Joint Hypermobility Syndrome (Normal Loose Joints)

Definition

• Children with this syndrome have loose joints
• Movement at their joints are excessive
• Joints can be stretched beyond the normal range
• Affects over 10% of children

• Joint swelling occurs
• Joint pains become frequent
• You think your child needs to be seen
• Your child becomes worse

Symptoms

• Usually, there is no pain or other symptoms.
• Joint pains may follow hard sports or play. The pain is from over-stretching of the ligaments around the joints. It is usually mild and doesn't last long.
• Some of these children are "double- jointed" (usually refers to fingers). Many can easily do the "splits" or other extreme postures.
• Slight increased risk for dislocated shoulder or kneecap with injuries.

Diagnosis
The diagnosis is made by the findings below on physical exam:

• Thumb can touch the wrist
• Little finger can be bent backward more than 90 degrees
• Elbow can be bent backward more than 10 degrees
• Knee can also be bent backward more than 10 degrees
• Palms of the hand can rest flat on the floor while bending from the waist. The knees must remain straight.
• Feet are flat with no arch
• A few children with this are double-jointed. This means they can dislocate some of their joints at will.
• Lab tests or X-rays are of no value in making this diagnosis.

Cause

• The ligaments that hold the joints together are loose or lax.
• The elastic (collagen) tissue found in ligaments stretches more than normal. This difference is genetic.
• Loose-jointed findings are often present in other family members.