REMEDY : BNSSG referral pathways

Hypermobility

Checked: 18-05-2018 by katy.kearley Next Review: 17-05-2019

Diagnosis and management

Joint hypermobility is a common condition and can often be diagnosed and managed in primary care. The vast majority of people with hypermobile joints do not require onward referral and can be reassured. Patients may find it helpful to be referred to physiotherapy, especially if joint pain or dislocation is a feature.

There is a Referral Pack for GPs produced by the Royal National Hospital for Rheumatic Diseases in Bath which gives advice on diagnosis using the Beighton score and when and where to refer including red flags.

Referral

To help clinicians decide on the most appropriate management of symptoms in adults with isolated musculoskeletal hypermobility a guideline (pdf) has been produced.

If the patient fits the criteria for specialist physio please refer via e-referral (by choosing "specialty";  "rehabilitation"; clinic type: NOS)  This will bring up the RNHRD service (Bristol and wider area services TBC)

To help clinicians decide whether an adult with musculoskeletal hypermobility requires further investigations or onward referral for identification of an underlying collagen abnormality a guideline for referral (pdf) has been produced.

Patients with more severe or debilitating symptoms may have Hypermobility Syndrome (HMS).

The RNHRD  (Bath) Rheumatology Therapy Service offers a multi-disciplinary approach with both physiotherapy and occupational therapy intervention available for patients with HMS. However, they do not offer a diagnostic service; diagnosis of HMS should take place in primary care.