Issues and Management of Joint Hypermobility: A Guide for the Ehlers-Danlos Syndrome Hypermobility Type and the Hypermob
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BOOK REVIEW
Issues and Management of Joint Hypermobility: A Guide for the Ehlers-Danlos Syndrome Hypermobility Type and the Hypermobility Syndrome By Brad Tinkle, MD, PhD. Left Paw Press, Greens Fork, IN 47345, 2008, 144 pp., $17.95 paperback Melanie Pepin
Received: 26 January 2009 / Accepted: 18 February 2009 / Published online: 7 March 2009 # National Society of Genetic Counselors, Inc. 2009
Issues and Management of Joint Hypermobility is a welcome addition to a diminutive set of resources currently available to those who care for children and adults with hypermobility type Ehlers-Danlos syndrome (EDS type III). This 133 page book offers “talking points” for affected adults, parents of children with EDS III, genetic counselors and therapists in their efforts to design and carry out an individualized treatment plan. Within its pages, the author provides a summary of medical research and gives expert opinion, and he reviews symptoms and potential medical problems. The author teaches while he guides the reader through avenues for optimizing good health.
The impact of the diagnosis of Hypermobility syndrome on health and well being is featured throughout. The 37 short chapters that follow are loosely organized by similar topic areas. The initial chapters discuss pain, pain treatment and therapies, followed by chapters addressing specific orthopedic problems (knee, hip, spine, and surgery) and the concluding chapters address body systems (heart, gastrointestinal, vision, dental) and overall mental health. In each instance, the published literature is quoted, recommendations offered where appropriate and helpful links or references supplied.
Key Features Book Organization A description of the clinical criteria used for making the diagnosis of EDS III, the hypermobile type is presented. In addition to using the typical Beighton scale for measuring joint flexibility, the author, Dr. Brad Tinkle, recommends the use of the Brighton criteria for accurately identifying the hypermobility syndrome. The Brighton criteria take into account the decrease in joint laxity that naturally occurs with age and they factor in joint subluxations and pain, symptoms often seen with EDS type III. A brief description of all forms of EDS follows, with a short note about autosomal dominant inheritance (with reduced penetrance), believed to be the pattern of inheritance in hypermobility type. M. Pepin (*) Department Pathology, University of Washington, Box 357470, Seattle, WA 98195-7470, USA e-mail: [email protected]
Two concepts stand out as major contributions to the reader’s understanding of Hypermobility syndrome (EDS type III). 1. The Pain Experience: The author discusses recurrent and chronic pain, a problem reported in the majority of adults with hypermobile EDS who seek medical care. He describes the concept of the “cycle of chronic pain.” When pain is present, its effects on mood may result in changes in energy (poor sleep and reduced activity). This low energy, in turn, may lead to depressed mood or anxiety and alter the perc
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