School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia.
Rheumatology Department, Princess Margaret Hospital for Children, Perth, Western Australia, Australia.
Arch Dis Child. 2019 Nov;104(11):1099-1101. doi: 10.1136/archdischild-2017-314149. Epub 2018 Aug 17.
To investigate a cohort of children with symptomatic joint hypermobility.
Case notes for 318 children with joint hypermobility attending a rheumatology clinic were reviewed for clinical presentation, medical history, psychosocial factors and physical examination findings. Seven key variables were extracted and used as indicator variables in a latent class analysis to estimate the presence and number of subgroups of children with symptomatic joint hypermobility.
Two subgroups with differing clinical presentations were identified accounting for age and gender: an 'athletic-persistent' class (62%) characterised by higher probabilities for recurrent and chronic musculoskeletal pain, and less severe hypermobility; and a 'systemic-profound' class (38%) characterised by generalised hypermobility, recurrent musculoskeletal pain, gastro-oesophageal reflux and motor delay.
Findings suggest the presence of two distinct presentations of children with hypermobility. This finding may be important for clinical decision-making and management of this group of children.
研究一组有症状关节过度活动症的儿童。
对 318 名在风湿病诊所就诊的关节过度活动症儿童的病历进行了回顾,以了解其临床表现、病史、社会心理因素和体格检查结果。提取了 7 个关键变量,并将其用作潜在类别分析中的指示变量,以估计有症状关节过度活动症儿童亚组的存在和数量。
确定了两个具有不同临床表现的亚组,分别占年龄和性别:“运动型-持续性”类(62%)表现为反复和慢性肌肉骨骼疼痛的可能性更高,且关节过度活动程度较轻;“全身性-深刻性”类(38%)表现为全身性关节过度活动、反复肌肉骨骼疼痛、胃食管反流和运动迟缓。
研究结果表明,存在两种不同表现形式的过度活动症儿童。这一发现可能对该组儿童的临床决策和管理具有重要意义。