Orthopedic Care and Consultation
Major Criteria
Minor Criteria
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The Beighton score is used for assessing the presence of hypermobility. However, it must be noted that the diagnosis of Hypermobility Syndrome or HMS should be made using the Brighton Criteria.
Beighton scoring is based on testing the simple movement or hypermovements if you want to call them
Passive Dorsiflexion of Little Finger
In a normal individual, little finger cannot be extended beyond 90 degrees, even passively. Score 0
If the passive extension [dorsiflexion] reveals this movement beyond 90 degrees – Score 1
Passive Dorsiflexion of Thumb
If thumb cannot be made to touch the flexor aspect of forearm – Score 0
If thumb can be made to touch the flexor aspect of forearm – Score 1
Hyperextension of left elbow
In a most of individual the range of movement of elbow is 0-120 degrees. 0 signifies that arm can be made to straighten but further movement is not possible. Any further extension movement of elbow would result in arm bending backward. [Read more...]
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Benign joint hypermobility syndrome, thought to be a connective tissue disorder, is the occurrence of pain in multiple joints in hypermobile individuals in the absence of systemic rheumatologic disease.
The entity is different from the disorders that cause local joint hypermobility and generalized joint laxity, such as Marfan syndrome and Ehlers–Danlos syndrome.
Hypermobility not associated with systemic disease occurs in 4% to 13% of the people.
Hypermobility may occur in several different connective tissue disorders including Marfan syndrome, EDS, and osteogenesis imperfecta, Down syndrome, homocystinuria and hyperlysinemia.
Benign joint hypermobility syndrome has a strong genetic component with an autosomal dominant pattern.
Pathophysiology
Why do some people have symptoms with hypermobile joints. Four factors have been suggested -
Clinical Presentation
Pain in a hypermobile joint which may affect one or multiple joints is the most common symptom. This can occur at any age are often exacerbated by physical activity.
Though it may occur in any joint but knee and ankle are most commonly involved.
Other symptoms that may occur are are joint stiffness, myalgia, muscle cramps, and nonjoint limb pain.
There might be a history of double-jointedness or recurrent dislocations in the family.
Easy bruising, ligament or tendon rupture, congenital hip dysplasia, and temporomandibular joint dysfunction may be associated findings.
On physical examination, there might be pain in joints on manipulation.
Other assoicated findings that might be present are [Suggesting some connective tissue disorder]
People with hypermobility syndrome may develop other conditions caused by their unstable joints. These conditions include frequent sprains, tendinitis, or bursitis when doing activities that would not affect the normal individual. [Read more...]
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Other Terms For The Condition
Hypermobile joint is a joint that can be stretched beyond what is called normal range is normal.
It could be due to
Hypermobility can run in families suggesting a genetic basis too.
Most of people with hypermobile joints do not have any problem but others especially those in sports may become prone to repeated joint injuries.
When generalized joint hypermobility is present with symptoms of muscle and joint pain, it is termed as Hypermobility syndrome.
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Though weak, there is an evidence to show that custom orthotics may help relieve pain and elevated forefoot plantar pressures in patients with rheumatoid arthritis
This has been reported by a meta-anlysis conducted by Kym Hennessy and colleagues at Glasgow Caledonian University and published online December 12 in Arthritis Care & Research
The study involved analysis of 17 studies involving more than 700 patients. According to researchers, most of the studies they analyzed were not of high quality.
[Read more...]
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The distal radioulnar articulation or inferior radioulnar joint is a joint formed between the head of the ulna and the ulnar notch on the distal radius.
The articular surfaces are connected together by the following ligaments:
Triangular fibrocartilage complex is ulnar continuation of distal radius & presents concave surface for articulation with lunate and triquetrium. [Read more...]
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Knee arthrodesis as primary surgery is very rare now a days because of success of knee arthroplasty. It usually is reserved for patients who are not candidates for total knee replacement or where arthrodesis is be more appropriate than arthroplasty due to age , occupation, weight or activity.
Apart from this following patients can undergo arthrodesis are
The most frequent indication for knee arthrodesis at present is salvage of a failed total knee arthroplasty. [Read more...]
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Ankle arthrodesis is performed more commonly than that of the hip or knee. It is also called ankle fusion
Most common indication for performing this surgery is common indication is arthritis following injury to ankle also called post-traumatic arthritis.
Other indications are
Before proceeding with arthrodesis, surgeon might give you a below knee cast to see if you are suitable candidate for arthrodesis. [Read more...]
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Osteoarthritis is also called called degenerative joint disease or osteoarthroses occurs when cartilage in the joints wears down over time.
It can affect any joint in your body. But most commonly it is seen in following joints
Following are the risk factors for this disease [Read more...]
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Magnetic resonance imaging is very sensitive and identifies joint damage in the wrists and fingers of patients with early-stage rheumatoid arthritis, a new research published on November 15th in Arthritis Care & Research.
The study was conducted by Dr. Mami Tama and colleagues in Nagasaki University.
In the study, MRI of wrists and finger joints of both hands were examined in 51 early-stage rheumatoid arthritis (RA) patients by both plain and Gd-DTPA enhanced MRI.
Synovitis, bone edema and bone erosion were considered as MRI-proven joint injury. A physical examination just before the MRI study was done by certified rheumatologist.
The presence of tender and/or swollen joints in the same fields as MRI was considered as joint injury on physical examination.
The association of MRI-proven joint injury with physical examination-proven joint injury was examined.
A total of 1110 sites were examined in the above mentioned patients.
MRI-proven joint injury was found in 521 sites whereas other 589 sites were normal.
[Read more...]
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