Hypermobility and Joint Instability Quiz

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Questions and Answers

Which symptom is NOT typically associated with joint instability?

Chronic joint pain

Poor proprioception

Neuropathic symptoms

Uterine prolapse (correct)

What complication is related to the influence of progesterone?

Enhanced proprioception

Reduced menstrual pain

Worsening musculoskeletal symptoms (correct)

Improved joint stability

Which factor is linked to the chronic pain syndrome due to hypermobility?

Strong proprioception

Stable connective tissue

Multiple fractures (correct)

Increased joint stability

Which of the following is a potential consequence of pelvic floor weakness?

Chronic bladder inflammation Signup and view all the answers

What is a common characteristic of symptoms linked to chronic fatigue in this context?

Poor response to local anaesthetic Signup and view all the answers

What is a characteristic of constitutional hypermobility?

It can be asymmetrical and affects the whole body. Signup and view all the answers

Which of the following groups is most likely to be hypermobile?

Individuals involved in physical disciplines like dance and gymnastics. Signup and view all the answers

Which condition is classified under symptomatic hypermobility?

Ehlers-Danlos syndrome. Signup and view all the answers

What is a common characteristic of asymptomatic hypermobility?

Many individuals may not experience significant symptoms. Signup and view all the answers

What triggers compensational hypermobility?

Injury or mechanical decrease in range of motion in one segment. Signup and view all the answers

What indicates hypermobility in the neck rotation test?

Range of motion greater than 90° Signup and view all the answers

During the scarf test, what is the positioning of the elbow?

Elbow in a vertical axis Signup and view all the answers

What signifies hypermobility in the Apley’s Scratch Test?

Palms crossing each other Signup and view all the answers

What is the expected range of motion for the neck rotation test in a normal individual?

Around 80° Signup and view all the answers

What should be tested on both sides during the Apley’s Scratch Test?

Shoulder flexibility Signup and view all the answers

What is the minimum angle at which hypermobility is indicated for the extended elbows test?

110° Signup and view all the answers

During the Facing Hands test, what is the requirement for hypermobility?

Palms must fully touch at 90° DFL Signup and view all the answers

What position of the fingers is required during the Facing Fingers test for hypermobility assessment?

Fingers must be in one axis with touching Signup and view all the answers

What should be the condition of the pelvis in the Heel Sitting test to indicate hypermobility?

Pelvis significantly lower than ankle line Signup and view all the answers

In the Lateroflexion test, what is a crucial aspect to observe apart from the reach of the fingers?

Presence of lateral pelvic shift Signup and view all the answers

What is the maximum score achievable on the Beighton scale?

9 points Signup and view all the answers

Which joint movement is NOT assessed in the Beighton score?

Shoulder abduction beyond 90° Signup and view all the answers

What does a Beighton score of 5/9 indicate?

Significant hypermobility concerns Signup and view all the answers

Which condition is associated with excess stretch marks and scarring?

Cardiovascular dysautonomia Signup and view all the answers

What additional health issue can stem from mechanical and neuropathic bowel dysfunction?

Spontaneous rupture of viscera Signup and view all the answers

Which of the following statements about the Beighton score is true?

It assesses a limited number of joints. Signup and view all the answers

What cardiovascular symptoms are associated with dysautonomia?

Hypotension and tachycardia Signup and view all the answers

Which is a test maneuver included in the Beighton scale for scoring?

Passive dorsiflexion of the little fingers Signup and view all the answers

Study Notes

Hypermobility Overview

Hypermobility is a condition where the range of motion (ROM) in a joint exceeds the typical range.
It affects approximately 1 in 10 people.
It's more common in women and children, and individuals of Afro-Caribbean and Asian descent.
Hypermobility can be asymptomatic (no noticeable symptoms) or symptomatic.
Gymnasts, athletes, dancers, and musicians are more susceptible due to repetitive movements and training.

Hypermobility Types

Constitutional Hypermobility

Involves the whole body, but deficits aren't necessarily equal in upper and lower halves.
Asymmetry is common.
Crucial to assess the extent and choose the correct approach to treatment.
Neurological disorders (e.g., tabes dorsales, Down syndrome) sometimes cause hypermobility.

Post-traumatic/Pathological/Compensational Hypermobility

Hypermobility in a specific joint might lead to adjustments in surrounding joints for compensation.
Mechanical restrictions in one area (decreased ROM) necessitates compensatory adjustments in others.

Symptomatic Hypermobility

Involves specific heritable connective tissue disorders, e.g., Ehlers-Danlos syndromes, Marfan syndrome, Stickler syndrome, osteogenesis imperfecta, plus other conditions
Other causes include joint shape, loose ligaments, or muscle tone deficiencies (without connective tissue disorders) and conditions like Down syndrome and cerebral palsy.
Injury or repetitive stretching/training (yogis, gymnasts, and dancers) can contribute to symptomatic hypermobility

Hypermobility Symptoms & Concerns

Musculoskeletal symptoms (acute and chronic pain, joint instability, injury). Joint pain is an important symptom
Chronic pain syndromes and chronic fatigue syndrome.
Cardiovascular symptoms, dysautonomia (tachycardia, hypotension, syncope).
Mechanical and neuropathic bowel dysfunction (hernia, reflux, poor bowel movements, constipation, chronic inflammation, mast cell activation)
Poor wound healing, thin or atrophic scarring, excessive stretch marks, eye problems like cataracts or retinal detachment.
Possible complications of pregnancy on musculoskeletal and pelvic systems, as well as psychological anxiety.
Hypermobility itself can explain poor response to local anesthetic
Possible pelvic floor weakness/prolapse and chronic bladder inflammation
Additional concerns include muscle weakness, poor posture and general aches and pains.

Janda's Hypermobility Tests

Neck rotation: Normal range is 80 degrees; hypermobility is greater than 90 degrees, possibly affecting the entire cervical spine.
"Scarf" test: Elbow positioning and finger contact to assess hypermobility, possible scapular elevation during the test.
Internal-External Rotation (Apley's Scratch Test): Evaluates shoulder and rotator cuff flexibility.
Palm-to-Scapula Test: Hand contact with opposite shoulder girdle to assess shoulder flexibility.
Extended Elbow Test: Extends elbows beyond 110 degrees.
Facing Hands Test: Wrist and potential hypermobility beyond 90 degrees.
Facing Fingers Test: MCP joint tests possible hypermobility.
Thomayer Test: Determines the degree of flexion across the segments. Look for bending issues if abnormal
Lateroflexion Test: assesses posture based on the positioning of the axilla and intergluteal area. Important to look for lateral shifts of the pelvis during testing
Heel Sitting Test: Evaluates pelvis position relative to the ankle line; possible trunk flexion or issues.
Additional tests: Specific joint motions, like Apley's scratch test for the shoulder, assessing various joint motions, were also described.

Beighton Score

A scoring system used to assess joint hypermobility.
Involves 5 maneuvers (finger, thumb, elbow, knee, spine) and evaluates the degree of hypermobility (range of motion beyond the norm).

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Description

Test your knowledge on hypermobility and its related symptoms, complications, and consequences. This quiz covers various aspects of joint instability and chronic pain syndromes associated with hypermobility conditions. Challenge yourself to identify characteristics and factors influencing this complex topic.