BEIGHTON SCORE FOR HYPERMOBILE SYNDROME,

Editor's Notes

• #3 It was originally introduced for epidemiological studies involving the recognition of hypermobility in populations. Therefore the scale was well suited, being easy and quick to perform in large numbers of people [1]. The criteria of the Beighton score were the first used to recognize hypermobility, and this method has been in use for 30 years. It involves the evaluation of only a few joints. It does not include other involved systems [2][3]. The Beighton score is a modification of the Carter and Wilkinson scoring system (1964) [4]. Because the passive extension of the fingers was too severe, it was replaced by a passive extension of just the little finger beyond 90° with the forearm flat on a table [
• #5 Disadvantages: It samples only a small number of joints for examination so that hypermobile joints outside this selected group will inevitably and invariably be overlooked. It is an “all-or-none” test. It does not indicate the degree of hypermobility, merely an expression of the widespread nature of its distribution. A n alternative scale that offers a wider view of joint laxity (including the shoulder, hip, patella, ankle, foot and toes) is the 10 – point hospital Del Mar criteria (Barcelona) [1]
• #6 goniometer, an instrument that measures the joint angle. The Beighton score has subsequently been used internationally to define generalized joint laxity in all populations and all age groups. Most of the available prevalence studies used different cutoffs, ranging from >3 hypermobile joints to > 6 hypermobile joints of 9 assessed (both thumbs, both little fingers, both elbows, both knees and the trunk), and in some, only the dominant side was assessed. The most frequent choice of cutoff was > 4 hypermobile joints [6] Beighton and Horan (1969) revised the test to measure joint laxity in people with Ehlers–Danlos syndrome 
• #7 The first four elements can be given a maximum score of 2, because these are performed bilaterally. The last element is scored with 0 or 1. The maximum score for ligament laxity is 9. A score of 9 means hyperlax. A score of zero is tight. Several researchers appoint a score of 0-3 as normal and 4-9 as representing ligamentous laxity (Al-Rawi et al 1985, Diaz et al 1993, Klemp et al 1984). According to Child (1986), a score of 4 or more out of 9 indicates generalized hypermobility of the joints [5]. The spinal forward flexion criterion differs from the other criteria, in that it measures hamstring flexibility and anatomic proportions to ligamentous laxity [4]. According to the Beighton and Horan criteria, generalized joint laxity is present when four or more of five tests are positive, including contralateral knee hyperextension [6]. There is no universal agreement on a threshold for BJHMS, some researchers use a Beighton scale score of 5/9, other researchers use a score of 6/9 and still others use a modified score of 3/9