THE OCCURRENCE OF JOINT HYPERMOBILITY AND GROWING PAINS IN SCHOOL CHILDREN - COINCIDENCE OR CAUSE?
Khubchandani R*, Viswanathan Vijay **
Jaslok Hospital & Research Center, Mumbai, India *, Jaslok Hospital & Research Center, Mumbai, India **
Objectives
To examine school children for coexistence of Joint Hypermobility (JHM) and Growing Pains (GP) and test the hypothesis that JHM may play a part in the pathogenesis of GP.
Methods
Cross-sectional study N = 448 (M-226, F-222; range 4-10 years) HM and GP assessed independent of each other.

JHM assessed using Beighton criteria, score > / = 4/9 considered positive. GP diagnosed if Naish and Apley criteria adapted by Hawksley and others fulfilled.
Results
237/448 (52.2%) found to have JHM. 126/448 (28.1%) fulfilled criteria for GP in the recent past 98/126 (77.7%) with GP had JHM and 98/237 (41.3%) with JHM had GP. JHM and GP found to be significantly associated (p <.0001). On analyzing children with knee hypermobility irrespective of the Beighton's score, strong association was found between children with this sign and those with GP (p value)
Conclusions
This study shows a strong association between JHM and GP. Additionally, there seems to exist a significant association of knee hypermobility with GP. We propose that JHM may play a part in the pathogenesis of GP. Longitudinal studies of both entities and assessment of children with GP using hypermobility scoring systems with greater weight age to lower extremity joints are needed. Confirmation of this causal relationship would allow for a tangible explanation to parents and a rational basis for physical therapy.

Meanwhile it is recommended that all children with GP be screened for JHM, specifically of the knees.
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