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Hypermobility spectrum disorder

Hypermobility spectrum disorders (HSD) are a group of heritable connective tissue disorders where joints are flexible enough to cause problems such as instability and pain. Different forms and sub-types have been distinguished, but it does not include asymptomatic joint hypermobility, colloquially known as double-jointedness, nor does it include Ehlers–Danlos syndromes.

Classification
Hypermobility spectrum disorders are diagnosed when individuals have symptomatic joint hypermobility but do not meet the criteria for other connective tissue disorders, such as Ehlers–Danlos syndrome. In March 2017, the International Consortium on the Ehlers-Danlos Syndromes published a revised classification naming two syndromes: hypermobile EDS (hEDS), which has narrowly defined criteria, and hypermobility spectrum disorder (HSD) for those with some but not all the features of hEDS. This reclassification aimed to address the overlap between joint hypermobility syndrome and what was previously termed EDS-hypermobile type (EDS-HT). Patients who have a diagnosis of EDS-HT or JHS will fall into one of these two new categories. Hypermobility spectrum disorder does not include people with asymptomatic hypermobility or people with double-jointedness but no other symptoms. Hypermobile Ehlers–Danlos syndrome and hypermobility spectrum disorders may be equally severe. HSD is further classified into different subtypes, which include: • Generalized HSD (G-HSD): Involves widespread joint hypermobility affecting multiple joints. • Localized HSD (L-HSD): Limited to a few joints, without generalized involvement. • Peripheral HSD (P-HSD): Affects joints in the hands and feet. • Historical HSD (H-HSD): Diagnosed when there is a history of joint hypermobility that is no longer present, along with other symptoms. These classifications help in identifying the specific pattern and extent of joint hypermobility and in determining the appropriate management strategies. ==Signs and symptoms ==
Signs and symptoms
Some common symptoms of hypermobility spectrum disorder may include: Musculoskeletal symptoms • Joint instability and soft tissue injuries: Dislocations, subluxations, or damage to muscles, ligaments, tendons, synovium, or cartilage as a result of excessive joint movement. • Chronic pain: Recurrent joint pain that can develop into hyperalgesia, with a higher rate of small fiber neuropathy in some individuals. == Diagnosis ==
Diagnosis
The Beighton score can be used to determine generalised joint hypermobility (GJH) related to hypermobility syndrome. The newer term "generalised hypermobility spectrum disorder" includes people with generalised joint hypermobility, often determined using the Beighton score, and other symptoms. Those who do not meet the Beighton score criteria may be diagnosed with historical joint hypermobility spectrum disorder, peripheral hypermobility spectrum disorder, or localised hypermobility spectrum disorder. == Treatment==
Treatment
There is no direct cure for Hypermobility Spectrum Disorder, but its symptoms can be treated. Physiotherapy, particularly exercise, is the main treatment for the condition, although there is only limited evidence for its effectiveness. ==Prevalence==
Prevalence
While the heritability of hypermobility is strong, specific genes implicated in the condition have not been identified. Other studies have suggested that it affects around 3% of the UK population. ==References==
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