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Clinical Orthopaedics and Related Research®
Published in: Clinical Orthopaedics and Related Research® 7/2010

01-07-2010 | Symposium: Gender-specific Issues in Orthopaedic Surgery

Incidence of Joint Hypermobility Syndrome in a Military Population: Impact of Gender and Race

Authors: Danielle L. Scher, MD, Brett D. Owens, MD, Rodney X. Sturdivant, PhD, Jennifer Moriatis Wolf, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 7/2010

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Abstract

Background

Joint hypermobility syndrome is defined by abnormal laxity in multiple joints in association with symptomatic joint pain. Previous studies in small populations suggest a predominance of female gender and nonwhite race among those diagnosed with hypermobility syndrome.

Questions/purposes

We investigated the epidemiology of joint hypermobility in a large military population, presuming this syndrome would be less prevalent in this specialized population but that demographic analysis would reveal risk factors for this rare condition.

Methods

We queried the Defense Medical Epidemiology Database by race, gender, military service, and age for the years 1998 to 2007 using the International Classification of Diseases, 9th Revision code 728.5 (hypermobility syndrome).

Results

We identified 790 individuals coded for joint hypermobility syndrome among a population at risk of 13,779,234 person-years for a raw incidence rate of 0.06 per 1000 person-years. Females had a higher incidence rate for joint hypermobility syndrome compared with males. Racial stratification showed service members of white race had higher rates of joint hypermobility syndrome compared with service members categorized as black and “other.”

Conclusions

In a large, established military database it appears joint hypermobility syndrome is a rare condition within the young, active population we studied and female gender is the most important risk factor.

Level of Evidence

Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
Literature
1.
Adib N, Davies K, Grahame R, Woo P, Murray KJ. Joint hypermobility syndrome in childhood. A not so benign multisystem disorder? Rheumatology (Oxford). 2005;44:744–750.CrossRef
2.
Al-Rawi ZS, Al-Aszawi AJ, Al-Chalabi T. Joint mobility among university students in Iraq. Br J Rheumatol. 1985;24:326–331.CrossRefPubMed
3.
Beighton P, Horan F. Orthopaedic aspects of the Ehlers-Danlos syndrome. J Bone Joint Surg Br. 1969;51:444–453.PubMed
4.
Beighton P, Solomon L, Soskolne CL. Articular mobility in an African population. Ann Rheum Dis. 1973;32:413–418.CrossRefPubMed
5.
Beighton P, De Paepe A, Steinmann B, Tsipouras P, Wenstrup RJ. Ehlers-Danlos syndromes: revised nosology, Villefranche, 1997. Ehlers-Danlos National Foundation (USA) and Ehlers-Danlos Support Group (UK). Am J Med Genet. 1998;77:31–37.CrossRefPubMed
6.
Biro F, Gewanter HL, Baum J. The hypermobility syndrome. Pediatrics. 1983;72:701–706.PubMed
7.
Birrell FN, Adebajo AO, Hazleman BL, Silman AJ. High prevalence of joint laxity in West Africans. Br J Rheumatol. 1994;33:56–59.CrossRefPubMed
8.
Bridges AJ, Smith E, Reid J. Joint hypermobility in adults referred to rheumatology clinics. Ann Rheum Dis. 1992;51:793–796.CrossRefPubMed
9.
Carter C, Wilkinson J. Persistent joint laxity and congenital dislocation of the hip. J Bone Joint Surg Br. 1964;46:40–45.PubMed
10.
Colin C, Ecochard R, Delahaye F, Landrivon G, Messy P, Morgon E, Matillon Y. Data quality in a DRG-based information system. Int J Qual Health Care. 1994;6:275–280.PubMed
11.
De Paepe A, Devereux RB, Dietz HC, Hennekam RC, Pyeritz RE. Revised diagnostic criteria for the Marfan syndrome. Am J Med Genet. 1996;62:417–426.CrossRefPubMed
12.
Decoster LC, Vailas JC, Lindsay RH, Williams GR. Prevalence and features of joint hypermobility among adolescent athletes. Arch Pediatr Adolesc Med. 1997;151:989–992.PubMed
13.
Didia BC, Dapper DV, Boboye SB. Joint hypermobility syndrome among undergraduate students. East Afr Med J. 2002;79:80–81.PubMed
14.
Dolan AL, Hart DJ, Doyle DV, Grahame R, Spector TD. The relationship of joint hypermobility, bone mineral density, and osteoarthritis in the general population: the Chingford Study. J Rheumatol. 2003;30:799–803.PubMed
15.
el-Shahaly HA, el-Sherif AK. Is the benign joint hypermobility syndrome benign? Clin Rheumatol. 1991;10:302–307.CrossRefPubMed
16.
Grahame R. Joint hypermobility—clinical aspects. Proc R Soc Med. 1971;64:692–694.PubMed
17.
Grahame R, Bird HA, Child A. The revised (Brighton 1998) criteria for the diagnosis of benign joint hypermobility syndrome (BJHS). J Rheumatol. 2000;27:1777–1779.PubMed
18.
19.
Hall MG, Ferrell WR, Sturrock RD, Hamblen DL, Baxendale RH. The effect of the hypermobility syndrome on knee joint proprioception. Br J Rheumatol. 1995;34:121–125.CrossRefPubMed
20.
Harris H, Joseph J. Variation in extension of the metacarpo-phalangeal and interphalangeal joint of the thumb. J Bone Joint Surg Br. 1949;31B:547–559, illust.PubMed
21.
Hirsch C, John MT, Stang A. Association between generalized joint hypermobility and signs and diagnoses of temporomandibular disorders. Eur J Oral Sci. 2008;116:525–530.CrossRefPubMed
22.
Jessee EF, Owen DS, Jr., Sagar KB. The benign hypermobile joint syndrome. Arthritis Rheum. 1980;23:1053–1056.CrossRefPubMed
23.
Kirk JA, Ansell BM, Bywaters EG. The hypermobility syndrome. Musculoskeletal complaints associated with generalized joint hypermobility. Ann Rheum Dis. 1967;26:419–425.CrossRefPubMed
24.
Klemp P, Williams SM, Stansfield SA. Articular mobility in Maori and European New Zealanders. Rheumatology (Oxford). 2002;41:554–557.CrossRef
25.
Lamari NM, Chueire AG, Cordeiro JA. Analysis of joint mobility patterns among preschool children. Sao Paulo Med J. 2005;123:119–123.CrossRefPubMed
26.
Leone V, Tornese G, Zerial M, Locatelli C, Ciambra R, Bensa M, Pocecco M. Joint hypermobility and its relationship to musculoskeletal pain in schoolchildren: a cross-sectional study. Arch Dis Child. 2009;94:627–632.CrossRefPubMed
27.
Mallik AK, Ferrell WR, McDonald AG, Sturrock RD. Impaired proprioceptive acuity at the proximal interphalangeal joint in patients with the hypermobility syndrome. Br J Rheumatol. 1994;33:631–637.CrossRefPubMed
28.
Nijs J, Aerts A, De Meirleir K. Generalized joint hypermobility is more common in chronic fatigue syndrome than in healthy control subjects. J Manipulative Physiol Ther. 2006;29:32–39.CrossRefPubMed
29.
Orueta JF, Urraca J, Berraondo I, Darpon J. Can primary care physicians use the ICD-9-MC? An evaluation of the quality of diagnosis coding in computerized medical records [in Spanish]. Gac Sanit. 2006;20:194–201.CrossRefPubMed
30.
Owens B, Mountcastle S, White D. Racial differences in tendon rupture incidence. Int J Sports Med. 2007;28:617–620.CrossRefPubMed
31.
Owens BD, Duffey ML, Nelson BJ, DeBerardino TM, Taylor DC, Mountcastle SB. The incidence and characteristics of shoulder instability at the United States Military Academy. Am J Sports Med. 2007;35:1168–1173.CrossRefPubMed
32.
Owens BD, Dawson L, Burks R, Cameron KL. Incidence of shoulder dislocation in the United States military: demographic considerations from a high-risk population. J Bone Joint Surg Am. 2009;91:791–796.CrossRefPubMed
33.
Quatman CE, Ford KR, Myer GD, Paterno MV, Hewett TE. The effects of gender and pubertal status on generalized joint laxity in young athletes. J Sci Med Sport. 2008;11:257–263.CrossRefPubMed
34.
Scher DL, Belmont PJ, Jr., Mountcastle S, Owens BD. The incidence of primary hip osteoarthritis in active duty US military servicemembers. Arthritis Rheum. 2009;61:468–475.CrossRefPubMed
35.
Schweitzer G. Laxity of metacarpophalangeal joints of fingers and interphalangeal joint of the thumb: a comparative inter-racial study. S Afr Med J. 1970;44:246–249.PubMed
36.
Seckin U, Tur BS, Yilmaz O, Yagci I, Bodur H, Arasil T. The prevalence of joint hypermobility among high school students. Rheumatol Int. 2005;25:260–263.CrossRefPubMed
37.
38.
Subramanyam V, Janaki KV. Joint hypermobility in south Indian children. Indian Pediatr. 1996;33:771–772.PubMed
39.
van der Esch M, Steultjens M, Knol DL, Dinant H, Dekker J. Joint laxity and the relationship between muscle strength and functional ability in patients with osteoarthritis of the knee. Arthritis Rheum. 2006;55:953–959.CrossRefPubMed
40.
Wolf JM, Oren TW, Ferguson B, Williams A, Petersen B. The carpometacarpal stress view radiograph in the evaluation of trapeziometacarpal joint laxity. J Hand Surg Am. 2009;34:1402–1406.CrossRefPubMed
41.
Wolf JM, Sturdivant RX, Owens BD. Incidence of de Quervain’s tenosynovitis in a young, active population. J Hand Surg Am. 2009;34:112–115.CrossRefPubMed
42.
Wood PH. Is hypermobility a discrete entity? Proc R Soc Med. 1971;64:690–692.PubMed
43.
Yazici M, Ataoglu S, Makarc S, Sari I, Erbilen E, Albayrak S, Yazici S, Uyan C. The relationship between echocardiographic features of mitral valve and elastic properties of aortic wall and Beighton hypermobility score in patients with mitral valve prolapse. Jpn Heart J. 2004;45:447–460.CrossRefPubMed
Metadata
Title
Incidence of Joint Hypermobility Syndrome in a Military Population: Impact of Gender and Race
Authors
Danielle L. Scher, MD
Brett D. Owens, MD
Rodney X. Sturdivant, PhD
Jennifer Moriatis Wolf, MD
Publication date
01-07-2010
Publisher
Springer-Verlag
Published in
Clinical Orthopaedics and Related Research® / Issue 7/2010
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-009-1182-2

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