Hypermobility Lectures

Why the Zebra?  

Some medical students have been taught to look for the more common and usual diagnosis, not the unexpected one. 

“When you hear hoofbeats think horse, not zebra.”  The zebra became the symbol for those with Ehlers-Danlos Syndrome (EDS) and Hypermobility Spectrum Disorder (HSD) because they are the unexpected  

“Sometimes when you hear hoofbeats, it really is a zebra” (EDS Society) 

hypermobility. A diagnosis of HSD includes identifying the type of joint hypermobility present (including generalised, historical, peripheral or localised) plus one or more secondary musculoskeletal manifestations (trauma, chronic pain, disturbed proprioception etc) and excluding other possible causes of the symptoms.  HSD has superseded the previously used term Joint Hypermobility Syndrome (JHS).   

Hypermobile Ehlers–Danlos Syndrome (hEDS) has many similar features to those with symptomatic HSD but there are more stringent guidelines for diagnosis including not just the presence of hypermobility and pain, but also considering the family inheritance, and other common features such as body morphology and skin. As connective tissue is distributed throughout the body, manifestations of EDS are present, to varying degrees, in virtually every system of the body. This can make these disorders particularly challenging to diagnose and manage.   Etc

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