Vogel, Sarah K, Primavera, Isabelle R, Marden, Colleen L et al. · The Journal of pediatrics · 2022 · DOI
This study looked at whether people with ME/CFS who have unusually flexible joints (joint hypermobility) experience the illness differently than those without this feature. Researchers compared 55 patients and found no meaningful differences between the two groups in terms of when symptoms started, how severe they were, or how much the condition affected their daily lives. Even though joint hypermobility may increase the risk of developing ME/CFS, having it does not appear to change how the illness presents or progresses.
This study clarifies an important clinical question: while joint hypermobility may predispose people to develop ME/CFS, it does not appear to create a distinct or more severe form of the illness. This helps clinicians understand that ME/CFS patients with joint hypermobility may not require fundamentally different management approaches based solely on hypermobility status.
This study does not prove that joint hypermobility plays no role in ME/CFS pathogenesis—only that once ME/CFS develops, hypermobility does not alter its clinical features. The small sample size (55 patients) limits generalizability. The cross-sectional design cannot establish causality or clarify the mechanism by which hypermobility increases ME/CFS risk.
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
Vogel, Sarah K, Primavera, Isabelle R, Marden, Colleen L, Jasion, Samantha E, Cranston, Erica M, Flaherty, Marissa A K, et al. (2022). The Presentation of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Is Not Influenced by the Presence or Absence of Joint Hypermobility.. The Journal of pediatrics. https://doi.org/10.1016/j.jpeds.2021.09.014
BibTeX
@article{mecfsatlas-vogel-2022-presentation-myalgic,
author = {Vogel, Sarah K and Primavera, Isabelle R and Marden, Colleen L and Jasion, Samantha E and Cranston, Erica M and Flaherty, Marissa A K and Violand, Richard L and Rowe, Peter C},
title = {The Presentation of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Is Not Influenced by the Presence or Absence of Joint Hypermobility.},
journal = {The Journal of pediatrics},
year = {2022},
doi = {10.1016/j.jpeds.2021.09.014},
note = {PubMed: 34537220},
url = {https://www.mecfsatlas.com/evidence/vogel-2022-presentation-myalgic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/vogel-2022-presentation-myalgic
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