PDF(Pubmed)
Abstract：
Joint hypermobility syndromes, particularly chronic pain associated with this condition, including Hypermobile Ehlers-Danlos Syndrome (hEDS) and Hypermobility Spectrum Disorders (HSD), present diagnostic challenges due to their multifactorial origins and remain poorly understood from biomechanical and genomic-molecular perspectives. Recent diagnostic guidelines have differentiated hEDS, HSD, and benign joint hypermobility, providing a more objective diagnostic framework. However, incorrect diagnoses and underdiagnoses persist, leading to prolonged journeys for affected individuals. Musculoskeletal manifestations, chronic pain, dysautonomia, and gastrointestinal symptoms illustrate the multifactorial impact of these conditions, affecting both the physical and emotional well-being of affected individuals. Infrared thermography (IRT) emerges as a promising tool for joint assessment, especially in detecting inflammatory processes. Thermal distribution patterns offer valuable insights into joint dysfunctions, although the direct correlation between pain and inflammation remains challenging. The prevalence of neuropathies among hypermobile individuals accentuates the discordance between pain perception and thermographic findings, further complicating diagnosis and management. Despite its potential, the clinical integration of IRT faces challenges, with conflicting evidence hindering its adoption. However, studies demonstrate objective temperature disparities between healthy and diseased joints, especially under dynamic thermography, suggesting its potential utility in clinical practice. Future research focused on refining diagnostic criteria and elucidating the underlying mechanisms of hypermobility syndromes will be essential to improve diagnostic accuracy and enhance patient care in this complex and multidimensional context.
摘要：
关节过度活动综合征,特别是与这种情况相关的慢性疼痛，包括HypermobileEhlers-Danlos综合征（hEDS）和高移动性频谱障碍（HSD），由于其多因素起源，目前存在诊断挑战，并且从生物力学和基因组分子的角度仍然知之甚少。最近的诊断指南区分了hEDS，HSD,良性关节过度活动，提供更客观的诊断框架。然而,错误的诊断和诊断不足持续存在，导致受影响个体的长途旅行。肌肉骨骼表现，慢性疼痛,自主神经失调,胃肠道症状说明了这些疾病的多因素影响，影响受影响个体的身体和情绪健康。红外热成像(IRT)成为一种有前途的联合评估工具，特别是在检测炎症过程中。热分布模式提供了对关节功能障碍的宝贵见解，尽管疼痛和炎症之间的直接相关性仍然具有挑战性。超动个体中神经病的患病率加剧了疼痛感知和热成像发现之间的不一致。进一步复杂的诊断和管理。尽管有潜力,IRT的临床整合面临挑战，相互矛盾的证据阻碍了它的采用。然而,研究表明健康和患病关节之间的客观温度差异，特别是在动态热成像下，表明其在临床实践中的潜在效用。未来的研究重点是完善诊断标准和阐明过度活动综合征的潜在机制，对于在这种复杂和多维的背景下提高诊断准确性和增强患者护理至关重要。
