Beighton Score

What is the Beighton score?

The Beighton score is a test that measures joint hypermobility (flexibility). It involves simple maneuvers, such as bending your pinky (little) finger backward to check the joint angle. The Beighton score uses a nine-point scoring system. The higher your score, the more flexible your joints are.

The test examines the following joints:

• Base of both thumbs.
• Elbows.
• Knees.
• Knuckles of pinky fingers.
• Spine.

When is the Beighton score used?

The Beighton score is a standard test used to help diagnose joint hypermobility syndrome, a common syndrome. About 3% of the general population has joint hypermobility syndrome.

Many healthy people have hyper-flexible joints, but joint hypermobility syndrome may come from an underlying condition. It’s associated with heritable connective tissue disorders (HCTD), including:

• Ehlers–Danlos syndrome (EDS).
• Marfan syndrome.
• Osteogenesis imperfecta.

How is the Beighton score test used to measure joint hypermobility?

Your healthcare provider gently maneuvers your joints into certain positions. Using a nine-point joint mobility scale, you get one point if you can:

• Bend forward and place your hands flat on the floor without bending your knees.
• Straighten your elbows past a neutral position (hyperextend) (one point for each elbow).
• Straighten your knees past a neutral position (hyperextend) (one point for each knee).
• Bend your pinky (little) fingers back beyond 90 degrees (one point for each finger).
• Bend your thumbs back to touch your forearms (one point for each thumb).

The second part of the Beighton score involves questions about your history. Your healthcare provider asks you about your joint mobility and any joint pain. Each “yes” answer is one point:

1. Can you now (or could you ever) put your hands flat on the floor while keeping your knees straight?
2. Can you now (or could you ever) bend your thumb and touch your lower arm?
3. When you were younger, did you entertain your friends by warping yourself into different positions? Could you do splits?
4. When you were a child or teenager, did you have a dislocated shoulder or kneecap more than once?
5. Do you think of yourself as double-jointed?

Your healthcare provider tallies up your points. You could have joint hypermobility syndrome if you either:

• Reach four or more points on the maneuvers and have had pain in four or more joints for at least three months.
• Answer “yes” to two or more of the historical questions.

What should I expect during the Beighton score?

Your healthcare provider asks you to move your joints into certain positions. You may have to lie down or sit in a chair to perform the maneuvers. The test should only take a few minutes, and you should not feel pain.

What are the risks of the Beighton score? Are there side effects?

There are no risks or side effects associated with the Beighton score.

What is a positive Beighton score?

A positive Beighton score for joint hypermobility syndrome is either:

• Four points or more on the flexibility maneuvers.
• Two points or more on the historical questions.

What do the results of a Beighton score mean?

The higher your number, the higher the laxity of your joints. Positive results on a Beighton score test mean you likely have joint hypermobility syndrome. But this syndrome is sometimes a result of other underlying conditions. Your provider will talk to you about the next steps, which will most likely be more testing to figure out any other condition you may have.

The Beighton score itself can’t diagnose EDS, Marfan syndrome or osteogenesis imperfecta. It’s part of a series of tests to get to the bottom of your symptoms.

When should I know the Beighton score results?

You should know the results of the Beighton score immediately. Your provider can calculate the results as you complete each part of the test.

What questions should I ask my provider about the Beighton score test?

Ask your healthcare provider:

• Do I need any additional testing after the Beighton score?
• How is joint hypermobility syndrome treated?
• What can I do to improve my joint health?
• What is the outlook for joint hypermobility syndrome?

A note from Cleveland Clinic

The Beighton score is a simple test you do in your provider’s office to check the flexibility of your joints. The closer your result is to nine on the hypermobility scale, the more flexible your joints are. If you have joint hypermobility syndrome, you may need more tests — underlying conditions can cause this syndrome. Talk to your healthcare provider about the best next steps or any additional testing you may need.