD±3) were included. GJH prevalence was 52%, with 20% of children referring to joint pain. When GJH was associated with joint pain, the OR was 0.68 with p=.07 (95% CI; 0.44-1.04). The comparison between localised pain in joints and hypermobility in the subjects with and without GJH, the OR was 4.80 with p=.0001 (95% CI; 2.17 to 10.63). ConclusionsThe prevalence of GJH was 52%, being higher in girls (66%). The prevalence of pain was 20%, and 17 and 23% of children with and without GJH, respectively, had joint pain.No association between joint pain and HAG was found in the group evaluated. The result did not change when stratified by age and gender.It was found that children with GJH were more likely to have pain in joints and an increased range of motion than those who did not have GJH.

Clinical signs in the foot that are predictors of ligamentous laxity in the adult population

ObjectivesThis study evaluates the influence of ligamentous laxity on the foot from observation of clinical signs and quantification of certain joint ranges. MethodsThe sample consisted of 400 subjects – 200 in the non-lax control group (ages 32.49 ± 11.06 years) and 200 in the lax group (ages 29.82 ± 9.41 years). The Beighton criteria were applied to each subject to diagnose laxity or non-laxity after noting their gender, age, and 2 joint ranges and 2 clinical signs for both feet. This was an observational analytical study of cases and controls, in which a multivariate binary logistic regression model was applied. ResultsExtension of the first metatarsophalangeal joint (MTPJ) ≥95°, extension of the 1st toe's interphalangeal joint (IPJ) ≥14°, and the signs 1st “in the plantar footprint, marked and narrowly confined support under metatarsal heads” and 2nd “in the plantar footprint, continuity of the 1st toe to the 1st metatarsal” presented significant differences between the lax and the non-lax groups. These are usable as parameters with which to detect laxity. The Beighton criteria were confirmed as being the most appropriate for diagnosis. ConclusionsWe propose the use of 2 clinical signs that can be evaluated in plantar footprints (“1st” and “2nd”) and 2 exploratory manoeuvres (extension of the first MTPJ ≥95° and extension of the 1st toe's IPJ ≥14°) as factors present in the foot which allow the detection of ligamentous laxity in the adult population, for subsequent confirmation by applying the Beighton criteria.

Clinical Outcomes After Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction: Comparison of Extreme Knee Hyperextension and Normal to Mild Knee Hyperextension

The aim of this study was to compare postoperative outcomes after anatomic double-bundle anterior cruciate ligament reconstruction (ACLR) in extreme knee hyperextension versus normal to mild knee hyperextension. For 100 patients who underwent anatomic double-bundle ACLR using semitendinosus tendon, we evaluated the side-to-side difference (SSD) in anterior tibial translation (measured on stress radiographs) and rotational stability (assessed by the pivot-shift test) 2 years after surgery. Loss of extension (LOE) was evaluated on lateral radiographs of both knees in full extension, and graft integrity was assessed during second-look arthroscopy 1 to 2 years after surgery. In accordance with the Beighton and Honan criteria, patients with an extension angle less than or equal to 10° in the contralateral uninjured knee composed the group with 10° or less hyperextension (N group), and those with an extension angle of greater than 10° composed the group with more than 10° hyperextension (H group). Postoperative results were compared between these groups. Mean extension angles in the N and H groups were 5.8° ± 2.9° and 14.7° ± 3.0°, respectively. The mean SSD in anterior translation was 2.2 ± 2.9 mm for the N group and 2.8 ± 2.9 mm for the H group, with no significant difference. The positive ratios on the pivot-shift test were not significantly different between the groups. Mean LOE in the N and H groups was-0.7° ± 3.7° and 1.3° ± 3.3°, respectively, with a significant difference (P= .007). During second-look arthroscopy, 6 of 58 knees in the N group and 13 of 42 knees in the H group had superficial graft laceration of the anteromedial bundle graft, with a significant difference (P= .01) seen between groups. Anatomic double-bundle ACLR for extreme knee hyperextension may attain the same postoperative anterior and rotational stability as seen in knees with normal to mild hyperextension. However, it increased superficial graft laceration. Level III, retrospective comparative study.

Arthroscopic Stabilization for Recurrent Shoulder Instability With Moderate Glenoid Bone Defect in Patients With Moderate to Low Functional Demand

The purpose of this study was to investigate the functional outcomes of arthroscopic Bankart repair for recurrent shoulder instability in the setting of moderate glenoid bone defect ranging from 20% to 30% in patients with moderate to low functional demand. This study included 36 patients with unilateral recurrent instability and glenoid bone defects of 20% to 30% treated with arthroscopic stabilization. Glenoid bone loss was estimated on the en-face view of preoperative 3-dimensional computed tomography. Joint laxity was assessed clinically by use of the Beighton and Horan criteria, and patients were divided into 2 groups based on the presence of excessive joint laxity, group L (n=13), or absence of excessive joint laxity, group N (n= 23). Functional assessments were performed with the patient-reported activity level; subjective shoulder value; Rowe score; and University of California, Los Angeles shoulder score. The mean glenoid defect size was 25.1% (range, 20% to 29%), and the overall functional outcomes improved significantly after surgery. A return to greater than 90% of the premorbid activity level was reported by 72% of patients (26 of 36 patients), and patient satisfaction was 83% (30 of 36 patients). There was no significant difference in functional outcomes between groups L and N (subjective shoulder value, 85.0% for group L v 88.9% for group N, P= .397; Rowe score, 83.5 for group L v 92.8 for group N, P= .537; and University of California, Los Angeles shoulder score, 32.2 for group L v 31.9 for group N, P= .697). Recurrent instability occurred in 4 patients (11%), 3 patients in group L (3 of 13, 23%) and 1 patient in group N (1 of 23, 4%), but this difference was not statistically significant (P= .125). Arthroscopic stabilization for recurrent shoulder instability in patients with moderate to low functional demand produced satisfactory outcomes despite the presence of moderate glenoid bone defects of 20% to 30%. For patients with excessive joint laxity, however, arthroscopic stabilization may not be reliable, with a recurrence rate of 23%. Level IV, therapeutic case series.

Prevalence and Predictors of Adolescent Idiopathic Scoliosis in Adolescent Ballet Dancers

ObjectiveTo determine any differences between the prevalence of adolescent idiopathic scoliosis in ballet dancers who are girls compared with age-matched nondancers, and to establish if any relations exist between the presence of scoliosis and generalized joint hypermobility, age of menarche, body mass index (BMI), and the number of hours of dance training per week. DesignCross-sectional, matched pair study. SettingDance school. ParticipantsDancers (n=30) between the ages of 9 and 16 years were recruited from a certified dance school in Western Australia; each dancer provided a consenting age-matched nondancer (n=30). InterventionsNot applicable. Main Outcome MeasuresMeasurements were taken for angle of trunk rotation using a scoliometer (presence of scoliosis) and for height and weight to produce generalized joint hypermobility using Beighton criteria and an age-adjusted BMI, respectively. A subjective questionnaire regarding age of menarche and participation in dance and other sports was completed. ResultsThirty percent of dancers tested positive for scoliosis compared with 3% of nondancers. Odds ratio calculations suggest that dancers were 12.4 times more likely to have scoliosis than nondancers of the same age. There was a higher rate of hypermobility in the dancer group (70%) compared with the nondancers (3%); however, there were no statistically significant relations between scoliosis and hypermobility, age of menarche, BMI, or hours of dance per week. ConclusionsAdolescent dancers, similar to adult dancers, are at significantly higher risk of developing scoliosis than nondancers of the same age. Vigilant screening and improved education of dance teachers and parents of dance students may be beneficial in earlier detection and, consequently, reducing the risk of requiring surgical intervention.

Evaluation of antioxidative/oxidative status and prolidase parameters in cases of inguinal hernia with joint hypermobility syndrome

Most previous reports have shown that the basic mechanism of inguinal hernia involves insufficient collagen strength and metabolism. The aim of this study was to evaluate whether joint hypermobility is involved in the development of inguinal hernia in children and to investigate oxidative stress parameters and prolidase activity in tissue samples from children with inguinal hernia. This cross-sectional study involving 41 patients (age, 6.36±2.96years) with inguinal hernia treated in the pediatric surgery department of our institution and 40 age- and sex-matched controls (age, 6.02±3.13years) was performed from May to December 2011. Joint hypermobility was assessed using the Beighton criteria in all patients. Hernia sacs were analyzed with respect to the total antioxidative/oxidative status and prolidase activity. The patients were divided into two groups (inguinal hernia with and without hypermobility) according to a Beighton score cut-off of ≥6. A total of 81 subjects aged 3-10years participated. The ratio of joint hypermobility was significantly higher in patients than in controls (p=0.01). The prolidase activity, total oxidant status, and oxidative stress index were higher in tissue samples from patients with joint hypermobility (p<0.001). Our results show that joint hypermobility syndrome is associated with inguinal hernia in children and that increased prolidase activity and oxidative stress in tissue samples from patients with joint hypermobility syndrome are related to collagen tissue damage and turnover.

Joint Laxity Negatively Correlates With Lumbar Disc Degeneration in Young Adults

Cross-sectional study of preselected cohort of patients with neck pain. To determine the association between joint laxity and lumbar disc degeneration in young adults. Joint laxity is known to be closely related with orthopedic injuries and disease; however, studies about the relationship between spinal disorder and joint laxity are lacking. Patients aged 30 to 40 years, seen at the outpatient clinic of our hospital for the evaluation of neck pain, who had magnetic resonance imaging of the cervical spine with routine inclusion of T2-weighted sagittal plane of the whole spine were included in the study. The Beighton and Horan criteria was used for the assessment of joint laxity. Logistic regression analysis was performed to estimate the odds ratio for lumbar disc degeneration in patients with joint laxity, and other variables including age, sex, body mass index, physical workload, neck pain (visual analogue scale score), and related disability (neck disability index score), and sagittal alignment. A total of 101 patients were enrolled in the study: 34 patients with joint laxity and 67 patients without joint laxity. There were no differences in age, body mass index, physical workload, neck pain (visual analogue scale score), and neck disability index score between the 2 groups, but there was a significant difference in sex ratio (P < 0.001). Patients with joint laxity showed increased lumbar lordosis (P = 0.004) and increased sacral slope (P = 0.003) but without significant difference in pelvic incidence (P = 0.084). In univariate analysis, presence of joint laxity (Beighton score ≥4) as well as positive results of thumb (P = 0.016) and elbow (P = 0.047) tests were significantly associated with decreased risk for lumbar disc degeneration. Presence of joint laxity remained significant after multivariate adjustment for sex and lumbar lordosis (odds ratio = 0.373, P = 0.040). Increased joint laxity was closely associated with lower prevalence of lumbar disc degeneration in young adults, and the increased lumbar lordosis associated with joint laxity might explain the decreased risk of lumbar disc degeneration. 2.

AB0668 Joint hypermobility, growing pains and obesity are mutually exclusive as causes of musculoskeletal pain in schoolchildren

BackgroundChronic Musculoskeletal pain (MSP) is common in children and can be due to several non-inflammatory conditions such as the Benign Joint Hypermobility Syndrome (BJHS) and Growing Pains (GP). Since these...

AB0672 Articular hyper mobility in chronic lumbar pain : touching 10% of the patients

BackgroundChronic lumbar pain is a relative frequent pain problem, with different etiologies: a great part is of no specific origin. Another part of the problem, is the presence of increased...

HYPERMOBILITY AS MEASURED BY THE BEIGHTON HYPERMOBILITY TEST IS NOT PREDICTIVE OF HAND GRIP STRENGTH IN YOUNG ADULTS

Purpose: Past literature has suggested that benign joint hypermobility is related to reduced strength, reduced proprioception and greater risk of musculoskeletal injury. This study aimed to determine any relationship between benign joint hypermobility and hand grip strength in young adults. Methods: A convenience sample of 12 adults aged 18–35 were tested for joint hypermobility using the nine-point Beighton Hypermobility Criteria. Their hand grip strength was also tested using a dynamometer. To achieve 0.8 power and &lt; 0.05 significance, 120 participants were required. Results: The results determined that benign joint hypermobility and hand grip strength were not related. Many participants demonstrated hypermobility in joints other than those tested by the Beighton criteria. Conclusion: Benign joint hypermobility, according to the Beighton criteria, and hand grip strength were not related. Hypermobility of the shoulders and interphalangeal joints were not assessed, and these joints may be hypermobile even when an individual's results are negative by the Beighton criteria.

Evaluation of the Prevalence of Joint Laxity in Children with Attention Deficit/Hyperactivity Disorder

Objective: The purpose of this study was to assess the prevalence of joint laxity in children with attention deficit hyperactivity disorder (ADHD). Method: Eighty-six children, 28 girls and 58 boys, with attention deficit hyperactivity disorder were diagnosed at the child psychiatry outpatient clinic of the Mofid Children’s Hospital, and 86 controls were assessed for joint laxity using Beighton criteria. Result: Joint laxity was discovered in 74.4% of children with attention deficit hyperactivity disorder and in 12.8% of healthy controls. Conclusion: The prevalence of benign joint hypermobility syndrome was high in children with attention deficit hyperactivity disorder, which shows a new basis for further studies.