Ahmad Usaid Qureshi, Abdul Maalik, Tahir Masood Ahmad


Background: The majority of individuals with joint hypermobility remain asymptomatic. However,
those associated with Benign Joint Hypermobility Syndrome (BJHS), develop a number of systemic
manifestations. Our objective was to determine the relationship between joint hypermobility and
musculoskeletal problems, and frequency of BJHS in children and adolescents. Method: This crosssectional observational descriptive study was conducted at Outpatient Department, The Children’s
Hospital, Lahore, Pakistan. A total of 872 individuals (4–18 year) were examined for hypermobile
joints using Beighton score ≥4. A questionnaire was implied to get data regarding demographic
profile, musculoskeletal and extra-articular complaints, family history of joint problems and daily
activity. Brighton’s criteria were implied for diagnosis of BJHS. Results: The frequency of joint
hypermobility was 37.0%; male 39.5%, and female 34.2% (p=0.1). There was a gradual decline in
mean Beighton score with age. The female population showed increase in mean Beighton score
around 16–17 year age. Arthralgias and back pains 7.7% vs. 1.6%, (p<0.001), and hernias 2.5%
(p=0.03) were significantly higher in individuals with joint hypermobility. History of joint problems
in the family was also significantly higher in children with joint hypermobility (p=0.01). BJHS was
detected in 4.8% children (male 3.6% and female 6.3%, p=0.06). Arthralgias (51.0%), hernias
(16.3%), joint dislocations (8.2%) and varicose veins (8.2%) were the most common presentations.
Conclusion: BJHS is common among children. Arthralgias, back pains and hernias are significantly
higher in these individuals.
Keywords: Joint hypermobility, Benign Joint Hypermobility Syndrome, musculoskeletal
problems, Children

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Remvig L, Jensen DV, Ward RC. Epidemiology of general joint

hypermobility and basis for the proposed criteria for benign joint

hypermobility syndrome: review of the literature. J Rheumatol


Murray KJ. Hypermobility disorders in children and adolescents.

Best Pract Res Clin Rheumatol 2006;20:329–51.

Grahame R, Bird HA, Child A. The revised (Brighton 1998)

criteria for the diagnosis of benign joint hypermobility syndrome

(BJHS). J Rheumatol 2000;27:1777–9.

Qvindesland A, Jonsson H. Articular hypermobility in Icelandic

year olds. Rheumatology 1999;38:1014–6.

Birrell FN, Adebajo AO, Hazleman BL, Silman AJ. High

prevalence of joint laxity in West Africans. Br J Rheumatol


Klemp P, William SM, Stansfield SA. Articular mobility in

Maori and European New Zealanders. Rheumatology (Oxford)


Russek LN. Hypermobility syndrome. Phys Ther 1999;79:591–9.

Jansson A, Saartok T, Werner S, Renstrom P. General joint laxity

in 1845 Swedish school children of different ages: age-and

gender-specific distributions. Acta Paediatr 2004;93:1202–6.

Beynnon BD, Bernstein IM, Belisle A, Brattbakk B, Devanny P,

Risinger R, et al. The effect of estradiol and progesterone on knee

and ankle joint laxity. Am J Sports Med 2005;33:1298–304.

Gedalia A, Brewer EJ Jr. Joint hypermobility in pediatric

practice: a review. J Rheumatol 1993;20:371–4.

Larsson LG, Baum J, Mudholkar GS. Hypermobility: features

and differential incidence between the sexes. Arthritis Rheum


el-Shahaly HA, el-Sherif AK. Is the benign joint hypermobility

syndrome benign? Clin Rheumatol 1991;10:302–7.

Denko CW, Boja B. Growth hormone, insulin, and insulin-like

growth factor-1 in hypermobility syndrome. J Rheumatol


Adib N, Davies K, Grahame R, Woo P, Murray KJ. Joint

hypermobility syndrome in childhood. A not so benign

multisystem disorder? Rheumatology (Oxford) 2005;44:744–50.

Didia BC, Dapper DV, Boboye SB. Joint hypermobility

syndrome among undergraduate students. East Afr Med J


Mogren IM, Pohjanen AI. Low back pain and pelvic pain during

pregnancy: prevalence and risk factors. Spine 2005;30:983–91.

Ferrell WR, Tennant N, Sturrock RD, Ashton L, Creed G,

Brydson G et al. Amelioration of symptoms by enhancement of

J Ayub Med Coll Abbottabad 2010;22(4)

proprioception in patients with joint hypermobility syndrome.

Arthritis Rheum 2004;50:3323–8.

Ofluoglu D, Gunduz OH, Ozaras N, Kayhan O. Early-onset

hemochromatic arthropathy in a patient with idiopathic

hypermobility syndrome. Rheumatol Int 2003;23:305–8.

Zapata AL, Moraes AJ, Leone C, Doria-Filho U, Silva CA. Pain

and musculoskeletal pain syndromes in adolescents. J Adolesc

Health 2006;38:769–71.

Manning J, Korda A, Benness C, Solomon M. The association of

obstructive defecation, lower urinary tract dysfunction and the

benign joint hypermobility syndrome: a case-control study. Int

Urogynecol J Pelvic Floor Dysfunct 2003;14:128–32.

Skoumal M, Haberhauer G, Mayr H. Concomitant diseases in

primary joint hypermobility syndrome. Med Klin (Munich)


El-Garf AK, Mahmoud GA, Mahgoub EH. Hypermobility

among Egyptian children: prevalence and features. J Rheumatol


van der Giessen LJ, Liekens D, Rutgers KJ, Hartman A, Mulder

PG, Oranje AP. Validation of Beighton score and prevalence of

connective tissue signs in 773 Dutch children. J Rheumatol


Rikken-Bultman DG, Wellink L, van Dongen PW.

Hypermobility in two Dutch school populations. Eur J Obstet

Gynecol Reprod Biol 1997;73:189–92.


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