Table 1.

The Brighton criteria for diagnosing benign joint hypermobility,¹ incorporating the Beighton criteria

Brighton Criteria for diagnosing BJHS (incorporating the Beighton criteria)

MAJOR CRITERIA Beighton score ≥4/9 (currently or historically) Arthralgia for longer than 3 months in ≥4 joints

MINOR CRITERIA Beighton score = 1, 2 or 3/9 (0, 1, 2, 3 if age >50 years) Arthralgia (≥3 months) in 1 to 3 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 <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

Beighton Criteria

(1 point gained for each side where the sign is found, except for lumbar hyperflexion) Passive dorsiflexion of fifth metacarpophalangeal joint to 90° or more Opposition of thumb to volar aspect of ipsilateral forearm Hyperextension of elbow to 10° or more Hyperextension of knee to 10° or more Placing of hands flat on floor without bending knees