Beighton score for joint hypermobility —
JHM should be evaluated in all patients suspected of JHS. JHM is ascertained by determination of their Beighton score, which depends on the presence of JHM in the hands, elbows, lumbar spine, and knees using specific examination techniques . One point is awarded for the ability to perform each of nine maneuvers (including four maneuvers tested bilaterally and evaluation of the spine). A score of 4 or more points represents generalized hypermobility. The specific maneuvers include:
●Passive apposition of the thumb to the volar aspect of the ipsilateral forearm
●Passive hyperextension of fingers, demonstrated by passive dorsiflexion of the fifth metacarpophalangeal joint to at least 90 degrees
●Hyperextension of the elbow to at least 10 degrees
●Hyperextension of the knee to at least 10 degrees
●Flexion of the spine with placement of the palms flat on the floor without bending the knees
The presence of JHM can be documented by an examination limited to those areas required for calculating the Beighton score, but an examination for JHM and joint stability that is adequate for fuller assessment of the patient and the formulation of treatment plans should also encompass the other joints, including the temporomandibular joints, shoulders, hips, cervical and thoracic spine, ankles, and feet.
In addition to determination of the Beighton score based upon the examination, the presence of generalized JHM, including its presence historically, may also be suspected in patients who answer ‘yes’ to two or more questions in a simple five-part questionnaire :
●Can you now (or could you ever) place your hands flat on the floor without bending your knees?
●Can you now (or could you ever) bend your thumb to touch your forearm?
●As a child did you amuse your friends by contorting your body into strange shapes OR could you do splits?
●As a child or teenager did your shoulder or kneecap dislocate on more than one occasion?
●Do you consider yourself double-jointed?
Bhopalwala. H
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