In this issue we have three papers on the theme of hypermobility. In large part this is through the initiative of a member of our editorial board, Lars Remvig, who has taken a special interest in the subject. I learnt at the recent meeting of the International Academy of Manual/Musculoskeletal Medicine in Denmark that he has a devoted group of grateful patients attending his clinic in the Rigshospitalet in Copenhagen. With his help and the generosity of Karl-August Lindgren, who has run his famous Physiatric Summer Schools in Helsinki for years, we have been able to bring you presentations made in Finland in 2010. And we add to that some new research from Denmark on the prevalence of hypermobility, with two members of our editorial board on the research team.
Hypermobility is a structural condition, having a variable effect on function. My experience is that its presence is easily missed unless the examiner is interested in function. Looking at your patient in a chair won't reveal it! Nor will palpating the patient's joints for tenderness or swelling. Even looking at him or her standing in front of you may not show you anything (although a side view may show the ‘over-extended’ genu recurvatum).
But look at the function of the joints and, as in so many of the musculoskeletal disorders we deal with, much more will be revealed. Take the joint through its full range of passive movement and assess the end-feel, for a start, and the picture will become clearer. And the patient will have a professional who can understand their musculoskeletal system.