Generalized Joint Hypermobility: A Statistical Analysis Identifies Non-Axial Involvement in Most Cases

Area of Science:

• Pediatric Rheumatology
• Connective Tissue Disorders
• Orthopedics

Background:

• Joint hypermobility (JH) is the extreme range of motion or a symptom of genetic connective tissue disorders.
• Generalized joint hypermobility (GJH) is identified in children and adolescents using the Beighton Score (BS) of 6 or higher.
• GJH assessment is crucial for diagnosing conditions like hypermobile Ehlers-Danlos syndrome (hEDS) and hypermobility spectrum disorders (HSDs).

Purpose of the Study:

• To characterize children with JH based on the distribution of variables within the Beighton Score (BS) ≥ 6.
• To identify children exhibiting JH in the axial skeleton, upper limbs (ULs), and lower limbs (LLs) simultaneously.

Main Methods:

• Analysis of 124 medical records of children aged one to nine years diagnosed with JH via BS.
• Categorization of GJH based on the specific locations of positive Beighton Score variables.

Main Results:

• Simultaneous GJH involving the axial skeleton, ULs, and LLs was observed in 25.7% of cases.
• BS scores of 6 and 8 primarily involved variables in the ULs and LLs.
• A BS score of 7 indicated involvement of the axial skeleton, ULs, and LLs.
• The majority of the sample (BS ≥ 6) comprised predominantly girls.

Conclusions:

• A Beighton Score (BS) ≥ 6 in children predominantly includes girls.
• BS scores of 6 and 8, with variables in ULs and LLs only, do not necessarily indicate generalized joint hypermobility (GJH).
• In pediatric populations, BS scores of 7 and 9 are indicative of GJH, encompassing the axial skeleton, ULs, and LLs.
• These findings have significant implications for the diagnostic criteria of hEDS and HSDs in children.