Re: Hypermobile shoulder socket, Ht>90%

[Guest guest]

This article looks relevant:http://www.jaoa.org/cgi/content/full/106/9/531Benign Joint Hypermobility Syndrome: Evaluation, Diagnosis, and ManagementBenign joint hypermobility syndrome (BJHS) is a connective tissue disorder with hypermobility in which musculoskeletal symptoms occur in the absence of systemic rheumatologic disease. Although BJHS has been well recognized in the rheumatology and orthopedic literature, it has not been discussed in the family medicine literature. Because most patients with musculoskeletal complaints are first seen by family physicians, it behooves primary care physicians to be familiar with recognizing and diagnosing BJHS. When patients with this syndrome are first seen by a physician, their chief complaint is joint pain, so BJHS can be easily overlooked and not considered in the differential diagnosis. Use of the Brighton criteria facilitates the diagnosis of BJHS. Treatment modalities include patient education, activity modification, stretching and strengthening exercises for the affected joint, and osteopathic manipulative treatment. SetoSouth Pasadena, CAAny thoughts on an 11 yo who is large for age Ht>90%ile (BMI is normal). No clinical evidence of Marfan's. Main question is his hypermobile shoulder joints.He can move both shoulers around such that it appears they are basically coming out the joint and back in. Not hyper-extendible elsewhere. Is this something that should be worked up? Thanks for your thoughts.  Locke, MDBasalt, COEau  (WI) Family Medicine Residency 1994Job Share w/ Wife=======================================5 Years in Air Force -- [Laughlin AFB (Del Rio, TX) // Spangdahlem AB, Germany]Joined Alpine Medical Group -- Private Group Practice since 1999AMG went independent from hospital MSO 10/04AMG implemented Centricity EMR April 2005AMG dissolved 17 August 2007Locke Family Medicine begins 18 August 2007www.LockeFamilyMedicine.comImplementing EMR/eClinicalWorks 9/07

[Guest guest]

Thanks .

I usually google this stuff first, but got lazy, plus I figured it was too generic of a symptom - kind of like searching headache.

But after you posted, It put in hypermobility joint and lo and behold, all these hits on the BJHS popped up - just like you found.

I'll have to go look at these articles and see if they fit my 11 yo patient.

thanks for getting me jump started.

Cheers

From: [mailto: ] On Behalf Of SetoSent: Friday, December 14, 2007 6:25 PMTo: Subject: Re: Hypermobile shoulder socket, Ht>90%

This article looks relevant:

http://www.jaoa.org/cgi/content/full/106/9/531

Benign Joint Hypermobility Syndrome: Evaluation, Diagnosis, and Management

Benign joint hypermobility syndrome (BJHS) is a connective tissue disorder with hypermobility in which musculoskeletal symptoms occur in the absence of systemic rheumatologic disease. Although BJHS has been well recognized in the rheumatology and orthopedic literature, it has not been discussed in the family medicine literature. Because most patients with musculoskeletal complaints are first seen by family physicians, it behooves primary care physicians to be familiar with recognizing and diagnosing BJHS. When patients with this syndrome are first seen by a physician, their chief complaint is joint pain, so BJHS can be easily overlooked and not considered in the differential diagnosis. Use of the Brighton criteria facilitates the diagnosis of BJHS. Treatment modalities include patient education, activity modification, stretching and strengthening exercises for the affected joint, and osteopathic manipulative treatment.

Seto

South Pasadena, CA

Any thoughts on an 11 yo who is large for age Ht>90%ile (BMI is normal).

No clinical evidence of Marfan's.

Main question is his hypermobile shoulder joints.

He can move both shoulers around such that it appears they are basically coming out the joint and back in.

Not hyper-extendible elsewhere.

Is this something that should be worked up?

Thanks for your thoughts.

Locke, MDBasalt, COEau (WI) Family Medicine Residency 1994

Job Share w/ Wife=======================================5 Years in Air Force -- [Laughlin AFB (Del Rio, TX) // Spangdahlem AB, Germany]Joined Alpine Medical Group -- Private Group Practice since 1999AMG went independent from hospital MSO 10/04AMG implemented Centricity EMR April 2005

AMG dissolved 17 August 2007

Locke Family Medicine begins 18 August 2007

www.LockeFamilyMedicine.com

Implementing EMR/eClinicalWorks 9/07