Bulbena et al evaluated the different criteria for the diagnosis of joint hypermobility. The essential elements were combined into a new scale. The authors are from the Hospital del Mar in Barcelona, Spain.
Parameters (10)
Finding
thumb
passive apposition of the thumb to the flexor aspect of the forearm, separated by < 21 mm
metacarpophalangeal
with the palm of the hand resting on the table, the fifth finger can be passively dorsiflexed >= 90°
elbow hyperextension
passive hyperextension >= 10°
external shoulder rotation
with the upper arm touching the body and with the elbow flexed to 90°, the forearm is taken in external rotation up to >85° of the sagittal plane (shoulder to shoulder line)
hip abduction
in the supine position, passively abducted to >= 85°
rotular hypermobility
in the supine position and with the proximal end of the tibia held in one hand, the rotula (patella) can be moved well to the sides with the other hand
ankle and foot hypermobility
in the supine position, excessive passive dorsiflexion of the ankle and eversion of the foot
metatarsophalangeal
in the supine position, dorsal flexion of the toe over the diaphysis of the first metatarsal to >= 90°
knee hyperextension
in the prone position, the heel can make contact with the buttock
ecchymoses
bruising after minimal trauma
total score =
= SUM(number of findings present)
Interpretation:
• minimum score: 0
• maximum score: 10
• The higher the score, the greater the joint mobility.
• For men, joint hypermobility was defined with a score >= 4.
• For women, joint hypermobility was defined with a score > =5.
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