Joint hypermobility or double jointedness is said to be present when a joint that can be stretched beyond what is called normal range is normal.
It could be due to
- Malaligned joints
- Joint with abnormal shape of articular surfaces
- Connective tissue disorder (such as Ehlers-Danlos syndrome, Marfan syndrome)
- Abnormal joint proprioception
Joint hypermobility can run in families suggesting a genetic basis too.
Most of people with joint hypermobility do not have any problem but others especially those in sports may become prone to repeated joint injuries.
When generalized joint hypermobility is present with symptoms of muscle and joint pain, it is termed as Hypermobility syndrome.
Beighton Score For Joint Hypermobility
The Beighton score is used for assessing the presence of joint hypermobility. However, it must be noted that the diagnosis of Hypermobility Syndrome or HMS should be made using the Brighton Criteria.
Beighton scoring is based on testing the simple movement or hypermovements if you want to call them
Passive Dorsiflexion of Little Finger
In a normal individual, little finger cannot be extended beyond 90 degrees, even passively. Score 0
If the passive extension [dorsiflexion] reveals this movement beyond 90 degrees – Score 1
Passive Dorsiflexion of Thumb
If thumb cannot be made to touch the flexor aspect of forearm – Score 0
If thumb can be made to touch the flexor aspect of forearm – Score 1
Hyperextension of left elbow
In a most of individual the range of movement of elbow is 0-120 degrees. 0 signifies that arm can be made to straighten but further movement is not possible. Any further extension movement of elbow would result in arm bending backward.
Some normal individual may have a slight backward bending movement. To look for a hypermobile joint a cut off point of 10 degrees is kept.
If elbow cannot be bent backwards is less than 10 degrees [has less than 10 degrees of extension – Score 0
If elbow can be bent backwards more than 10 degrees [has more than 10 degrees of extension] – Score 1
Hyperextension of Knee
The concept of elbow when applied to knee would provide scores of knee. In a normal individual the knee can not be straightened beyond 0 degrees. Further extension is known as hyperextension
Hyperextension of right knee beyond 10 degrees not present – Score 0
Hyperextension of right knee beyond 10 degrees present – Score 1
Individual is not able to rest the palms and hands on the floor with forward flexion [bending] of trunak with knees full extended – Score 0
Individual is able to rest the palms and hands on the floor with forward flexion [bending] of trunak with knees full extended – Score 1
Calculation of Score
The score is calculated by adding the scores of
- Both the thumbs
- Both the little fingers
- Both elbows
- Both knees
- One Trunk Movement
Maximum possible score thus becomes 9
4/9 score is considered significant.
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