Fontanelle paediatric education Fontanelle

Many of us see children with joint pain, some of whom are incredibly bendy. But have they "got hypermobility" or even EDS? Join Dr Alice Leahy and Marisa McMillan in their wide ranging discussion about EDS, hypermobility syndrome, arthritis, factors affecting how people perceive pain, and possible reasons why EDS has become more prominent on social media recently.
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Pearls include:
The Beighton Score: not very useful in the local paediatric population and is not validated.
---- Ehlers Danlos Syndrome (EDS) is a collection of collagen disorders
13 subtyes of EDS, 12 of which have known genetic mutations and histopathological changes, the
13th - neither genetic nor histopathological changes, otherwise known as hypermobility EDS. ----The 3 types worth remembering are:
☆Vascular type EDS - very rare - usually present to genetics depts rather than to rheumatology department - FH vascular rupture, Distinctive facial characteristics.
☆☆Classical type EDS. Also rare. Extremely hypermobile. Excessively stretchy skin. Can pull skin out from forearm 6cm (upper range of normal 2cm)
Autosomal dominant. Often very bruised with plentiful scarring on body.
☆☆☆Hypermobility type EDS: Beighton score of >6 pre-pubescent children; >4 in pubescent children
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Joint pain is not a good indicator of inflammatory arthritis. ♡♡♡JIA usually presents with very little pain. Arthritis will present with joint swelling.
If arthritis is suspected, request an ultrasound. A normal USS will exclude inflammatory disease. Blood tests are not helpful in diagnosing arthritis - neither are X-rays.
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Useful Resources:
•••The 2017 international classification of the Ehlers–Danlos syndromes (Malfait et al)
https://doi.org/10.1002/ajmg.c.31552

••••The RCPCH position statement on establishing a correct diagnosis of Ehlers Danlos Syndrome hypermobility type (hEDS) in children and adolescents 
https://www.rcpch.ac.uk/resources/establishing-correct-diagnosis-ehlers-danlos-syndrome-hypermobility-type-heds-children#footnote5_xb0pjtb
•••Head First by Alistair Santhouse Head First: A Psychiatrist's Stories of Mind and Body https://www.amazon.co.uk/dp/1838950311/ref=cm_sw_r_apan_glt_fabc_6KB3WZ7BY8XBW3WEYA8Q
•••It's All in Your Head by Suzanne O'Sullivan

It's All in Your Head: Stories from the Frontline of Psychosomatic Illness https://www.amazon.co.uk/dp/0099597853/ref=cm_sw_r_apan_glt_fabc_M77GAQV12ES834PWHCTT

A look inside the world of adolescent medicine and the benefits of the HEEADSSS tool with Dr David James, who explains to Marisa McMillan how we can be opportunistic in reaching the 10-22 year olds presenting to our ED departments. Check out the must-have HEEADSSS app on Google Play/Apple or http://app.heeadsss.uk Review on itunes 🌟🌟🌟🌟🌟 if you like what you hear and get in touch if you want to get involved. Spread the word and share the knowledge!

Low appetite? Tired? Tummy ache? Perhaps your child is constipated. Let Dr Mark Tighe guide you through the essentials of constipation - what it is, what sets it off, and most importantly, what you can do about it. Go to eric.org.uk for excellent resources. Please review 🌟🌟🌟🌟🌟Meet us online @fontanellepod - we'd love to hear from you.

Dr Antoinette McAulay, General Paediatrician in Poole talks to Dr Marisa McMillan, Wessex Paediatric Trainee, guest hosting on Fontanelle - Thank you Marisa and Antoinette! Refer to www.bsped.org.uk (British Society for Paediatric Endocrinology and Diabetes) for up to date guidelines. Get in touch if you would like to get involved in any of the work of the Fontanelle team by writing to me, Caroline Storey at fontanellepod@gmail.com

Dr Phil Parslow, training programme director for ST4-8 in Wessex Deanery guides us through the whole appraisal process, with plenty of advice and wisdom to light your way! Amazing nuggets on how to write an effective reflection. ***************************************************🌟🌟🌟🌟🌟🌟🌟🌟🌟🌟🌟🌟🌟🌟🌟🌟🌟🌟 Fontanelle is growing and has now reached 50 countries with over 5000 listens. Many thanks for all your support. If you would like to help Fontanelle or get involved in any way, please get in touch! Thanks 🌟🌟🌟🌟🌟

Dr Mich Lajeunesse consultant in paediatric allergy takes us through using the EATERS method to take an allergy focused clinical history and help diagnose food allergies. EATERS stands for Exposure, Allergen, Timing, Environment, Reproducibility, Symptoms. Based on a 15 Minute Consultation in E&P edition of ADC (http://dx.doi.org/10.1136/archdischild-2018-316397) If your interest is piqued Mich also directs us to the RCPCH Paediatric Allergy Training study days.~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Other news: Fontanelle is nearly 1!🎂🎈To celebrate our first birthday we're giving away a pair of Sony headphones so the winner can listen to educational podcasts on their way to work. For a chance to win, go to Twitter, find me @fontanellepod and retweet the pinned tweet. The winner will be announced at the PIER conference 2019. Tickets still available. Come and find me there and say hello! Thanks so much for listening! 🌟🎂❤🍭🍬