Presentation of two cases with hypermobility syndrome and review of the related literature.

The aim of this study was to show that simple criteria like Beighton and Brighton criteria are sufficient to determine a diagnosis of hypermobility and may be useful prior to performing excessive diagnostic studies on children with variable joint pain and limited range of motion. Additionally, this study underlines how limitations of deformed joints can be restored with physiotherapy, which can also help preventing further complications of hypermobility. This study reports the case of a five-year-old girl and her 10-year-old brother, who both were suffering from difficulty in holding a spoon. Our diagnosis was hypermobility syndrome. The patients showed significant improvement with physiotherapy of the elbows. Evaluating patients for hypermobility in routine rheumatologic examination will prevent unnecessary diagnostic studies and treatments. Moreover, although the most common initial symptom of hypermobility is pain (usually in the knees), a limited range of motion due to subluxations in any other joints, like the elbows, may be the first symptom.