Beighton Score | Generalized Joint Hypermobility (Laxity) Assessment

The Beighton score is commonly used to assess for generalized joint hypermobility in both children and adults. Bouwien Smits-engelman (2010) found it to be a valid tool in assessing generalized hypermobility in children between 6 -12 (references Bouwien Smits-Engelman)

It is a test battery of five items with a maximum score of 9. Each positive score receives 1 point.

Execution:

1) Have your patient sit with the arm in 80° abduction, elbow flexed to 90°, the forearm pronated and resting on the table. Perform passive dorsiflexion of the fifth metacarpophalangeal joint The score is positive if dorsiflexion is greater than 90°. Repeat the test on the other hand.

2) Have the patient sit on a chair at the long end of the table with the shoulder in 90° anteflexion, the forearm is supinated. Perform passive hyperextension of the elbow.
The score is positive if there is ≥10° hyperextension. Again check both sides and score accordingly.

3) Have your patient in supine lying position and check for hyperextension in the knee joint. The score is positive at ≥10° of hyperextension. Repeat the process on the opposite limb.

4) Ask your patient to flex the shoulder to 90°, extend the elbow and pronate the forearm. Then the patient should try to bend the thumb to the flexor side of the forearm. (flat thumb aspect touches arm, not just the tip). If the patient is able to do it, it indicates a positive score.

5) Instruct the patient to bend over and try to touch the floor with flat hands while keeping the legs fully extended.

For scores 1-4 one point may be gained for each side, so max. 2 per item if left and right are positive, and only one point in total for the last item. This results in a maximum score of 9.

Usually, a score of 4 or more indicates GJHM. Smits-Engelman recommends a cutoff score of 7 specifically for children between 6-12.