Assessment Of Joint Hypermobility In Iraqi Patients With Inflammatory Bowel Diseases

  • Khalaf Anber Obaid
  • Faiq I. Gorial
  • Naser Hussein Sabr


Background Joint hypermobility  is a common condition characterized by joint laxity and an increased range of joint motion and may be associated with joint pain. joint pain is common in  inflammatory  bowel disease (IBD) and is often attributed to seronegative arthropathy.  Objective To assess JHM in Iraqi patients with IBD and to evaluate the associates of this possible relationship. Patients And Method A case-control study was conducted on 83 patients with IBD who were randomly seen between December 2014 and June 2015 at the gastrointestinal and liver diseases center of the medical city and the endoscopy unit of Baghdad Teaching Hospital compared to a 83 healthy individuals served as a control group who were randomly selected during the period of the study and matched for age and sex to the patient group.. Full  history was taken and complete clinical examination was done for all  individuals in both groups . Beighton’s Score for joint  hypermobility was   performed on patients and controls.  Results  Joint hypermobility was found in 12(14.5%) of IBD patients and 10 12% in  healthy controls (p> 0.05)  JHM was present and 6(17.6%) of 34 CD  patients  and 6  12.2%  of 49 UC patients (P> 0.05). The presence of JHM was significantly associated with younger age, short in duration of the disease, positive family history of JHM and low BMI (p< 0.05).  Conclusion  JHM was comparable in  IBD and controls. Younger age, short duration of the disease, positive family history of JHM and low BMI were significant associates with JHM.


Vounotrypidis P, Efremidou E, Zezos P, et al. Prevalence of joint hypermobility and patterns of articular manifestations in patients with inflammatory bowel disease. Gastroenterology Research and Practice 2009, 5 pages, doi:10.1155/2009/924138.

Grahame R. The revised (Brighton 1998) criteria for the diagnosis of benign joint hypermobility syndrome (BJHS). J Rheumatol. 2000; 27:1777-9.

Hakim AJ, Cherkas LF, Grahame R, et al. The genetic epidemiology of joint hypermobility: a population study of female twins. Arthritis Rheum.2004;50:2640-4. August 29,2006.

Martinez FD. Genes, Environment, development and asthma: a reappraisal. EurRespir J 2007;29 (1): 179-84. doi :10.1183/09031936. 00087906. PMID 17197483.

Al-Rawi ZS, Al-Aszawi AJ, Al-Chalabi T. Joint mobility among University students in Iraq. Br J Rheumatol 1985;24:326-31.

“Joint hypermobility”.Arthritis Research UK.

Sartor RB. Probiotic therapy of intestinal inflammation and infections. CurrOpinGasteroenterol. 2005;21:44-50.

Abraham C, Cho Jh. Inflammatory bowel disease. N Eng J Med. 2009;361:2066-2078.

Cantor M, Bernstein CN. Clinical course and natural history of ulcerative colitis. In: Sartor RB, Sanborn WJ (eds). Kirsner’s Inflammatory Bowel Dieases. Edinburgh: Saunders, 2004:280-288.

Munkholm P, Binder V. Clinical features and natural history of Crohn’s disease. In: Sartor RB, Sanborn WJ (eds). Kirsner’sInflammatory Bowel diseases. Edinburgh: Saunders, 2004:289-300.

Gary R L. Inflammatory Bowel Disease. In: Lee Goldman, Andrew I. Schafer (eds). Goldman’s cecil medicine.24thedn. Philadelphia USA: Elsevier, Saunders 2012; Ch 143; 913-20(CD).

12. Nicki R. Colledge, Brian R. Walker, Stuart H. Ralston. Davidson’s principles and practice of medicine. Churchill Livingstone 2010; 22:895-904.

Scherr R. Essers J, Hakonarson H. et al. Genetic determinants of pediatric inflammatory bowel disease: is age of onset genetically determined. Dig Dis 2009;27:236-239.

De Hertogh G, Aerssens J, Geboes KP et al. Evidence for the involvement of infectious agents in the pathogenesis of Crohn’s disease. World J Gastroenterol2008 ; 14: 845-852.

Fikree A, Aziz Q, Aktar R, et al . Joint pain and joint hypermobility ininflammatory bowel disease. Gut April 2011 vol 60 suppl I. doi: 10. 1136/gut.2011.239301. 305.

C. Baeza-Velasco, M. C. Ge’ly-Nargeot, A. BulbenaVilarrasa, J. F. Bravo. Joint hypermobility syndrome: problems that require psychological intervention. RheumatolInt 2011; 31: 1131-6.

Fatoye F, Palmer S, Macmillan F, et al. pain intensity and quality of life perception in children with hypermobility syndrome. Rheumatol Int. 2012; 32(5): 1277-84. Epub 2011 Jan 26.

Salvarani C, Vlachonikolis IG, van der Heijde DM, et al. Musculoskeletal manifestations in a population-based cohort of inflammatory bowel diseas patients. Scand J Gastroenterol. 2001; 36:1307-1313.

Bourikas LA and Papadakis KA. Musculiskeletal Manifestations of Inflammatory Bowel Disease.Inflamm Bowel disease.Inflamm Bowel Dis 2009;15:1915-1924.

Al-rawi Z. S., Al-Dubaikel K. Y. and Al-Sikafi H. Joint mobility in people with hiatus hernia. Rheumatology 2004; 43:574-6


Malfait F, Hakim AJ,DePaepe A, Grahame R. The genetic basis of the joint hypermobility syndromes. Rheumatology Oxford 2006;45:502.

Englebert RH, Bank RA, Sakkers RJ, Helders PJ, Beemer FA, Uiterwaal CS. Pediatric generalized joint hypermobility with and without musculoskeletal complaint: a localized or systemic disor-der, pediatrics 2003;111:e248-54.

Jacqui Clinch, Kevin Deer, Adrian Sayers, et al. Epidemiology of Generalized joint laxity (hypermobility) in Fourteen years old children from the UK: A population-based evolution. Arthritis Rheum. 2011. Sep;(9):2819-27. Doi:10.1002/art.30435.