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Two subtypes of symptomatic joint hypermobility: a descriptive study using latent class analysis
  1. Francesco Di Mattia1,
  2. Robyn Fary1,
  3. Kevin J Murray2,
  4. Erin Howie1,
  5. Anne Smith1,
  6. Susan Morris1
  1. 1 School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
  2. 2 Rheumatology Department, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
  1. Correspondence to Dr Susan Morris, School of Physiotherapy and Exercise Science, Curtin University, Perth, WA 6845, Australia; s.morris{at}


Objective To investigate a cohort of children with symptomatic joint hypermobility.

Methods 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.

Results 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.

Conclusion 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.

  • hypermobility
  • musculoskeletal pain
  • developmental coordination disorder
  • joint hypermobility syndrome
  • hypermobility spectrum disorder

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  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval The study was approved by Curtin Human Research Ethics Committee (RDHS 178-15).

  • Provenance and peer review Not commissioned; externally peer reviewed.