Two subtypes of symptomatic joint hypermobility: A descriptive study using latent class analysis

Objective: To investigate a cohort of children with symptomatic joint hypermobility. Methods: Case notes for 318 children with joint hypermobility attending a rheumatology clinic were reviewed for clinical presentation, medical history, psychosocial factors and physical examination findings. Seven k...

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Bibliographic Details
Main Authors: Di Mattia, F., Fary, Robyn, Murray, K., Howie, E., Smith, Anne, Morris, Susan
Format: Journal Article
Published: BMJ Group 2018
Online Access:http://hdl.handle.net/20.500.11937/72276
Description
Summary:Objective: To investigate a cohort of children with symptomatic joint hypermobility. Methods: Case notes for 318 children with joint hypermobility attending a rheumatology clinic were reviewed for clinical presentation, medical history, psychosocial factors and physical examination findings. Seven key variables were extracted and used as indicator variables in a latent class analysis to estimate the presence and number of subgroups of children with symptomatic joint hypermobility. Results: Two subgroups with differing clinical presentations were identified accounting for age and gender: an 'athletic-persistent' class (62%) characterised by higher probabilities for recurrent and chronic musculoskeletal pain, and less severe hypermobility; and a 'systemic-profound' class (38%) characterised by generalised hypermobility, recurrent musculoskeletal pain, gastro-oesophageal reflux and motor delay. Conclusion: Findings suggest the presence of two distinct presentations of children with hypermobility. This finding may be important for clinical decision-making and management of this group of children.