Flexible Joints Associated With Chronic Fatigue Syndrome, Researchers Find

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Source:   s Hopkins Medical Institutions

(http://www.hopkinsmedicine.org/)

Date:   Posted 9/6/2002

Flexible Joints Associated With Chronic Fatigue Syndrome, Researchers Find

Researchers at s Hopkins Children's Center report that children and

teens with chronic fatigue syndrome (CFS) are three and a half times more

likely to have hyperflexible joints than their healthy counterparts.

The findings, reported in the September issue of The Journal of Pediatrics,

contradict widely shared clinical observations that people with CFS have

normal physical examinations. CFS is an often disabling constellation of

fatigue- and pain-related symptoms that can interfere with daily life and

cause long absences from school.

" This study suggests either that hypermobility itself is an important factor

in the development of CFS, or it is associated with another factor that

predisposes a person to CFS, " says lead researcher C. Rowe, M.D.,

professor of pediatrics at the s Hopkins Children's Center.

Rowe cautions that joint hypermobility alone is not a direct cause of CFS.

" We know that about 20 percent of healthy adolescents have joint

hypermobility, but clearly most do not go on to develop CFS, so simply

finding this on an exam need not start a search for CFS, " Rowe says.

Researchers examined 116 children, ages 10 and older, for joint

hypermobility. The test group was split evenly between patients diagnosed

with CFS and otherwise healthy children. Joint hypermobility was graded on

the degree to which a patient could bend the pinkie finger back beyond 90

degrees; bend the thumb to touch the forearm; hyperextend the knee beyond

190 degrees; hyperextend the elbow beyond 190 degrees; and place the palms

flat on the floor without bending the legs. Sixty percent of those with CFS

showed joint hypermobility, compared with 24 percent of the healthy

children.

The link between flexible joints and CFS may provide further insight into

the development of CFS symptoms, because an individual's degree of joint

mobility is apparent in early childhood, long before the onset of CFS

symptoms, Rowe says.

Children with CFS often have orthostatic intolerance, a condition associated

with excessive pooling of blood that results in heart and blood pressure

problems, headaches, dizziness and other symptoms. Rowe and colleagues had

previously reported that patients with orthostatic intolerance also have

Ehlers-Danlos syndrome, a connective tissue disorder characterized by joint

hypermobility.

Researchers from the departments of Pediatrics and Dermatology, and the

McKusick-s Institute of Genetic Medicine, s Hopkins University

School of Medicine, contributed to the study.