Observational studyClinical medicine (London, England)2021
Beyond bones: The relevance of variants of connective tissue (hypermobility) to fibromyalgia, ME/CFS and controversies surrounding diagnostic classification: an observational study.
Observational study in Clinical medicine (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Recent research in myalgic encephalomyelitis/chronic fatigue syndrome: an evidence map.Health technology assessment (Winchester, England) · 2025Pooled it
- A Cross-Neurotype Analysis of Camouflaging and Illness Perceptions in People with Central Sensitivity Syndromes.Autism in adulthood · 2026Article
- Beyond bendy joints: number of variant connective tissue features predicts neurodivergent characteristics in hypermobile individuals with anxiety.Npj mental health research · 2026Article
- Treatment Modalities, Pain Response, and Referrals for Hypermobile Ehlers-Danlos Syndrome and Hypermobility Spectrum Disorders: A Retrospective Study.Mayo Clinic proceedings. Innovations, quality & outcomes · 2025Article
- Anti-Nuclear Antibody (ANA) Positivity and Nuclear Antigen Reactivity in Patients with Joint Hypermobility Syndrome/Hypermobile Ehlers Danlos Syndrome (JHS/hEDS).Biomedicines · 2025Article
- Central Sensitivity Symptoms and Autistic Traits in Autistic and Non-Autistic Adults.Autism research : official journal of the International Society for Autism Research · 2025Article
- Key Pathophysiological Role of Skeletal Muscle Disturbance in Post COVID and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Accumulated Evidence.Journal of cachexia, sarcopenia and muscle · 2025Review
- Mitochondrial Measures in Primary Cells Isolated from Patients with ME/CFS.Methods in molecular biology (Clifton, N.J.) · 2025Article
- Variant connective tissue as a risk factor for long COVID: a case-control study of data from a retrospective online survey of adults in the USA and UK.BMJ public health · 2025Article
- A network medicine approach to investigating ME/CFS pathogenesis in severely ill patients: a pilot study.Frontiers in human neuroscience · 2025Article
- Is joint hypermobility linked to self-reported non-recovery from COVID-19? Case-control evidence from the British COVID Symptom Study Biobank.BMJ public health · 2024Article
- Joint Flexibility and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome After Mononucleosis.Clinical therapeutics · 2024Article
- Overlapping conditions in Long COVID at a multisite academic center.Frontiers in neurology · 2024Article
- Longitudinal cytokine and multi-modal health data of an extremely severe ME/CFS patient with HSD reveals insights into immunopathology, and disease severity.Frontiers in immunology · 2024Article
- Childbearing with Hypermobile Ehlers-Danlos Syndrome and Hypermobility Spectrum Disorders: A Large International Survey of Outcomes and Complications.International journal of environmental research and public health · 2023Article
- Autoantibody Correlation Signatures in Fibromyalgia and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Association with Symptom Severity.Biomedicines · 2023Article
- Female reproductive health impacts of Long COVID and associated illnesses including ME/CFS, POTS, and connective tissue disorders: a literature review.Frontiers in rehabilitation sciences · 2023Review
- Gastrointestinal symptoms and nutritional issues in patients with hypermobility disorders: assessment, diagnosis and management.Frontline gastroenterology · 2023Article
- Autism and chronic ill health: an observational study of symptoms and diagnoses of central sensitivity syndromes in autistic adults.Molecular autism · 2022Observational
- New Clinical Phenotype of the Post-Covid Syndrome: Fibromyalgia and Joint Hypermobility Condition.Pathophysiology : the official journal of the International Society for Pathophysiology · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors.
Funding
Abstract
backgroundFibromyalgia and myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS) are poorly understood conditions with overlapping symptoms, fuelling debate as to whether they are manifestations of the same spectrum or separate entities. Both are associated with hypermobility, but this remains significantly undiagnosed, despite impact on quality of life.
objectiveWe planned to understand the relevance of hypermobility to symptoms in fibromyalgia and ME/CFS.
methodSixty-three patient participants presented with a confirmed diagnosis of fibromyalgia and/or ME/CFS; 24 participants were healthy controls. Patients were assessed for symptomatic hypermobility.
resultsEvaluations showed exceptional overlap in patients between fibromyalgia and ME/CFS, plus 81% met Brighton criteria for hypermobility syndrome (odds ratio 7.08) and 18% met 2017 hypermobile Ehlers-Danlos syndrome (hEDS) criteria. Hypermobility scores significantly predicted symptom levels.
conclusionSymptomatic hypermobility is particularly relevant to fibromyalgia and ME/CFS, and our findings highlight high rates of mis-/underdiagnosis. These poorly understood conditions have a considerable impact on quality of life and our observations have implications for diagnosis and treatment targets.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.