Mudie, Kathleen, Ramiller, Allison, Whittaker, Sadie et al. · Frontiers in neurology · 2024 · DOI
This study looked at whether ME/CFS patients with loose, flexible joints (joint hypermobility) form a distinct group with different symptoms and health impacts. Researchers surveyed 815 ME/CFS patients and found that about 16% had joint hypermobility. These patients reported worse quality of life, more pain, and more symptoms affecting their nervous system, thinking, digestion, and muscles compared to ME/CFS patients without joint hypermobility.
ME/CFS is highly heterogeneous, and identifying clinical subgroups could enable better diagnosis and targeted treatment strategies. This study provides evidence that ME/CFS patients with joint hypermobility—particularly those with concurrent EDS—may represent a distinct subgroup requiring specialized assessment and management approaches, potentially improving clinical outcomes.
This study does not establish that joint hypermobility causes ME/CFS or is responsible for worse outcomes—it only shows an association. Self-assessed Beighton scores lack clinical validation and may not accurately reflect true hypermobility status. The cross-sectional design cannot determine temporal relationships or whether the associations reflect shared underlying biological mechanisms.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Mudie, Kathleen, Ramiller, Allison, Whittaker, Sadie, & Phillips, Leslie E (2024). Do people with ME/CFS and joint hypermobility represent a disease subgroup? An analysis using registry data.. Frontiers in neurology. https://doi.org/10.3389/fneur.2024.1324879
BibTeX
@article{mecfsatlas-mudie-2024-people-cfs,
author = {Mudie, Kathleen and Ramiller, Allison and Whittaker, Sadie and Phillips, Leslie E},
title = {Do people with ME/CFS and joint hypermobility represent a disease subgroup? An analysis using registry data.},
journal = {Frontiers in neurology},
year = {2024},
doi = {10.3389/fneur.2024.1324879},
note = {PubMed: 38545281},
url = {https://www.mecfsatlas.com/evidence/mudie-2024-people-cfs},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/mudie-2024-people-cfs
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