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Assessment of Hypermobility

  • Peter Beighton
  • Rodney Grahame
  • Howard Bird
Chapter

Abstract

Adequate methods for measuring the range of movement at joints are essential for the definition of criteria used in the study of clinical problems associated with joint hypermobility. Scoring systems for hypermobility that survey a large number of joints in simple fashion are ideal for epidemiological studies in large populations. Latterly, investigators have devised sophisticated mechanical devices for the precise quantification of movement at a single joint. The greater precision afforded may be ideal for serial assessments in the same patient but the greater precision is of limited use in epidemiological work if the joint fails to mirror the status of laxity at other joints in the body. Moreover, a joint may display acquired hyperlaxity in compensation for a reduced range of movement at adjacent joints, for example in the vertebral column.

Keywords

Osteogenesis Imperfecta Joint Mobility Joint Laxity Metacarpophalangeal Joint Spinal Mobility 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Al-Rawi ZS, Al-Aszawi AJ, Al-Chalabi T (1985) Joint mobility among University Students in Iraq. Br J Rheumatol 24: 326–331PubMedCrossRefGoogle Scholar
  2. American Academy of Orthopedic Surgeons (1965) Joint motion: method of measuring and recording. Churchill Livingstone, EdinburghGoogle Scholar
  3. Anderson JAD (1982) The thoraco-lumbar spine. In: Wright, V (ed) Measurement of joint movement, WB Saunders Company Ltd, London pp 631–653 (Clinics in rheumatic diseases, Vol 8 )Google Scholar
  4. Atha J, Wheatley DW (1976) The mobilising effects of treatment on hip flexion. Br J Sports Med 10: 22–25PubMedCrossRefGoogle Scholar
  5. Beighton PH (1988) Hypermobility scoring. Br J Rheumatol 27: 163PubMedCrossRefGoogle Scholar
  6. Beighton PH, Horan F (1969) Orthopaedic aspects of the Ehlers-Danlos syndrome. J Bone Joint Surg [Br] 51: 444–453Google Scholar
  7. Beighton PH, Solomon L, Soskolne CL (1973) Articular mobility in an African population. Ann Rheum Dis 32: 413–418PubMedCrossRefGoogle Scholar
  8. Bird HA (1983) Joint and tissue laxity. In: Wright V (ed) Topical reviews in the rheumatic disorders, vol 2. John Wright and Sons Ltd, Bristol, pp 133–166Google Scholar
  9. Bird HA, Calguneri M (1986) Joint mobility among university students. Br J Rheumatol 25: 314PubMedCrossRefGoogle Scholar
  10. Bird HA, Brodie DA, Wright V (1979) Quantification of joint laxity. Rheumatol Rehabil 18: 161–166PubMedCrossRefGoogle Scholar
  11. Bird HA, Calguneri M, Wright V (1981a) Changes in joint laxity occurring during pregnancy. Ann Rheum Dis 40: 209–212CrossRefGoogle Scholar
  12. Bird HA, Jobbins B, Wright V (1981b) A finger arthrograph for the quantification of joint stiffness. Ann Rheum Dis 40: 200–205CrossRefGoogle Scholar
  13. Bird HA, Walker A, Newton J (1987) A study of hyperlaxity in Olympic gymnasts. Br J Rheumatol 26 [Abstract Suppl. No 2]: 111Google Scholar
  14. Burton AK (1986) Regional lumbar sagittal mobility; measurement by flexicurves. Clin Biomech 1: 20–26CrossRefGoogle Scholar
  15. Burton AK, Tillotson KM (1988) Reference values for “normal” regional lumbar sagittal mobility. Clin Biomech 3: 106–113CrossRefGoogle Scholar
  16. Campbell RR, Hawkins SJ, Maddison PJ, Reckless JPD (1985) Limited joint mobility in diabetes mellitus. Ann Rheum Dis 44: 93–97PubMedCrossRefGoogle Scholar
  17. Carter C, Wilkinson J (1964) Persistent joint laxity and congenital dislocation of the hip. J Bone Joint Surg [Br] 46: 40–45Google Scholar
  18. Dubs L, Gschwend N (1988) General joint laxity. Quantification and clinical relevance. Arch Orthop Trauma Surg 107: 65–72Google Scholar
  19. Fairbank JCT, Pynsent PB, Phillips H (1984) Quantitative measurements of joint mobility in adolescents. Ann Rheum Dis 43: 288–294PubMedCrossRefGoogle Scholar
  20. Grahame R, Jenkins JM (1972) Joint hypermobility-asset or liability. Ann Rheum Dis 31: 109–111PubMedCrossRefGoogle Scholar
  21. Harris H, Joseph J (1949) Variation in extension of the metacarpophalangeal and interphalangeal joints of the thumb. J Bone Joint Surg [Br] 31: 547–559Google Scholar
  22. Haskard DO, Silman AJ (1985) Measuring devices for studying joint mobility in the normal population. Eng Med 14: 75–77PubMedCrossRefGoogle Scholar
  23. Hilton RC, Ball J, Benn RT (1978) In vitro mobility of the lumbar spine. Ann Rheum Dis 38: 378–383CrossRefGoogle Scholar
  24. Howe A, Thompson D, Wright V (1985) Reference values for metacarpophalangeal joint stiffness in normals. Ann Rheum Dis 44: 469–476PubMedCrossRefGoogle Scholar
  25. Jobbins B, Bird HA, Wright V (1979) A joint hyperextensometer for the quantification of joint laxity. Eng Med 8: 103–104CrossRefGoogle Scholar
  26. Kirk JA, Ansell BM, Bywaters EGL (1967) The hypermobility syndrome. Ann Rheum Dis 26: 419–425PubMedCrossRefGoogle Scholar
  27. Larsson L-G, Baum J, Mudholkar GS (1987) Hypermobility: features and differential incidence between the sexes. Arthritis Rheum 30: 1426–1430PubMedCrossRefGoogle Scholar
  28. Loebl WY (1967) Measurement of spinal posture and range of spinal movement. Ann Phys Med 9: 103–110PubMedGoogle Scholar
  29. Loebl WY (1972) The assessment of mobility in the metacarpophalangeal joints. Rheumatol Phys Med 9 (8): 365–379CrossRefGoogle Scholar
  30. MacLennan AH, Green RC, Nicolson R, Bath M (1986) Serum relaxin and pelvic pain of pregnancy. Lancet 2: 243–245PubMedCrossRefGoogle Scholar
  31. Macrae IF, Wright V (1969) Measurement of back movement. Ann Rheum Dis 28: 584–589PubMedCrossRefGoogle Scholar
  32. McNerney JE, Johnston WB (1979) Generalised ligamentous laxity, hallux abducto valgus and the first metatarsocuneiform joint. J Am Podiatr Assoc 69: 69–82Google Scholar
  33. Pal B, Anderson J, Dick WC, Griffiths ID (1986) Limitation of joint mobility and shoulder capsulitis in insulin-and non-insulin-dependent diabetes mellitus. Br J Rheumatol 25: 147–151PubMedCrossRefGoogle Scholar
  34. Pearcy M (1986) Measurement of back and spinal mobility. Clin Biomech 1: 44–51CrossRefGoogle Scholar
  35. Poul J, Fait M (1986) Generalisierte Bandlaxität bei Kindern. Z Orthop 124: 336–339PubMedCrossRefGoogle Scholar
  36. Poul J, Fait M (1989) Frequency of occurrence of generalised ligamentous laxity in a population of children. Reumatologia (CSSR), in press.Google Scholar
  37. Schober P (1937) Lendenwirbelsaul und Kreuzschmerzen. München Med Wochenschr 84: 336–339Google Scholar
  38. Schweitzer G (1970) Laxity of metacarpophalangeal joints of finger and interphalangeal joint of the thumb: a comparative interracial study. S Afr Med J 44: 246–249PubMedGoogle Scholar
  39. Silman AJ, Haskard D, Day S (1986) Distribution of joint mobility in a normal population: results of the use of fixed torque measuring devices. Ann Rheum Dis 45: 27–30PubMedCrossRefGoogle Scholar
  40. Silman AJ, Day SJ, Haskard DO (1987) Factors associated with joint mobility in an adolescent population. Ann Rheum Dis 46: 209–212PubMedCrossRefGoogle Scholar
  41. Silverman S, Constine L, Harvey W, Grahame R (1975) Survey of joint mobility and in vivo skin elasticity in London schoolchildren. Ann Rheum Dis 34: 177–180PubMedCrossRefGoogle Scholar
  42. Starkman HS, Gleason RE, Rand LI, Miller DE, Soeldner JS (1986) Limited joint mobility (LJM) of the hand in patients with diabetes mellitus: relation to chronic complications. Ann Rheum Dis 45: 130–135PubMedCrossRefGoogle Scholar
  43. Sturrock RD, Wojtulewski J, Dudley Hart F (1973) Spondylometry in a normal population and in ankylosing spondylitis. Rheumatol Rehabil 12: 135–142PubMedCrossRefGoogle Scholar
  44. Troup JDG, Hood CA, Chapman AE (1968) Measurements of the sagittal mobility of the lumbar spine and hips. Ann Phys Med 9: 308–321PubMedGoogle Scholar
  45. Wagner C, Drescher D (1984) Measuring ability of the metacarpophalangeal joints II, III, IV, Vin the dorso-volar plane. Eng Med 13: 15–20Google Scholar
  46. Wood PHN (1971) Is hypermobility a discrete entity? Proc R Soc Med 64: 690–6692PubMedGoogle Scholar
  47. Wordsworth P, Ogilvie D, Smith R, Sykes B (1987) Joint mobility with particular reference to racial variation and inherited connective tissue disorders. Br J Rheumatol 26: 9–12PubMedCrossRefGoogle Scholar
  48. Wright V (ed) (1982) Measurement of joint movement. WB Saunders Company Ltd, London (Clinics in rheumatic diseases, vol 9 )Google Scholar
  49. Wynne-Davis R (1970) Acetabular dysplasia and familial joint laxity: two aetiological factors in congenital dislocation of the hip. J Bone Joint Surg [Br] 52: 704–708Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1989

Authors and Affiliations

  • Peter Beighton
    • 1
  • Rodney Grahame
    • 2
  • Howard Bird
    • 3
  1. 1.MRC Research Unit for Inherited Skeletal Disorders, Medical School and Groot Schuur HospitalUniversity of Cape TownSouth Africa
  2. 2.Rheumatology Unit, Division of Medicine, United Medical and Dental SchoolsGuy’s HospitalLondonUK
  3. 3.Royal Bath HospitalUniversity of Leeds, and Clinical Pharmacology Unit (Rheumatism Research)HarrogateUK

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