Hypermobility syndrome is genetically inherited disorder that is thought to affect the encoding of the connective tissue protein’s collagen in the ligament of joints. The loosened or stretched ligaments in the joint provide little stability and allow for the joint to be easily dislocated. Diagnosis
Initial evaluation of a suspected joint dislocation should begin with a thorough patient history, including mechanism of injury, and physical examination. Special attention should be focused on the neurovascular exam both before and after reduction, as injury to these structures may occur during the injury or during the reduction process. Subsequent imaging studies are frequently obtained to assist with diagnosis. Standard plain radiographs, usually a minimum of 2 views
Generally, pre- and post-reduction X-rays are recommended. Initial X-ray can confirm the diagnosis as well as evaluate for any concomitant fractures. Post-reduction radiographs confirm successful reduction alignment and can exclude any other bony injuries that may have been caused during the reduction procedure. In certain instances if initial X-rays are normal but injury is suspected, there is possible benefit of stress/weight-bearing views to further assess for disruption of ligamentous structures and/or need for surgical intervention. This may be utilized with AC joint separations. Nomenclature: Joint dislocations are named based on the distal component in relation to the proximal one. Ultrasound
Ultrasound may be useful in an acute setting, particularly with suspected shoulder dislocations.
It is imperative that the correct diagnosis is made the misdiagnosis of a neurofibroma may lead to unnecessary further investigation into associated systemic syndromes such as neurofibromatosis type 1 or multiple endocrine neoplasia syndrome.The differential diagnosis for PEN includes a neurofibroma, basal cell carcinoma, melanocytic nevus, epidermoid cyst and a skin appendage. Treatment
The only definitive treatment of PEN is surgical excision. Excision is curative and rarely recur. Gallery
See also
List of cutaneous conditions

References


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