Chronic Pain and Joint Hypermobility: A Brief Diagnostic Review for Clinicians and the Potential Application of Infrared Thermography in Screening Hypermobile Inflamed Joints.

IF 2.5 3区 工程技术 Q2 BIOLOGY
Yale Journal of Biology and Medicine Pub Date : 2024-06-28 eCollection Date: 2024-06-01 DOI:10.59249/WGRS1619
João Alberto de Souza Ribeiro, Guilherme Gomes, Alexandre Aldred, Ivan Cesar Desuó, Luciana Aparecida Giacomini
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Abstract

Joint hypermobility syndromes, particularly chronic pain associated with this condition, including Hypermobile Ehlers-Danlos Syndrome (hEDS) and Hypermobility Spectrum Disorders (HSD), present diagnostic challenges due to their multifactorial origins and remain poorly understood from biomechanical and genomic-molecular perspectives. Recent diagnostic guidelines have differentiated hEDS, HSD, and benign joint hypermobility, providing a more objective diagnostic framework. However, incorrect diagnoses and underdiagnoses persist, leading to prolonged journeys for affected individuals. Musculoskeletal manifestations, chronic pain, dysautonomia, and gastrointestinal symptoms illustrate the multifactorial impact of these conditions, affecting both the physical and emotional well-being of affected individuals. Infrared thermography (IRT) emerges as a promising tool for joint assessment, especially in detecting inflammatory processes. Thermal distribution patterns offer valuable insights into joint dysfunctions, although the direct correlation between pain and inflammation remains challenging. The prevalence of neuropathies among hypermobile individuals accentuates the discordance between pain perception and thermographic findings, further complicating diagnosis and management. Despite its potential, the clinical integration of IRT faces challenges, with conflicting evidence hindering its adoption. However, studies demonstrate objective temperature disparities between healthy and diseased joints, especially under dynamic thermography, suggesting its potential utility in clinical practice. Future research focused on refining diagnostic criteria and elucidating the underlying mechanisms of hypermobility syndromes will be essential to improve diagnostic accuracy and enhance patient care in this complex and multidimensional context.

慢性疼痛与关节过度活动:为临床医生提供的简明诊断综述以及红外热成像技术在筛查过度活动的发炎关节中的潜在应用》。
关节过度活动综合征,尤其是与这种情况相关的慢性疼痛,包括过度活动埃勒斯-丹洛斯综合征(hEDS)和过度活动频谱障碍(HSD),由于其多因素起源,给诊断带来了挑战,而且从生物力学和基因组分子的角度来看,人们对这些综合征的了解仍然很少。最近的诊断指南对 hEDS、HSD 和良性关节过度活动症进行了区分,提供了一个更客观的诊断框架。然而,错误诊断和诊断不足的情况依然存在,导致受影响的个体不得不长期奔波。肌肉骨骼表现、慢性疼痛、自主神经功能障碍和胃肠道症状说明了这些病症的多因素影响,对患者的身体和情绪都有影响。红外热成像(IRT)是一种很有前途的关节评估工具,尤其是在检测炎症过程方面。虽然疼痛与炎症之间的直接关联仍具有挑战性,但热分布模式为了解关节功能障碍提供了宝贵的信息。活动过度人群中神经病变的流行加剧了疼痛感觉与热成像结果之间的不一致性,使诊断和管理更加复杂。尽管 IRT 具有潜力,但其临床整合仍面临挑战,相互矛盾的证据阻碍了其应用。不过,研究表明,健康关节和患病关节之间存在客观的温度差异,尤其是在动态热成像下,这表明它在临床实践中具有潜在的实用性。未来的研究将重点放在完善诊断标准和阐明过度活动综合征的内在机制上,这对提高诊断准确性和加强在这一复杂和多维背景下的患者护理至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Yale Journal of Biology and Medicine
Yale Journal of Biology and Medicine Biochemistry, Genetics and Molecular Biology-General Biochemistry,Genetics and Molecular Biology
CiteScore
5.00
自引率
0.00%
发文量
41
期刊介绍: The Yale Journal of Biology and Medicine (YJBM) is a graduate and medical student-run, peer-reviewed, open-access journal dedicated to the publication of original research articles, scientific reviews, articles on medical history, personal perspectives on medicine, policy analyses, case reports, and symposia related to biomedical matters. YJBM is published quarterly and aims to publish articles of interest to both physicians and scientists. YJBM is and has been an internationally distributed journal with a long history of landmark articles. Our contributors feature a notable list of philosophers, statesmen, scientists, and physicians, including Ernst Cassirer, Harvey Cushing, Rene Dubos, Edward Kennedy, Donald Seldin, and Jack Strominger. Our Editorial Board consists of students and faculty members from Yale School of Medicine and Yale University Graduate School of Arts & Sciences. All manuscripts submitted to YJBM are first evaluated on the basis of scientific quality, originality, appropriateness, contribution to the field, and style. Suitable manuscripts are then subject to rigorous, fair, and rapid peer review.
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