Revised Brighton diagnostic criteria for the joint hypermobility syndrome

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.

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