Jaime F' Bravo1, 2, Carlos Wolff 3

1
SIGNS AND SYMPTOMS OF JOINT HYPERMOBILITY
SYNDROME (JHS) TO CONSIDER WHEN DIAGNOSING THIS
CONDITION

• Jaime F. Bravo1, 2, Carlos Wolff 3
• 1.Clínica Arauco Salud 2. Servicio
  Reumatología, Hospital San Juan de Dios.
• 3.- Depto. Medicina Occidente, Universidad de
  Chile

Method We have studied 1395 JHS patients during
the last 8 years, in our adult Rheumatology
Clinic, in Santiago, Chile. In this study, the
Beighton score (BSc), the Brighton Criteria (BC)
and a checklist for frequent signs and symptoms
of JHS were used. Age range 16 - 87 y/o. Average
age 45.9. Females 78.1. Patients were
grouped by ages. Group A less than 30 y/o, 226
patients (16.2) Group B 571 patients (40.9)
and Group C 50 y/o or older, 598 patients
(42.9). Chi squared test was used for
statistical analysis.
Purpose. Facilitate the diagnosis of Joint
Hypermobility Syndrome (JHS), a frequent form of
Ehlers-Danlos Syndrome (EDS) that for most
authors is the same as EDS type III, which
usually goes undiagnosed.
Results. In the total group we found negative
BSc 56.9 Marfanoids 14.6 Light blue sclera
77.2 (M 56.0, F 83.1) Dysautonomia (Dys)
44.6 (M 23.8, F 50.5). Frequency of Dys in M
by groups A 52.0, B 27.7, C 10.6 In F A
80.2, B 61.8, C 27.8. Low BMD (Osteopenia and
Osteoporosis (O)) was present in 70.9 (M 79.3,
F 69.1). Frequency of low BMD in M by groups A
66.7, B 74.4, C 86.7. In F A 68.6, B 63.2,
C 73.4. Frequency of O M 25.6, F 23.1. O in
M by groups A 16.7 B 16.3, C 35.0, in F A
17.6, B 14.5, C 30.2. Frequency of other signs
studied are noted in Figure 1.
Figure 1
Conclusions The following signs and symptoms
were frequent enough ( 45) to feel that they
are important when considering the diagnosis of
JHS Hand holding the head elephant paw light
blue sclera horizontal thumb valgus elbow soft
skin flying bird hand typical JHS face low BMD
and Dys. Low BMD and Dys are extremely prevalent
in JHS, especially Dys in adolescents girls
(16-29 y/o) and should be look for. There was no
significant difference between sexes regarding
low BMD at all ages. Dys was significantly more
noticeable in women than in men at all ages. As
noted in our previous studies, the BSc was again
negative in high percentage of patients (56.9).
This is important since in some studies, many JHS
patients are not included when applying only the
BSc rather than the BC. We suggest preparing a
checklist similar to the one used here to
facilitate JHS diagnosis.
For further information see www.
reumatologia-dr-bravo.cl