Seattle Acupuncture &  Pain Management 

916 E Miller St    Seattle, WA 98102     Phone: (206) 459-3704  

Conditions Treated » Elhers-Danlos Syndrome

Seattle Acupuncture and Pain Management understands the seriousness of living with EDS and how painful life can be for people suffering with the hypermobility Type of EDS (Elhers-Danlos Syndrome Type III).

 

Ehlers-Danlos syndromes (EDS) are a collection of genetic disorders that affect a person's connective tissue. People who suffer with EDS exhibit problems with collagen, a protein that adds strength and elasticity to connective tissue. This irregular collagen affects many body parts, including skin, muscles and ligaments.

 

In patients with the Hypermobility Type of EDS we see loose joints and chronic joint pain. This form of Ehlers-Danlos Syndrome was formerly called type III.  Ehlers-Danlos Syndrome, Hypermobility Type is a subtype of Ehlers-Danlos Syndrome.

 

Most suffers exhibit large range of joint movement, hence hypermobility. Small and large joints can be unstable and some joints tend to dislocate often.  It is not unusuall for patients to exhibit chronic joint and limb pain that can begin in childhood. People with this condition may also have very soft, velvety, stretchy skin, however, skin symptoms can vary among people. 

 

Why Do You Have It?

The most common type of EDS is the Hypermobility Type. It is most often inherited in an autosomal dominant pattern, which means one copy of the altered gene is sufficient to cause the disorder. In these cases, family members in each generation are usually affected, but the features of the condition may vary person to person or generation to generation. 

 

It Can Be A Recessive Trait

It is possible in some families, to pass on a recessive pattern of the Syndrome. This inheritance pattern means that two copies of the gene must be altered for a person to be affected by the disorder. Most often, the parents of a child with an autosomal recessive disorder are not affected but are carriers of one copy of the altered gene

 

Major Diagnostic Criteria for the Hypermobility Type or EDS Joint hypermobility, which usually is confirmed by a score of five or more on the nine-point Beighton scale 
[Beighton et al 1973], including:

 

  1. One point for passive dorsiflexion of each fifth finger >90º
  2. One point for passive apposition of each thumb to the flexor surface of the forearm
  3. One point for hyperextension of each elbow >10º
  4. One point for hyperextension of each knee >10º
  5. One point for ability to place the palms on the floor with the knees fully extended
  6. Soft or velvety skin with normal or slightly increased  
extensibility

 

Minor Diagnostic Criteria for the Hypermobility Type of EDS

 

  1. Family history of similar features without significant skin or soft tissue fragility in a pattern consistent with autosomal dominant inheritance 
  2. Recurrent joint dislocations or subluxations
  3. Chronic joint or limb pain
  4. Easy bruising
  5. Functional bowel disorders (functional gastritis, irritable bowel syndrome)
  6. Neurally mediated hypotension or postural orthostatic tachycardia
  7. High, narrow palate
  8. Dental crowding

 

Assessment of skin hyperextensibility is performed at a site lacking excess or loose skin and in an area without evidence of prior trauma by gently pulling until resistance is met. The extensor surfaces of joints are typically not used used because of the presence of excess skin.  The perfect test location for skin hyperextensibility is the volar surface of the forearm, where the upper limit of normal is approximately 1-1.5 cm.

 

  1. Absence of skin or soft tissue fragility, which is suggestive of other types of EDS. Examples include:
  2. Spontaneous or easily induced skin cuts or tears
  3. Spontaneous or easily induced tears or ruptures of tendons, ligaments, vessels, or other internal organs
  4. Atrophic ("cigarette paper") scars (although mildly atrophic scars are  sometimes seen in the hypermobility  type, especially in areas subject to physical stress, such as extensor surfaces and the abdominal wall)
  5. Molluscoid pseudotumors
  6. Surgical complications, such as incisional hernia, wound dehiscence, or sutures tearing through tissues and failing to hold