The correct answer is:

Ehlers-Danlos syndrome.

Educational Objective:

Recognize the clinical presentation of Ehlers-Danlos syndrome.

Key Point:

Ehlers-Danlos is a connective tissue disorder characterized by joint hypermobility, skin hyperextensibility, and mitral valve prolapse.

Explanation:

The patient has Ehlers-Danlos syndrome a connective tissue disorder characterized by joint hypermobility and a skin hyperextensibility. Patients with this condition may also have mitral valve prolapse.

Patients with Marfan syndrome may have joint hypermobility but some of them have actually stiff joints. Classically they have aortic pathology rather than mitral valve disease.

The Loeys-Dietz syndrome causes aortic and other arterial aneurysms and dissections and may be also associated with widened space eyes and cleft palate.

The findings on this patient are clearly pathological.

References:

Meester JAN, Verstraeten A, Schepers D, Alaerts M, Van Laer L, Loeys BL. Differences in manifestations of Marfan syndrome, Ehlers-Danlos syndrome, and Loeys-Dietz syndrome. Ann Cardiothorac Surg. 2017 Nov;6(6):582-594.

Syx D, De Wandele I, Rombaut L, Malfait F. Hypermobility, the Ehlers-Danlos syndromes and chronic pain. Clin Exp Rheumatol. 2017 Sep-Oct;35 Suppl 107(5):116-122