What is the revised Brighton diagnostic criteria for the joint hypermobility syndrome?
Major criteria
- 1) Beighton score of 4/9 or greater currently or historically (see Question 5).
- 2) Arthralgia for >3 months in four or more joints.
Minor criteria
- 1) Beighton score of 1, 2, or 3/9 (0, 1, 2 or 3 if aged >50 years).
- 2) Arthralgia (≥3 months) in one to three joints or back pain (≥3 months), spondylosis, spondylolysis/spondylolisthesis.
- 3) Dislocation/subluxation in more than one joint, or in one joint on more than one occasion.
- 4) Three or more soft tissue lesions (epicondylitis, tenosynovitis, bursitis).
- 5) Marfanoid habitus.
- 6) Abnormal skin: striae, hyperextensibility, thin, papyraceous scarring.
- 7) Eye signs: drooping eyelids, myopia, or downslanted palpebral fissures.
- 8) Varicose veins or hernia or uterine/rectal prolapse.
The JHS is diagnosed in the presence of two major criteria, or one major and two minor criteria, or four minor criteria. Note that major and minor criteria 1 are mutually exclusive as are major and minor criteria 2 since they are measuring the same manifestation.