Benign Joint Hypermobility Syndrome (BJHS):
May be a forme fruste of an HDCT (hereditable disorder of connective tissue)
Generalised ligamentous laxity is present in up to 10% of adults
Clinical features:
Joint and muscle pain – cause of arthralgias is often unknown
Increased risk of joint dislocation
Premature osteoarthritis
Skin frequently thin and hyperextensible
In children growing pains common
Diagnostic criteria for BJHS :
A) Major criteria
1) A Beighton score of 4/9
2) Arthralgia for longer than 3 months in >4 joints
B) Minor criteria
1) A Beighton score of 1, 2 or 3/9
2) Arthralgia (>3 months) in 1 to 3 joints or back pain (>3 months)
3) Dislocation/subluxation in >1 joint, or in one joint on more than one occasion
4) Soft tissue rheumatism (3 or more lesions such as bursitis, tenosynovitis)
5) Marfanoid habitus (eg tall, slim, span/height ration >1.03)
6) Abnormal skin (striae, hyperextensibility, thin skin)
7) Eye signs (drooping eyelids, myopia, antimongoloid slant)
8) Varicose veins or hernia or uterine/rectal prolapse
BJHS is diagnosed in the presence of the two major criteria; or one major and two minor criteria; or four minor criteria.
In feet flat, excessively pronated
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