The functioning of the musculoskeletal system directly depends on the state of the connective structures that are next to the joints: capsules, ligaments and tendons. They are particularly strong and provide a person with normal movement, but at the same time they have flexibility and elasticity. It is these qualities of structures that help maintain the integrity of tissues when stretched under load. Joint hypermobility syndrome in children is a condition in which the range of motion in the joint is exceeded compared to physiological settings.
Reason for violations
Syndrome of hypermobility of the joints (in ICD 10 - code M35.7) most often occurs in those people who have a strong extensibility of the ligamentous tendon fibers transmitted from their parents. As a result of an inherited disorder, the proteoglycan, collagen, glycoprotein and enzymes that provide their metabolism are significantly changed. Violations in the synthesis, maturation and decay of connective tissue components lead to strong joint extensibility.
All the described processes can affect the body of a pregnant woman from the outside. In most cases, such changes occur in the early stages, when the embryo is just beginning its development and organs and systems are being formed in it. The following negative factors act on the connective tissue of the fetus:
- pollution coming from the environment;
- poor nutrition (lack of vitamins, trace elements and nutrients);
- infectious lesions of a woman;
- strong stress, anxiety and stress on the nervous system.
Acquired form
From all this it follows that hypermobility syndrome is a congenital disease. But it is important to distinguish it from other hereditary diseases in which some changes occur in the structure of the connective tissue (Marfan or Ehlers-Danlos syndrome). It is also important to remember about the natural flexibility, which does not apply to the pathological form. Many people do not even realize that they have such a difference, since childhood considering it to be quite ordinary.
Acquired form of joint mobility in most cases is diagnosed in dancers or athletes, but it occurs as a result of training and has a local character, spreading mainly to the lower limb. Difficulties with joint mobility are an uncommon lesion, but difficult to diagnose through diagnosis.
Features of the development of disorders in children
Beforehypermobility of the joints was attributed to a peculiar structural feature of the musculoskeletal system. Parents always tried to take a very plastic child to a special section at an early age. It was believed that such a structure of the skeleton ensures the rapid achievement of good sports results. Now the hypermobility of the joints in a child refers to a form of deviation.
When actively playing sports, the joints of children and adults with such a disorder experience strong loads that significantly exceed the permitted ones. In people with normal joints, such a load leads to various injuries - sprains or dislocations. After proper treatment, many athletes quickly resume training. With hypermobility, things are different. Even a minor injury can greatly change the structure of cartilage, bone tissue, tendons and ligaments, as well as lead to osteoarthritis.
Prohibited sports
Sick baby is prohibited from doing the following sports:
- gymnastics and acrobatics;
- running, biathlon;
- hockey, football;
- long jump;
- sambo and karate.
Treatment specialists recommend parents of particularly plastic children not to send them to sports facilities immediately. Such a child should undergo a full examination in the hospital. If he is found to have joint hypermobility, then he will have to give up all sports that are dangerous for him.
Clinical picturesyndrome
Joint hypermobility refers to a systemic non-inflammatory lesion of the musculoskeletal system. This condition has so many symptoms that it may seem that the patient is suffering from a completely different disease. These patients are often misdiagnosed.
Special diagnostic measures in a medical institution help to specify the boundaries of hypermobility and distinguish this lesion from other diseases with similar symptoms. When determining the main symptoms of the disease, it is important to consider articular and extra-articular manifestations of the disease.
Articular manifestation
The first signs of damage in this case appear for the first time in childhood or adolescence, when the child is actively involved in sports and various physical activities. Most often, they are not considered as a result of pathological changes in the structure of tissues and are quite familiar, for this reason the disease is determined rather late.
At the first stage of the development of joint hypermobility syndrome in adults and children, quiet clicks or crunching in the joints are observed, such sounds occur voluntarily or when physical activity changes. Over time, the sounds may pass on their own. But other, more severe signs are added to the symptoms, which help to accurately identify joint hypermobility syndrome in children and adults:
- pain (myalgia or arthralgia);
- recurrent dislocations and subluxations;
- scoliosis;
- flat feet of varying degrees.
Joint pain occurs after sports or at the end of the day. In most cases, it spreads to the legs (hip hypermobility syndrome in children), in addition, the shoulders, elbows and lower back can suffer. Persistent myofascial pain may occur in the shoulder girdle. At an early age, a child with this syndrome gets tired too quickly and asks to be put back in his arms.
Dangerous Complications
With excessive activity, joints and closely spaced tissues are damaged. People who are hypermobile are at risk of earning the following conditions:
- torn ligaments and various sprains;
- bursitis and tenosynovitis;
- post-traumatic arthritis;
- tunnel syndromes.
Against the background of general weakness, the patient may feel instability in the joints, which appears with a decrease in the stabilizing role of the capsule and ligamentous apparatus. Most often this occurs in the ankles and knees, which are heavily loaded every day. In the future, hypermobility syndrome may lead to degenerative joint diseases, such as osteoarthritis.
Assessment of joint mobility
When evaluating the movement of the joints, the specialist first of all establishes their volume. If it is higher than normal, then we can safely talk about the presence of hypermobility in the patient. The assessment mainly relies on the following clinical tests:
- thumb retracted intoside of the forearm;
- unbends the elbow or knee joint (the angle is not more than 10 degrees);
- the patient should touch the floor with their hands without bending their knees;
- unbend the metacarpophalangeal joints (the angle should not exceed 90 degrees);
- the hip is retracted to the side (an angle of about 30 degrees).
This helps to pinpoint the high flexibility of the joints, which is important in detecting disorders in ligaments, tendons and capsules. It is important to remember that the sooner such signs are detected, the less dangerous the consequences for the human musculoskeletal system will be.
Articular signs of joint hypermobility syndrome in children from birth are a good example of connective dysplasia. But not only they make up the general symptoms of the disease.
Extra-articular signs
Since hypermobility has a systemic form, it is characterized by extra-articular manifestations. Connective tissue is important for human organs and systems, so dysplasia can adversely affect all functions and even lead to significant disturbances in the overall structure. In most cases, pathological disorders extend to the skeletal system. In addition to articular disorders, the doctor may notice some external features: a high palate, a lag in the development of the upper or lower jaw, curvature of the chest, excess length of the toes or hands.
There are other signs of hypermobility:
- strong extensibility of the skin, increased chanceget injured and damaged;
- mitral valve prolapse;
- varicose veins on legs;
- prolapse of the kidneys, intestines, uterus, stomach;
- different forms of hernia (inguinal, navel hernia);
- strabismus, epicant.
People suffering from hypermobility often complain of fatigue, general weakness of the body, anxiety, aggression, headaches, sleep problems.
Treatment of disease
After establishing an accurate diagnosis, the doctor remains to choose an effective method of treatment. The choice of treatment for joint hypermobility in children and adults will depend on the cause of its occurrence, the main symptoms and the intensity of pain.
At the same time, it is very important that the patient understands that such a lesion cannot lead to disability, and that with the right treatment, all negative symptoms will quickly disappear.
To improve their condition, the patient should exclude from their daily life any activity that leads to pain or any discomfort in the joints.
With a high intensity of pain in individual joints, specialized elastic fixators are used, which are otherwise called orthoses (you can purchase elbow or knee pads).
In case of particularly severe pain, it is allowed to use medications. In most cases, analgesics are taken to eliminate pain (analgin, Deksalgin and Ketanov). For many patients, doctors prescribe special ointments withwarming effect and ointments with non-steroidal anti-inflammatory components in the composition.
Physiotherapeutic procedures will bring no less benefit: laser therapy, paraffin treatment, therapeutic mud.
The main thing in the treatment of hypermobility syndrome are special exercises and gymnastics. When performed, the joints, ligaments and muscles receive the necessary stability and strength.
Exercise therapy for joint hypermobility in children helps to fully bend and unbend the joints. Physiotherapy exercises also help to strain all muscles well. With hypermobility of the joints, exercises can be power and static, they are performed at a slow pace and without special weights. Stretching exercises are strictly prohibited, as they only worsen the condition of the joints.
Accurate diagnosis
To make a diagnosis, the doctor helps to examine the appearance of the patient and listen to his main complaints. The child can talk about frequent injuries, bruising on the body after a slight impact from the outside.
To distinguish hypermobility syndrome from osteoarthritis, arthritis, coxarthrosis, special instrumental diagnostics should be performed:
- ultrasound;
- radiography;
- magnetic resonance or computed tomography.
Going to treatment is necessary only in the presence of an articular disorder provoked by hypermobility of the limbs. In other situations, a child or an adult is recommended to strengthen muscles and ligamentous tendons: do therapeutic exercises, swim or just walk.
Relieving condition
The following orthopedic products help to significantly relieve pressure on the joints:
- elastic bandages;
- posture correctors;
- tips between fingers.
The results obtained after the research will help to accurately understand the severity of damage to the tendon-ligamentous apparatus, as well as the number of complications received.
