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Joint hypermobility and headache: understanding the glue that binds the two together--part 1
Derek Neilson1, Vincent T Martin
1Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Insights
Headaches can signal heritable connective tissue disorders (HCTD). Recognizing joint, skin, and arterial findings in patients with headaches aids in diagnosing and managing these complex conditions.
Area of Science:
- Neurology
- Genetics
- Rheumatology
Background:
- Heritable connective tissue disorders (HCTD) are associated with diverse clinical manifestations, including headaches.
- The underlying pathology of HCTD can lead to both common and rare causes of headaches.
Purpose of the Study:
- To review the association between heritable connective tissue disorders and headaches.
- To highlight key clinical findings that may suggest an underlying HCTD in patients presenting with headaches.
Main Methods:
- A literature review was conducted to synthesize information on HCTD and headaches.
Main Results:
- Ehlers-Danlos hypermobile type: characterized by joint hypermobility and potential for chronic pain.
- Ehlers-Danlos classic type: presents with joint laxity, skin laxity, and fragility.
- Ehlers-Danlos vascular type: associated with a high risk of vascular and organ rupture.
- Marfan syndrome: involves skeletal abnormalities, lens dislocation, and aortic root dilation, increasing dissection risk.
Conclusions:
- Identifying HCTD in patients with headaches can significantly improve diagnostic and management strategies.
- Clinical clues related to joints, skin, and arterial health warrant further investigation for HCTD.
Background:
Heritable connective tissue disorders (HCTD) present with a wide array of findings, including headache. Because of their unusual substrate, headaches in HCTD can derive from both common and uncommon circumstances.
Methods:
Literature review.
Results:
Ehlers-Danlos hypermobile type can be recognized by multiple joint findings and its tendency to progress to a multisystem chronic pain syndrome. Ehlers-Danlos classic type also manifests joint laxity and similar pain complaints, but is differentiated by its skin laxity and fragility. Ehlers-Danlos vascular type presents the most severe risk due to blood vessel and hollow organ rupture. Marfan syndrome demonstrates skeletal abnormalities, lens dislocations, and aortic root dilation that can result in dissection.
Conclusions:
In a headache patient, recognizing the presence of an HCTD improves the strategy for diagnosis and management. A brief review of findings related to joints, skin, and arteries may prompt further investigation into the HCTDs.
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