[Generalised joint hypermobility and benign joint hypermobility syndrome. I: reproducibility and validity of tests and criteria]

Abstract

The clinician's evaluation of the presence of joint hypermobility is most often performed through application of a joint mobility scoring system. Several systems are available, all of them based on tests of selected joints or movements. In most cases, a positive test is based on a range of motion at or above the mean range of motion +3 SD. The tests' reproducibility is good when performed by an experienced rheumatologist; however, their validity is unknown as there are no gold standards. The British Society of Rheumatology has recommended Beighton's scoring system and the level > or =4 positive tests out of 9 as the criterion for general hypermobility. The reproducibility of the criterion has been examined only once, and only with the cut level of > or =6/9 tests. At this level, the intra- and interobserver variability was 0.75 and 0.78, respectively. In another study it was demonstrated that the Beighton scoring system correlates well with a global joint mobility index and shows good agreement with two other scoring systems. The diagnostic specificity is poor with regard to the criteria for benign joint hypermobility syndrome.