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Assessing Joint Hypermobility in Preschool-Aged Children
Domenico M Romeo1, Simona Lucibello1, Elisa Musto1
1Pediatric Neurology Unit, Catholic University Rome, Rome, Italy.
Insights
A revised Beighton score effectively identifies joint hypermobility in children under five years. This tool aids in assessing children with genetic syndromes and general hypermobility.
Area of Science:
- Pediatrics
- Rheumatology
- Genetics
Background:
- Joint hypermobility assessment is crucial in pediatric care.
- The Beighton score is a standard tool but requires adaptation for younger children.
- Hypermobility can be associated with genetic syndromes, impacting diagnosis and management.
Purpose of the Study:
- To adapt the Beighton score for children under five years.
- To evaluate the revised score's reliability in preschool-aged children.
- To assess hypermobility in children with genetic syndromes.
Main Methods:
- A revised Beighton score was applied to 284 healthy children and 26 with genetic disorders.
- Assessment included five bilateral joint assessments.
- Data analysis focused on score distribution and cut-off identification.
Main Results:
- A cut-off score >4 identified hypermobility.
- 7% of healthy children and 89% of those with genetic syndromes scored >4.
- Thumb-to-forearm apposition and ankle dorsiflexion were most frequently hypermobile.
Conclusions:
- The revised Beighton score is reliable for assessing generalized joint hypermobility in children up to five years.
- This adapted score aids in longitudinal assessment of children with isolated or syndrome-associated hypermobility.
- The tool supports clinical evaluation and management of pediatric hypermobility.
Objective:
To provide a revision of the Beighton score adapted for children younger than the age of 5 years, to apply the revised version in a cohort of preschool age children, and to verify the reliability of the revised version in a cohort of preschool children with genetic syndromes associated with hypermobility.
Study Design:
The revised Beighton score was applied in a population of preschool children to evaluate joint hypermobility in 5 parts of the body, bilaterally (passive dorsiflexion of the fifth finger; passive hyperextension of the elbow; passive hyperextension of the knee; passive apposition of the thumb to the flexor side of the forearm; passive dorsiflexion of the ankle joint). The frequency distribution of the total scores was calculated with a range between 0 and 10.
Results:
A total of 284 healthy preschool children (146 boys and 138 girls) and 26 preschool children with genetic disorders (15 boys and 11 girls) were assessed. Mean age was 33.6 ± 12.7 months. A score ≤4 was found in more than 90% of the whole cohort; therefore, a cut-off score >4 was used to identify hypermobility. Twenty-two of the 284 (7%) healthy children and 23 of the 26 children (89%) with genetic syndromes associated with hypermobility had a score >4. The joints reporting a greater incidence of hypermobility were "apposition of the thumb to the forearm" and "passive dorsiflexion of the ankle," in 34% and 22% respectively. No differences related to sex or age were observed.
Conclusions:
The revised version of the Beighton score can be used to define generalized hypermobility for children up to 5 years of age and to assess and follow-up longitudinally patients with isolated hypermobility or those in whom the laxity is associated with other clinical features.
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