Assessing joint hypermobility (Beighton Scoring System)

• Knuckle of both little/5^th/pinky fingers
• Base of both thumbs
• Elbows
• Knees
• Spine

Where applicable, range of movement is measured using a goniometer, an instrument that measures the joint angle. The movements that make up the Beighton score are:

• (A) 5^th finger/"pinkies" – Test both sides: Rest palm of the hand and forearm a flat surface with palm side down and fingers out straight. Can the 5^th finger be bent/lifted upwards at the knuckle to go back beyond 90 degrees? If yes, add 1 point for each hand.

• (B) Thumbs – Test both sides: With the arm out straight, the palm facing down, and the wrist then fully bent downward, can the thumb be pushed back to touch the forearm? If yes, add 1 point for each thumb.

• (C) Elbows – Test both sides: With arms outstretched and palms facing upwards, does the elbow extend (bend too far) upwards more than an extra 10 degrees beyond a normal outstretched position? If yes, add 1 point for each side.

• (D) Knees – Test both sides: While standing, with knees locked (bent backwards as far as possible), does the lower part of either leg extend more than 10 degrees forward? If yes, add 1 point for each side.

• (E) Spine – Can you bend forward and place the palms of your hands flat on the floor in front of your feet without bending your knees? If yes, add 1 point.