CONTENT FOR PHYSICIANS

 

Members of the Joint Hypermobility Syndrome Study Group, Philadelphia Oct. 2009

 

 

   Malfait       Grahame       Rombaut         Daniel            Bravo            

(Belgium)       (UK)           (Belgium)          (UK)            (Chile)         

 

Typical features of the Ehlers-Danlos Syndrome Hypermobile type (EDS – III)

Jaime F. Bravo                                                                                          *** Noviembre 2011 ***

*** presented to the Joint Hypermobility Study Group at the ACR 2011 in Chicago, Michigan, Nov. 2011     ***

 

"Treatment of Dysautonomia in the Joint Hypermobility Syndrome"

**  presented to the Joint Hypermobility Study Group at the ACR 2010 in Atlanta, Georgia  Nov. 2010   **     ***    New January 2011    ***

 

 

Typical Joint Hipermobility Syndrome Pictures                                 ***     December 2010    ***

**  presented to the Joint Hypermobility Study Group at the ACR 2010 in Atlanta, Georgia  Nov. 2010  **

 

 

Hereditary Connective Tissue Disorders slide collection

*** Presented to the ACR Study Group.  Oct 2008 San Francisco, USA.    ***

 

Hereditary Disorders of the Connective Tissues (HDCT)

 

A)      Ehlers-Danlos  Syndrome (EDS).  From the previously known 10 types of EDS, they have been reduced into 6 types:

 

·       Hypermobile EDS or Classic EDS (formerly EDS type I-II).    Description

                                                                                                            Photos 

·       Joint Hypermobility Syndrome (JHS)  For most authors it is the same as EDS Type III

·       Vascular  EDS ( VEDS) o EDS type IV (formerly EDS-IV)     Description

                                                                                                            Photos 

·       Kyphoscoliosis EDS( formerly VEDS  type VI).

·       Arthrocalasia EDS (Congenital Hip Dislocation). Formerly included in EDS type VII

·       Dermatoparaxis EDS. Formerly included in EDS type VII

  

B)      Marfan Syndrome (MFS). 

 

                 Marfan Syndrome Photos   Photo taken from literature

 

                 Marfan Syndrome Diagnostic Criteria

 Marfanoide Habitus in JHS vs. Marfan Syndrome

 

 

C)      Osteogenesis Imperfecta (OI).  

 Description and Photos

 Photos of Osteogenesis Imperfecta

                 Sillence Classification

 

 

 

2. Classic Ehlers-Danlos Syndrome (CEDS) or EDS type I - II

 

 

 

 

 

 

Author and contributor of 2 chapters in the book "Hypermobility, Fibromyalgia and Chronic Pain"

 Hakim, Keer y Grahame, Elsevier, 2010, UK

 

Chapter 2. Contributor "What is the Joint Hypermobility Syndrome, JHS from the cradle to the grave"

 

Chapter 6.1. Author "Cardiovascular autonomic dysfunction and chronic fatigue in fibromyalgia and joint hypermobility syndrome"  This chapter deal with the subject of Dysautonomia in the Joint Hipermobility Syndrome

 

 

 

 

 

 

 

ARTICLES

 

 

Ehlers-Danlos Syndrome type III, also called Joint Hypermobility Syndrome (JHS): Epidemiology and Clinical Manifestations.

Jaime F. Bravo,                                                                                                                 *** July 2010 ***

**   Published in Reumatología 2010; 26(2):194 - 202  article in Spanish with Abstract in English.  Article contains an interesting amount of photos of the characteristic signs of this condition  ***

 

 

 

A better name for the Joint Hypermobility Syndrome (JHS) could be Ehlers-Danlos Syndrome type III (EDS-III)

                                                                                   ***     September 2010    ***

 

 

When to suspect the diagnosis of Ehlers-Danlos type III, also called Joint Hypermobility Syndrome (JHS).

                                                                    ***          New April 2010    ***

 

 Ehlers-Danlos syndrome, with special emphasis in the joint hypermobility syndrome 

          Abstract in English

Síndrome de Ehlers-Danlos con especial énfasis en el síndrome de hiperlaxitud articular.

 Jaime F. Bravo                                                             ***          New January 2010    ***

 ***   Revista Médica de Chile  2009, vol.137, n.11, pp. 1488-1497.  ***
 

 

 

 

 

                                                      

 

Signs and Symptoms of Joint Hypermobility Syndrome (JHS) to consider when diagnosing this condition.  

Jaime F. Bravo, Carlos Wolff                              Abstract

**¨Poster presented at the 2009 ACR Anual Scientific Meeting,  Philadelphia, PA, October  16 to 21, 2009

     Arthritis Rheum 2009; 60 ( Suppl ):S30 **

                                                                                                             ***        October 2009    ***

    Is there a Need to Change the Name of the Joint Hypermobility Syndrome (JHS)?

          Jaime F. Bravo

          *** Presented to the ACR Hipermobility Study Group.  Oct 2009 Philadelphia, PA, USA.    ***

 

                                                                                                             ***        October 2009    ***

 

        Osteoporosis and Dysautonomia in the Joint Hypermobility Syndrome

          Jaime F. Bravo

          *** Presented to the ACR Joint Hipermobility Syndrome Study Group.  Oct 2009 Philadelphia, PA,USA.    ***

 

                                                                                                             ***        October 2009    ***

Low Bone Mineral Density (BMD) and Dysautonomia in Adolescents and Young Patients with Ehlers-Danlos Type III. Clinical Study with 90 Patients          Abstract/Resumen

Jaime F. Bravo, Carlos Wolff 

**¨Poster presented at the 2008 Anual Scientific Meeting ACR  San Francisco, CA, November  23 to 28, 2008,

     Published in Arthritis Rheum 2008;Vol.56 (9) Suppl:S746 **                                                                                                                                             ***        November 2008    ***

        Criteria overlap in  EDS Hypermobility Type and JHS

            Jaime F. Bravo                                                                                  ***          November 2008    ***

            *** Presented to the ACR Study Group.  Oct 2008 San Francisco, USA.    ***

    

        Fibromyalgia or Joint Hypermobility Syndrome (JHS)

            Jaime F. Bravo                                                                                  ***          November 2008    ***

            *** Presented to the ACR Study Group.  Oct 2008 San Francisco, USA.    ***

 

Clinical Study of Dysautonomia in 1226 patients with Joint Hypermobility Syndrome

Jaime F. Bravo, Carlos Wolff 

** Presented as a Poster at the  XV Pan-American League of Associations for Rheumatology (Panlar) in Guatemala City, 

    August 12 - 16th 2008  

    Abstract published in JCR: Journal of Clinical Rheumatology Vol 14, Number 4, August Supplement   2008, S33   **

                                                                                                                                       ***      August 2008    ***

    

Importance and significance of studying people with joint hypermobility.

** Translated from the spanish version in Revista Chilena de Reumatología 2008; 24(1):4-5 **                ***        May 2008    ***

 

Clinical Study of 1124 Cases  of Ehlers-Danlos Syndrome (Classic EDS, JHS and Vascular EDS)

Jaime F. Bravo, Carlos Wolff                                                            *** November 2007 ***

** Poster presented at the 2007 Anual Scientific Meeting ACR

    Boston, MA, November 6 - 11 2007

     Published in Arthritis Rheum: Vol.56, No 9(Suppl), November 2007; pp 1633  ** 

Abstract   

 

    Clinical study of hereditary disorders of connective tissues in a 

     Chilean population. Joint hypermobility syndrome and vascular

     Ehlers-Danlos syndrome  

           Jaime F. Bravo, Carlos Wolff                ***  February 2006  ***

      ** Clinical Study published in Arthritis Rheum Vol.54, No 2, February 2006, 

           pp  515-523 ** 

 

 

     

 

Characteristic Photographs

 

1 . Joint Hypermobility Syndrome (JHS): 

     (Ehlers-Danlos Syndrome type III)            ***  February 2007  ***

"Typical Face" in Joint Hypermobility Syndrome (JHS) 

JHS "Typical Face" (II)

"Blue Sclera"

"Atypical Ears" in JHS

Mobile Tongue in JHS

Prominent Ribs in JHS

"Hand holding de head" Sign in JHS

"Flying Bird Hand" Sign in JHS

Marfanoid Habitus in JHS vs. Marfan Syndrome

Marfanoid Habitus in JHS

“Horizontal Thumb” Sign and "Duck neck Thumb" in JHS

Dark skin sign in the joint extension surfaces in JHS: “dark elbows”, “dark fingers” and “dark knees”.

Skin alterations in JHS

Prominent Veins in JHS

"Square shoulder" Sign in JHS

"Lax Scribe Hand" sign

"Elephant Track" sign

 

 

2. Classic Ehlers-Danlos Syndrome (CEDS) or EDS type I - II

 

3. Vascular Ehlers-Danlos Syndrome Facial Appearance (VEDS) (EDS-IV)

 

4. Marfan Syndrome

 

5. Osteogenesis Imperfecta

 

Description and Photos

Photos of Osteogenesis Imperfecta

 

 

 

 

 

Vascular Ehlers-Danlos Syndrome  (VEDS or EDS - IV)

 

Vascular Ehlers-Danlos Syndrome ( VEDS ), formerly known as EDS type IV.

Jaime F. Bravo

***  English Abstract Published in Revista Chilena de Reumatología 2008; 24(1):6-11  ***

 

 

Clinical Study of Dysautonomia in 1226 patients with Joint Hypermobility Syndrome

Jaime F. Bravo, Carlos Wolff 

** Presented as a Poster at the  XV Pan-American League of Associations for Rheumatology (Panlar) in Guatemala City, 

    August 12 - 16th 2008  

    Abstract published in JCR: Journal of Clinical Rheumatology Vol 14, Number 4, August Supplement   2008, S33   **

                                                                                                                                       ***       August 2008    ***

 

Clinical Study of 972 Rheumatological Patients with Joint Hypermobility Syndrome (JHS), using the Brighton Criteria

Jaime F. Bravo, Carlos Wolff, Sergio Correa                                                                    *** June 2007 ***

** Presented as a Poster at the Annual European Congress of Rheumatology (EULAR), 

    from June 13 till 16, 2007 , Barcelona, Spain  

    Published in Ann Rheum Dis 2007;66(Suppl II):244 ** 

Abstract      Tables

 

 

Pain in the Joint Hypermobility Syndrome (JHS)                                     ***   May  2007  **

Low bone mineral density in adolescents and young patients with joint hypermobility syndrome:  preliminary clinical  study of 79 patients

Abstract         Poster   (in Spanish)      Tables   (in Spanish)

 Jaime F. Bravo, Carlos Wolff, Paula Rojas                                                                    ***   August 2006  ***

 ** Presented at the  XIV Pan-American League of Associations for Rheumatology (Panlar) in Lima, Peru.   August 19th – 23rd, 2006   

      Abstract published in JCR: Journal of Clinical Rheumatology Vol 12, Number 4, August Supplement  2006, S30 **

Reasons why I think that the lack of Folic Acid during the periconceptional period

is an etiological factor for the Joint Hypermobility Syndrome. 

                                                                                                                                      

Poster  presented at the ACR/ARHP 68th Annual Scientific Meeting, 16 - 21 October

2004, San Antonio, Texas: "Hereditary Disorders of the Connective Tissues(HDCT).

A clinical study of 249 cases 

** Abstract published in Arthritis &Rheumatism Vol. 50, No. 9(Suplemment), September 2004, pp S309 **  

 

Detailed explanation of the "Hereditary Disorders of the Connective 

Tissues (HDCT). A clinical study of 249 cases" poster

** Abstract published in Arthritis Rheum Vol. 50, No 9(Supplemment), September 2004, pp S309 ** 

                                                                                                                                          

Poster presented at the XIII Congreso Internacional de Reumatologia, Termas de

Chillan, Chile, 17 - 20 Octubre 2004: "Importancia del Estudio de los Chilenos Altos:

Estudio Comparativo de 33 Marfanoides (MF) y 230 casos de Sindrome de

Hiperlaxitud Articular (SHA)"    

***Abstract published in REUMATOLOGIA 2004;20(4):218***

*** Both Poster and Abstract are presented in Spanish ***

 

Joint hypermobility syndrome: the most frequent cause of pain in rheumatological

practice? *** Press Interview at www.jointandbone.org which was also presented at the San Antonio

meeting ***

 

Joint Hypermobility  Syndrome (JHS) A Congenital Emergent Disease, that could be caused by a lack of Folic Acid during the periconceptional period      

       

When to suspect the diagnosis of Ehlers-Danlos type III, also called Joint Hypermobility Syndrome (JHS).

                                                                    ***          New April 2010    ***

 

Joint Hypermobility Syndrome (JHS) articles in Spanish found here

 

It Is Time For Rheumatologists To Identify Patients With Hypermobile Joints And To Diagnose The Benign Joint Hypermobility Syndrome                                                     

Utility of Bone Scintigraphy in the study of Hereditary Disorders of the Connective Tissues (HDCT)   

*** Published in the Alasbimn Journal 6(22): October 2003. Article N° AJ22- 5.  ***

 

Congenital Malformations and Folic Acid Administration in Fertile Aged Women 

*** Abstract ***

*** Published in the BOLETIN DEL HOSPITAL SAN JUAN DE DIOS 2003;50:300-02 ***

 

Dysautonomia:                                                                                       ***   January  2007  ***

                                                                     

 

Dysautonomia:  A not well known medical Problem 

** abstract **

*** Published in the BOLETIN DEL HOSPITAL SAN JUAN DE DIOS 2004;51:64-9 ***

 

 

Fibromyalgia

 

Diagnostic Criteria for: Joint Hypermobility Syndrome (JHS), Vascular Ehlers-Danlos and Marfan Syndrome 

 

Commentary about Marfanoid Habitus

 

 

 

   Letters to the Editor - Submitted by Dr. Bravo

 

Spontaneous Pneumothorax is seen in patients with Marfanoid habitus.

*** Letter to the Editor, submitted to The Internet Journal of Rheumatology  ***

                                                                                                                           ***   July 2007  ***

Spontaneous pneumothorax is seen in the joint hypermobility syndrome (JHS)

*** Letter to the Editor, published in Rheumatology Vol. 45 No. 8, Aug 2006; pp 1052 - 53 ***

                                                                                                                      ***   August  2006  ***

 

Letter to the Editor of Arthritis & Rheumatism, regarding the protective role of

Hypermobility on Hand Osteoarthritis,  published by Kraus et al.  

                                                                                                       ***   November  2004  ***

Commentary in response to Forum Topic: Is fibromyalgia being overdiagnosed  

***Commentary  which appeared in the  www.jointandbone.org Forum  ***

Fibromyalgia is not a diagnosis: Comment on the editorial by Crofford and Clauw and the comment by Ehrlich

Dry eyes and mouth syndrome or sicca, asthenia and polyalgia syndrome? Most patients previously diagnosed as Fibromyalgia probably have Joint Hypermobility Syndrome.

 

 

Jaime F. Bravo MD's commentaries about Joint Hypermobility written by other authors

 

Pediatric Generalized Joint Hypermobility With and Without Musculoskeletal Complaints: A Localized or Systemic Disorder?

 

Recomended further reading:

Hypermobility, Fibromyalgia and Chronic Pain

Hakim A., Keer R. y Grahame R.

UK: Elsevier; 2010

This book can be obtained from  www.elsevierhealth.com

 

 

 

Hypermobility Syndrome. Recognition and Management for Physiotherapists.

Keer R and Grahame R.

New York: Butterworth Heinemann Health; 2003. 

This book can be obtained from   www.elsevierhealth.com  or  www.amazon.com

 

        Bulbena A et al, CD on Joint Hypermobility.  Definition and exploration.

        Information on this CD  can be requested at 

        Asociación Síndromes de Ehlers-Danlos e Hiperlaxitud (ASEDH)

 

        Differential Diagnosis of the various Ehlers-Danlos Syndromes

         **   Published  online at Ehlers-Danlos Support Group (EDS), England 

                http://www.ehlers-danlos.org ***

 

  Articles of interest written by other authors:

 

Folic Acid's Benefits Go Beyond Birth

**   Published  on  Wall Street Journal, paper edition,  03/02/2004  ***