The Beighton Score and the Brighton Criteria for the diagnosis of Ehlers-Danlos hypermobile type (EDS type III). What are they, how are they used?

The Beighton Score and the Brighton Criteria are tools commonly used in the clinical assessment of joint hypermobility, particularly in the context of Ehlers-Danlos syndrome (EDS) hypermobile type, also known as EDS type III.


Beighton Score:

The Beighton Score is a simple and quick assessment of joint hypermobility. It involves evaluating the flexibility of specific joints. The criteria are as follows:


-Passive dorsiflexion of each fifth finger > 90 degrees (1 point for each hand)

-Passive apposition of the thumbs to the flexor aspects of the forearm (1 point for each thumb)

-Hyperextension of the elbow beyond 10 degrees (1 point for each elbow)

-Hyperextension of the knee beyond 10 degrees (1 point for each knee)

-Forward flexion of the trunk with knees fully extended, so that the palms of the hands rest flat on the floor (1 point)


The Beighton Score ranges from 0 to 9, with a higher score indicating greater joint hypermobility. A score of 4 or more out of 9 is often considered significant, though interpretation may vary.


Brighton Criteria:

The Brighton Criteria is a more comprehensive set of criteria that considers not only joint hypermobility but also other clinical features associated with Ehlers-Danlos syndrome. The criteria include major and minor criteria.


Major Criteria:

A Beighton Score of 4 or more out of 9

Arthralgia for more than three months in four or more joints


Minor Criteria:

A Beighton Score of 1, 2, or 3

Arthralgia in one to three joints or back pain for more than three months, spondylosis, spondylolysis/spondylolisthesis

Dislocation or subluxation in more than one joint or in one joint on more than one occasion

Soft tissue rheumatism

Marfanoid habitus (tall, slim, span greater than height, upper segment less than lower segment)


Diagnostic Criteria:

Two major criteria

One major and two minor criteria

Four minor criteria (two of which must be musculoskeletal)

Meeting these diagnostic criteria increases the likelihood of a diagnosis of EDS type III.


Both the Beighton Score and Brighton Criteria are used as part of a comprehensive clinical evaluation by healthcare professionals, often by rheumatologists, to assess joint hypermobility and other features associated with Ehlers-Danlos syndrome.