Assessing Joint Hypermobility by the Beighton Scoring System

THE BEIGHTON SCORING SYSTEM

The Beighton Scoring system measures joint hypermobility using a 9-point scale. These are the joints that were evaluated:

• Knuckle of both little/fifth/pinky finger

• The base of both thumbs

• Elbows

• Spine

• Knees

A goniometer is an instrument that measures joint angles and can measure the range of movement, where applicable.

These are the movements that makeup The Beighton Score

5th Finger/ Pinkies

Perform the test on both the sides

Place the palm of your hand and forearm on a flat surface on a smooth surface with the palm side down and fingers stretched out straight.

Can the fifth finger be lifted/bent upwards at the knuckle so that it can go back beyond 90 degrees? If yes then, Add one point for each hand.

Thumb

Perform the test on both the sides

The arm should be straight, and the palm should face downwards and the wrist then fully bent downwards. Can the thumb be pushed backwards to touch the forearm? If yes, then add one point to each thumb.

Elbows

Test Both Sides

The arms should be straightened or outstretched and the palms should face upwards. Is the elbow extended (bend too far) upwards more than an extra 10° beyond a normal outstretched position? If yes, then add one point to each side.

Knees

Perform the test on both the sides

While Standing with your knees bent backwards as far as possible. Check that the lower part or portion of either leg extend more than 10 degrees forward? If yes, then add one point to each side

Spine

Can you bend forward, place the palms of your hands on the ground in front of your feet without flexing or bending your knees? If yes, then add one point.

When you read this in a professional textbook, the formal language used is as follow -

• With the forearm and palm of the hand resting on a horizontal surface with the elbow flexed to 90°, if the (MCL) metacarpal-phalangeal joint of the 5th finger can be hyperextended more than 90 degrees with respect to the dorsum of the hand, If it is considered positive, it will score one point.

• The arms extended forward but hand pronated, if the thumb can be passively moved to touch the (same side) forearm then, it is considered positive scoring 1 point.

• With the arms outstretched or elongated to the side and hand supine, if the elbow extends more than 10deg, it is considered positive scoring 1 point.

• While standing, with knees locked in genu recurvatum, if the knee extends more than 10deg, it is considered positive scoring 1 point.

• With knees locked straight and feet together, if the patient can bend or flex forward to a place that the total palm of both the hands lies flat on the floor or ground just in front of the feet, it is considered positive scoring 1 point.