Poomkudy, Jeffrey Thomas, Torres, Chelsea, Jason, Leonard A et al. · Clinical therapeutics · 2024 · DOI
This study looked at whether having unusually flexible joints might increase the risk of developing ME/CFS after a mono infection. Researchers followed college students who got mono and checked 6 months later who had developed ME/CFS. They measured joint flexibility using a standard test and compared the flexibility of those who developed ME/CFS with those who recovered normally. The study found no connection between joint flexibility and developing ME/CFS after mono.
This study addresses a proposed hypothesis that connective tissue differences may predispose individuals to ME/CFS, which could inform our understanding of ME/CFS pathogenesis and risk factors. Given that ME/CFS often develops after viral infections like mononucleosis, identifying modifiable or identifiable risk factors is critical for early intervention and prevention strategies.
This study does not prove that connective tissue abnormalities play no role in ME/CFS—it only examines one specific measure (joint hyperflexibility) in one context (post-mono illness). The findings do not exclude other connective tissue abnormalities or mechanisms as potential risk factors, nor do they rule out that joint flexibility might matter in different populations or disease subtypes.
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
Poomkudy, Jeffrey Thomas, Torres, Chelsea, Jason, Leonard A, Fishbein, Joseph, & Katz, Ben Z (2024). Joint Flexibility and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome After Mononucleosis.. Clinical therapeutics. https://doi.org/10.1016/j.clinthera.2023.12.011
BibTeX
@article{mecfsatlas-poomkudy-2024-joint-flexibility,
author = {Poomkudy, Jeffrey Thomas and Torres, Chelsea and Jason, Leonard A and Fishbein, Joseph and Katz, Ben Z},
title = {Joint Flexibility and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome After Mononucleosis.},
journal = {Clinical therapeutics},
year = {2024},
doi = {10.1016/j.clinthera.2023.12.011},
note = {PubMed: 38242746},
url = {https://www.mecfsatlas.com/evidence/poomkudy-2024-joint-flexibility},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/poomkudy-2024-joint-flexibility
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