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Empowering you on your journey toward optimal physical health

The 7 Steps To Amazing Health

Beighton Hypermobility Score

The Beighton score is a simple system to quantify joint laxity and hypermobility.

It uses a simple 9 point system, where the higher the score the higher the laxity.

The threshold for joint laxity in a young adult is ranges from 4-6. Thus a score above 6 indicates hypermobility, but not necessarily true BHJS (see below)

JOINTFINDINGPOINTS
left little (fifth) fingerpassive dorsiflexion beyond 90°1
passive dorsiflexion <= 90°0
right little (fifth) fingerpassive dorsiflexion beyond 90°1
passive dorsiflexion <= 90°0
left thumbpassive dorsiflexion to the flexor aspect of the forearm1
cannot passively dorsiflex thumb to flexor aspect of the forearm0
right thumbpassive dorsiflexion to the flexor aspect of the forearm1
cannot passively dorsiflex thumb to flexor aspect of the forearm0
left elbowhyperextends beyonds 10°1
extends <= 100
right elbowhyperextends beyonds 10°1
extends <= 100
left kneehyperextends beyonds 10°1
extends <= 100
right kneehyperextends beyonds 10°1
extends <= 100
forward flexion of trunk with knees full extendedpalms and hands can rest flat on the floor1
palms and hands cannot rest flat on the floor0

Diagnostic Criteria For The Benign Joint Hypermobility Syndrome (Bjhs)

Major Criteria

  • A Beighton score of 4/9 or greater (either currently or historically)
  • Arthralgia for longer than 3 months in 4 or more joints

Minor Criteria

  • A Beighton score of 1, 2 or 3/9 (0, 1, 2 or 3 if aged 50+)
  • Arthralgia (> 3 months) in one to three joints or back pain (> 3 months), spondylosis, spondylolysis/spondylolisthesis.
  • Dislocation/subluxation in more than one joint, or in one joint on more than one occasion.
  • Soft tissue rheumatism. > 3 lesions (e.g. epicondylitis, tenosynovitis, bursitis).
  • Marfanoid habitus (tall, slim, span/height ratio >1.03, upper: lower segment ratio less than 0.89, arachnodactily [positive Steinberg/wrist signs].
  • Abnormal skin: striae, hyperextensibility, thin skin, papyraceous scarring.
  • Eye signs: drooping eyelids or myopia or antimongoloid slant.
  • Varicose veins or hernia or uterine/rectal prolapse.

The BJHS is diagnosed in the presence two major criteria, or one major and two minor criteria, or four minor criteria. Two minor criteria will suffice where there is an unequivocally affected first-degree relative.

BJHS is excluded by presence of Marfan or Ehlers-Danlos syndromes

References:

Beighton PH Horan F. Orthopedic aspects of the Ehlers-Danlos syndrome. J Bone Joint Surg [Br]. 1969; 51: 444-453.

The 7 Steps To Amazing Health

Beighton Hypermobility Score

The Beighton score is a simple system to quantify joint laxity and hypermobility.

It uses a simple 9 point system, where the higher the score the higher the laxity.

The threshold for joint laxity in a young adult is ranges from 4-6. Thus a score above 6 indicates hypermobility, but not necessarily true BHJS (see below)

JOINTFINDINGPOINTS
left little (fifth) fingerpassive dorsiflexion beyond 90°1
passive dorsiflexion <= 90°0
right little (fifth) fingerpassive dorsiflexion beyond 90°1
passive dorsiflexion <= 90°0
left thumbpassive dorsiflexion to the flexor aspect of the forearm1
cannot passively dorsiflex thumb to flexor aspect of the forearm0
right thumbpassive dorsiflexion to the flexor aspect of the forearm1
cannot passively dorsiflex thumb to flexor aspect of the forearm0
left elbowhyperextends beyonds 10°1
extends <= 100
right elbowhyperextends beyonds 10°1
extends <= 100
left kneehyperextends beyonds 10°1
extends <= 100
right kneehyperextends beyonds 10°1
extends <= 100
forward flexion of trunk with knees full extendedpalms and hands can rest flat on the floor1
palms and hands cannot rest flat on the floor0

Diagnostic Criteria For The Benign Joint Hypermobility Syndrome (Bjhs)

Major Criteria

  • A Beighton score of 4/9 or greater (either currently or historically)
  • Arthralgia for longer than 3 months in 4 or more joints

Minor Criteria

  • A Beighton score of 1, 2 or 3/9 (0, 1, 2 or 3 if aged 50+)
  • Arthralgia (> 3 months) in one to three joints or back pain (> 3 months), spondylosis, spondylolysis/spondylolisthesis.
  • Dislocation/subluxation in more than one joint, or in one joint on more than one occasion.
  • Soft tissue rheumatism. > 3 lesions (e.g. epicondylitis, tenosynovitis, bursitis).
  • Marfanoid habitus (tall, slim, span/height ratio >1.03, upper: lower segment ratio less than 0.89, arachnodactily [positive Steinberg/wrist signs].
  • Abnormal skin: striae, hyperextensibility, thin skin, papyraceous scarring.
  • Eye signs: drooping eyelids or myopia or antimongoloid slant.
  • Varicose veins or hernia or uterine/rectal prolapse.

The BJHS is diagnosed in the presence two major criteria, or one major and two minor criteria, or four minor criteria. Two minor criteria will suffice where there is an unequivocally affected first-degree relative.

BJHS is excluded by presence of Marfan or Ehlers-Danlos syndromes

References:

Beighton PH Horan F. Orthopedic aspects of the Ehlers-Danlos syndrome. J Bone Joint Surg [Br]. 1969; 51: 444-453.

The 7 Steps To Amazing Health

Beighton Hypermobility Score

The Beighton score is a simple system to quantify joint laxity and hypermobility.

It uses a simple 9 point system, where the higher the score the higher the laxity.

The threshold for joint laxity in a young adult is ranges from 4-6. Thus a score above 6 indicates hypermobility, but not necessarily true BHJS (see below)

JOINTFINDINGPOINTS
left little (fifth) fingerpassive dorsiflexion beyond 90°1
passive dorsiflexion <= 90°0
right little (fifth) fingerpassive dorsiflexion beyond 90°1
passive dorsiflexion <= 90°0
left thumbpassive dorsiflexion to the flexor aspect of the forearm1
cannot passively dorsiflex thumb to flexor aspect of the forearm0
right thumbpassive dorsiflexion to the flexor aspect of the forearm1
cannot passively dorsiflex thumb to flexor aspect of the forearm0
left elbowhyperextends beyonds 10°1
extends <= 100
right elbowhyperextends beyonds 10°1
extends <= 100
left kneehyperextends beyonds 10°1
extends <= 100
right kneehyperextends beyonds 10°1
extends <= 100
forward flexion of trunk with knees full extendedpalms and hands can rest flat on the floor1
palms and hands cannot rest flat on the floor0

Diagnostic Criteria For The Benign Joint Hypermobility Syndrome (Bjhs)

Major Criteria

  • A Beighton score of 4/9 or greater (either currently or historically)
  • Arthralgia for longer than 3 months in 4 or more joints

Minor Criteria

  • A Beighton score of 1, 2 or 3/9 (0, 1, 2 or 3 if aged 50+)
  • Arthralgia (> 3 months) in one to three joints or back pain (> 3 months), spondylosis, spondylolysis/spondylolisthesis.
  • Dislocation/subluxation in more than one joint, or in one joint on more than one occasion.
  • Soft tissue rheumatism. > 3 lesions (e.g. epicondylitis, tenosynovitis, bursitis).
  • Marfanoid habitus (tall, slim, span/height ratio >1.03, upper: lower segment ratio less than 0.89, arachnodactily [positive Steinberg/wrist signs].
  • Abnormal skin: striae, hyperextensibility, thin skin, papyraceous scarring.
  • Eye signs: drooping eyelids or myopia or antimongoloid slant.
  • Varicose veins or hernia or uterine/rectal prolapse.

The BJHS is diagnosed in the presence two major criteria, or one major and two minor criteria, or four minor criteria. Two minor criteria will suffice where there is an unequivocally affected first-degree relative.

BJHS is excluded by presence of Marfan or Ehlers-Danlos syndromes

References:

Beighton PH Horan F. Orthopedic aspects of the Ehlers-Danlos syndrome. J Bone Joint Surg [Br]. 1969; 51: 444-453.