Document Detail

Joint hypermobility is a risk factor for musculoskeletal pain during adolescence: findings of a prospective cohort study.
MedLine Citation:
PMID:  23450628     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine whether joint hypermobility (JH) in childhood is a risk factor for the subsequent development of musculoskeletal pain.
METHODS: JH was determined according to the Beighton score at age 13.8 years in children from the Avon Longitudinal Study of Parents and Children (ALSPAC), using a cutoff of ≥6 for the presence of hypermobility. Musculoskeletal pain was evaluated by questionnaire at age 17.8 years. Logistic regression analysis was performed in 2,901 participants (1,267 boys and 1,634 girls) who had complete data.
RESULTS: A total of 4.6% of participants had JH at age 13.8 years. Moderately troublesome musculoskeletal pain at age 17.8 years was reported most commonly in the lower back (16.1%), shoulder (9.5%), upper back (8.9%), knee (8.8%), neck (8.6%), and ankle/foot (6.8%). JH was associated with an increased risk of at least moderately troublesome musculoskeletal pain at the shoulder (odds ratio [OR] 1.68 [95% confidence interval (95% CI) 1.04, 2.72]), knee (OR 1.83 [95% CI 1.10, 3.02]), and ankle/foot (OR 1.82 [95% CI 1.05, 3.16]) (adjusted for sex, maternal education, and body mass index). An equivalent relationship was not observed at other sites, including the spine, elbows, hands, and hips. In analyses examining interactions with obesity, associations between JH and knee pain showed higher ORs in obese participants (OR 11.01) as compared with nonobese participants (OR 1.57) (P=0.037 for the interaction of hypermobility and obesity).
CONCLUSION: JH represents a risk factor for musculoskeletal pain during adolescence, comprising a specific distribution, namely, the shoulder, knee, and ankle/foot. These relationships were strongest in the presence of obesity, which is consistent with a causal pathway whereby JH leads to pain at sites exposed to the greatest mechanical forces.
Jonathan H Tobias; Kevin Deere; Shea Palmer; Emma M Clark; Jacqui Clinch
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Arthritis and rheumatism     Volume:  65     ISSN:  1529-0131     ISO Abbreviation:  Arthritis Rheum.     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-04-04     Completed Date:  2013-05-22     Revised Date:  2014-02-24    
Medline Journal Info:
Nlm Unique ID:  0370605     Medline TA:  Arthritis Rheum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1107-15     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2013 by the American College of Rheumatology.
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MeSH Terms
Ankle Joint / physiopathology
Arthralgia / epidemiology*
Back Pain / epidemiology
Cohort Studies
Foot / physiopathology
Joint Instability / complications,  epidemiology*
Knee Joint / physiopathology
Logistic Models
Longitudinal Studies
Low Back Pain / epidemiology
Musculoskeletal Pain / epidemiology*,  etiology
Neck Pain / epidemiology
Obesity / epidemiology
Odds Ratio
Prospective Studies
Risk Factors
Shoulder Pain / epidemiology
Grant Support
076467//Wellcome Trust; 092731//Wellcome Trust; 18185//Arthritis Research UK; 74882//Medical Research Council; G9815508//Medical Research Council

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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