Clinical Assessment and Management of Joint Hypermobility and Instability in Children and Adults with Hypermobility Disorders

Session outline

The term “joint hypermobility” refers to an excessive range of motion within the typical plane of movement and can be asymptomatic or even advantageous in sports performance throughout life. However, it may be associated with an increased risk of injury in some individuals. Generally, the presence of hypermobility in both the upper and lower extremities and the thorax is classified as generalized joint hypermobility, which can be  associated with hereditary connective tissue disorders (HTCDs) such as Ehlers-Danlos syndrome (EDS), Marfan syndrome, and others.

Individuals diagnosed with hypermobility may encounter symptoms such as joint pain, recurrent dislocations or subluxations, and a propensity for soft tissue injuries, all of which can lead to chronic musculoskeletal pain. The examination of hypermobility in a patient necessitates a thorough assessment of their joint flexibility and musculoskeletal complaints.

This workshop aims to provide a comprehensive understanding of assessing joint hypermobility, recognizing non-MSK features of genetic connective tissue dysplasia, and managing recurrent joint instability in relevant clinical settings.

Three expert faculty led stations will introduce the concept of joint hypermobility followed by a practical demonstration of clinical tools relevant to assessment of hypermobility of different joints of body. Insights will be provided into signs and red flags for underlying genetic connective tissue dysplasia, emphasizing the significance of non-MSK features.

Participants will learn to recognize dermatological manifestations associated with these conditions and their clinical implications.

Participants will also gain insights into assessment and management of recurrent joint instability and will explore various management strategies, encompassing conservative and therapeutic approaches, patient education, and rehabilitation.

Three stations will be as follows:

25 minutes each-

1. 1. Assessing Joint Hypermobility
      1. Beighton score demonstration
      1. Lower limb assessment score (LLAS)
      1. Upper limb Hypermobility Assessment tool (ULHAT)

       

      1. 1. Foot Posture Index (FPI)

• • Clinical assessment for non-MSK features of genetic connective tissue dysplasia
    • Skin signs and assessment
    • Marfanoid habitus assessments
    • Tissue fragility signs

     

    • • Signs of Bone dysplasia

• • Assessment and management of recurrent atraumatic joint instability in the setting of a hypermobility disorder or genetic defect in connective tissue

The workshop will conclude with a 10-minute Q&A session to address participant queries and concerns. We will also recap the key takeaways from the workshop and provide additional resources for further learning. This comprehensive workshop aims to empower participants with valuable skills and knowledge for the assessment and management of joint hypermobility and related connective tissue disorders.

Learning outcomes

At the end of this workshop, participants will be able to

• • Describe clinical tests for hypermobility assessment in children and adults

• • Identify hypermobility, laxity, and instability and identify generalised joint hypermobility

• • Illustrate clinical findings of heritable disorders of connective tissue of Ehlers Danlos Syndrome using the current classification framework

• • Summarize assessment and rehabilitation plan for recurrent instability of common joints in hypermobility related disorders

Target audience

• • Allied health

• • Medical practitioners

• • Students

• • Trainees

• • Nursing staff