Spectrum of Joint Hypermobility
Joint hypermobility is a term that describes the ability to move one's joints beyond normal limits and is crucial in the diagnosis of Hereditary Disorders of Connective Tissue (HDCTs). People exhibiting joint hypermobility can be assessed via the Beighton Score, and be first classified under one of the 4 following categories.
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Localized joint hypermobility (LJH): exhibits joint hypermobility in fewer than 5 joints
Generalized joint hypermobility (GJH): exhibits joint hypermobility in 5 or more joints
Peripheral joint hypermobility (PJH): exhibits joint hypermobility only in the hands and feet
Historical joint hypermobility (HJH): Present in adults who exhibited, but progressively lost, joint hypermobility
People who exhibit joint hypermobility can be asymptomatic (experiencing no other symptoms), and thus may be classified under Asymptomatic joint hypermobility. They require no further treatment.
However, if a person exhibiting joint hypermobility is also suffering from one or more of its associated secondary musculoskeletal manifestations, he/she may be diagnosed with Hypermobility Spectrum Disorders (HSD). The different types of HSDs are categorized by the type of joint hypermobility the affected individual exhibits.
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Generalized HSD (G-HSD): GJH plus one or more secondary musculoskeletal manifestations
Peripheral HSD (P-HSD): PJH plus one or more secondary musculoskeletal manifestations
Localized HSD (L-HSD): LJH plus one or more secondary musculoskeletal manifestations
Historical HSD (H-HSD): HJH plus one or more secondary musculoskeletal manifestations.
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Note: For an individual to be diagnosed with H-HSD, a physical examination has to be conducted to exclude the possibility of other types of HSDs and other rheumatologic conditions.
Hypermobile Ehlers-Danlos Syndrome (hEDS) lies at the other extreme end of the spectrum and has symptoms similar to G-HSD. It is currently the only form of EDS without a confirmed cause and can be diagnosed by assessing the severity and pattern of the musculoskeletal manifestations of the patient using the 2017 hEDS criteria.