Patient with hypermobile joint(s) develops chronic pain lasting 3 months or longer

Aetiology

• Higher incidence in females
• Usually presents in childhood or 3rd decade
• General or local
• Rare genetic syndromes e.g. Marfan's, Ehlers Danloes

Clinical features

• Joint pains especially after exercise/physical work
• Joint stiffness
• Foot and ankle pain
• Neck and backache
• Frequent sprains and dislocations
• Thin stretchy skin

Investigations

Modified Beighton score

• 10° hyperextension of the elbows

• Passively touch the forearm with the thumb, white flexing the wrist
• Passive extension of the fingers or a 90° or more extension of the fifth finger
• Touching the floor with the palms of the hands when reaching down without bending the knees
• Hypermobility if ≳4/9