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Abstract Number: 1562

Benign Joint Hypermobility Syndrome More Common Than Expected,Both in Controls and in SLE Patients

Pia Malcus-Johnsson1, Lotta Köhlin1, Gunnar K. Sturfelt2 and Ola Nived3, 1Department of Rheumatology, University Hospital, Lund, Sweden, 2Department of Rheumatology, University Hospital Lund, Lund, Sweden, 3Department of Clinical Science, Lund University, Rheumatology, Lund, Sweden

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords: Hypermobility and systemic lupus erythematosus (SLE)

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Session Information

Title: Clinical Practice/Patient Care

Session Type: Abstract Submissions (ARHP)

Background/Purpose:

Benign joint hypermobility syndrome(BJHS) in connection to rheumatic disease is sparsely investigated. It has been postulated that BJHS is more frequent in SLE than in the healthy population. The aim of this study was to investigate the frequency of BJHS in SLE patients.

Methods:

Seventy-one female individuals with SLE, age 18-65, were consecutively according to age groups, enrolled to the study and were matched by healthy female controls of the same age. The study required one visit to the clinic. All individuals were examined by physician (ON/GS) for Brighton criteria and medical symptoms, by physical therapist (LK) and occupational therapist (PMJ) for Beighton scores and manifestations in body structures and body functions.

Results:

Thirty-nine (55 %) individuals in SLE group and 22 (31%) in the control group satisfied  Brighton criteria for BJHS (p<.004), most commonly satisfying one major and two minor criterias, whereas 16 (23%) individuals with SLE and 19 (27%) healthy controls had Beighton score ≥4 (ns).  Brighton criteria to show significant differences between the groups were arthralgia major n 44/9 (p<.000), soft tissue leasions n 35/7 (p<.000), eye signs n 17/32 (p<.008), and in addition  depression n 15/6 p<.033. Six individuals in the SLE group and seven in the control group had Beighton score of four or more, but did not satisfy Brighton criteria.

Within the SLE group differences between satisfying Brighton criteria or not consisted of significant differences in arthralgia major (p<.000), soft tissue rheumatism (p<.000), abnormal skin (p<.041), eye signs (p<.000) and varicose veins or prolapse (p<.005). There was in addition a significant difference in disease activity (p<.009) and in pelvic pain (p<.035). No significant differences were found in Beighton scores or other factors constituting Brighton criteria.

In physical therapist protocol, within SLE-group, significant differences were detected in being clumsy or stumble (p<.003), standing still for a while (p<.033), jaw luxation  (p<.002) and experiencing problems in shoulders (p<.009), knee (p<.001), foot (p<.033) and back (p<.033).

In occupational therapist protocol, within SLE-group, significant differences were found in estimating hand function on VAS (right p<.014, left p<.029), grip force (right p<.001, left p<.002), pinch force (right p<.000, left p<.000) and in right hand dexterity (p<.005) and estimating hand pain at work on VAS (p<.025). No differences were found in deformities of the hand.

According to age, within SLE-group, there was no significant difference in satisfying Brighton criteria but a significant difference (p<.019) in ≥ 4 Beighton score with higher scores in younger individuals, cut off point 45 years. Older individuals had significantly higher rates of Beighton 1,2,3 (p<.005), arthralgia minor (p<.014) and in addition symptoms from bowel (p<.008).

Conclusion: From this study no certain conclusion can be drawn whether SLE and BJHS are related, but for both cases and controls BJHS was much more common than in other published age matched Caucasian series from Sweden.


Disclosure:

P. Malcus-Johnsson,
None;

L. Köhlin,
None;

G. K. Sturfelt,
None;

O. Nived,
None.

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