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Deconstructing and reconstructing joint hypermobility on an evo-devo perspective.
- Source :
-
Rheumatology (Oxford, England) [Rheumatology (Oxford)] 2021 Jun 18; Vol. 60 (6), pp. 2537-2544. - Publication Year :
- 2021
-
Abstract
- Joint hypermobility is a common characteristic in humans. Its non-casual association with various musculoskeletal complaints is known and currently defined "the spectrum". It includes hypermobile Ehlers-Danlos syndrome (hEDS) and hypermobility spectrum disorders (HSD). hEDS is recognized by a set of descriptive criteria, while HSD is the background diagnosis for individuals not fulfilling these criteria. Little is known about the aetiopathogenesis of the spectrum. It may be interpreted as a complex trait according to the integration model. Particularly, the spectrum is common in the general population, affects morphology, presents extreme clinical variability and is characterized by marked sex bias without a clear Mendelian or hormonal explanation. Joint hypermobility and the other hEDS systemic criteria are intended as qualitative derivatives of continuous traits of normal morphological variability. The need for a minimum set of criteria for hEDS diagnosis implies a tendency to co-vary of these underlying continuous traits. In evolutionary biology, such a co-variation (i.e. integration) is driven by multiple forces, including genetic, developmental, functional and environmental/acquired interactors. The aetiopathogenesis of the spectrum may be resolved by a deeper understanding of phenotypic variability, which superimposes on normal morphological variability.<br /> (© The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
- Subjects :
- Body Size genetics
Ehlers-Danlos Syndrome diagnosis
Ehlers-Danlos Syndrome etiology
Ehlers-Danlos Syndrome genetics
Ehlers-Danlos Syndrome pathology
Gene-Environment Interaction
Genetic Variation
Humans
Phenotype
Range of Motion, Articular physiology
Sex Characteristics
Sex Factors
Somatotypes genetics
Syndrome
Joint Instability diagnosis
Joint Instability etiology
Joint Instability genetics
Joint Instability pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1462-0332
- Volume :
- 60
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Rheumatology (Oxford, England)
- Publication Type :
- Academic Journal
- Accession number :
- 33668066
- Full Text :
- https://doi.org/10.1093/rheumatology/keab196