Epidemiology of generalized joint laxity (hypermobility) in fourteen‐year‐old children from the UK: A population‐based evaluation

Abstract

Although diagnostic criteria for generalised ligamentous laxity (hypermobility) in children are widely used, they may have limited validity as robust descriptive epidemiology of this condition is lacking. We used a large population-based birth cohort to describe the point prevalence and pattern of hypermobility in children aged 14 years. We performed a cross-sectional analysis of the Avon Longitudinal Study of Parents and Children (ALSPAC). Hyperrmobility was measured at aged 14 years using the Beighton scoring system. Objective measures of physical activity were collected by accelerometry. Data were collected on other variables including puberty and socio-economic status. Simple prevalence was calculated. Chi-squared tests and logistic regression were used to assess associations between variables and hypermobility. 6022 children were evaluated. Using a cut-off of ≥4, the prevalence of hypermobilty in girls and boys aged 13.8 years was 27.5% and 10.6% respectively. 45% of girls and 29% of boys had hypermobile fingers. There was a suggestion of a positive association between hypermobility in girls and variables including physical activity, body mass index and maternal education. No associations were seen in boys. We have shown that the prevalence of hypermobility in UK children is high; possibly suggesting that the Beighton cut off is too low or that the score is not appropriate in a developing musculoskeletal system. These results give a platform to evaluate the relationships between the Beighton criteria and key clinical features (including pain), thereby testing the clinical validity of this score in the childhood population.

Prevalence of generalised joint hypermobility in school-aged children from east-central European region

“…In general, the result of this study is in accordance with the previous studies on Western populations [3,8,11,16]. The fact that pupils without joint hypermobility were heavier, taller and older could be interpreted as the confirmation of hypothesis that the phenomenon of hypermobility disappears with age.…”

“…The prevalence of GJH was studied in different societies and populations. It ranges from 2% to 71% [3,7,8,11,14,[16][17][18][19]. Age, sex, and ethnic subjection have influenced the prevalence of GJH in different societies [2,3,7,13,15].…”

Need for international consensus on examining for joint laxity: Comment on the article by Clinch et al

“…The agreement between results obtained using these categories and those obtained using the tertiles was good for both the phalangeal and metacarpal 2D:4D ( ϭ 0.72 and ϭ 0.69, respectively). Analyses using these thresholds yielded similar results as were obtained in our primary model (as presented in the report), but the association between low 2D:4D length ratio and knee injury in men was attenuated (odds ratio 1 …”

“…Two previous studies demonstrated an association between low 2D:4D ratio (as a possible marker for prenatal testosterone) and knee OA (1,2). This observed association could possibly be due to a direct effect of testosterone on the cartilage in the prenatal period (3).…”

“…Several studies have relied on a visual classification, which is more prone to misclassification due to deviations of the hand. We therefore divided the participants into tertiles (i.e., the same approach as in earlier studies) (1,2). Mean values for the length ratio of the phalangeal and metacarpal bones in the 3 visual classification groups have previously been reported by Robertson et al (8).…”