A comparison of the definitions of hypermobility spectrum disorder with hypermobile Ehlers-Danlos syndrome

HSD (symptomatic hypermobility not meeting the hEDS criteria)	hEDS (by the 2017 criteria^[1])
Generalized, localized, peripheral, or historical joint hypermobility	Generalized joint hypermobility
Musculoskeletal structural concerns	Musculoskeletal structural concerns
Joint instability	Joint instability
Straining/soft tissue-related injury	Straining/soft tissue-related injury
Musculoskeletal pain	Musculoskeletal pain
	Skin pathology Tissue weaknesses Marfanoid body shape Cardiac valve pathologies
May be a family history of hypermobility and related injury	Family history (first-degree relative with hEDS)
If a person with generalized joint hypermobility and related injuries also has a first-degree relative with hEDS, then they too would fulfill the hEDS 2017 criteria
There should be no other primary explanation/diagnosis for signs and symptoms in either group
Neither group is defined by the presence of other related disorders, though both HSD and hEDS may have complex presentations with associated disorders

The similarities and differences in the definitions of HSD and hEDS are shown. The primary differences are that in HSD, joint hypermobility may be localized, regional, or generalized; and in hEDS, there are structural connective tissue features beyond the skeletal findings that are found to differing degrees in other subtypes of EDS (eg, skin pathology).

hEDS: hypermobile Ehlers-Danlos syndrome; HSD: hypermobility spectrum disorder.

Reference:

Malfait F, Francomano C, Byers P, et al. The 2017 international classification of the Ehlers-Danlos syndromes. Am J Med Genet C Semin Med Genet 2017; 175:8.

Courtesy of Alan J Hakim, MB BChir, MA, FRCP.

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A comparison of the definitions of hypermobility spectrum disorder with hypermobile Ehlers-Danlos syndrome