Accuracy of a Shortened Beighton Examination Method for Hypermobility

Background/objective: Generalized joint hypermobility (GJH) is a systemic condition characterized by excessive movement of the joints. GJH has been hypothesized to be a risk factor for temporomandibular joint disorders. The standard approach to assessing GJH is the Beighton examination. The aim of the study is to measure the accuracy of a quick and convenient shortened Beighton examination for evaluating hypermobility. Methods: 314 subjects aged 16 to 20 participated in the study. There were 177 female and 137 male participants. Their hypermobility was measured with the help of goniometer using the traditional 9 point Beighton scoring system. The 4 point Beighton involves passive dorsiflexion of the fifth metacarpopharyngeal joint and passive apposition of the thumb to the volar aspect of the forearm. Using the 9 point Beighton as the reference standard, the diagnostic accuracy of the shortened 4 point Beighton score was evaluated. The accuracy of the 4 point score was calculated using sensitivity, specificity and likelihood ratios. Results: The prevalence of hypermobility using the 9 point Beighton was 12.4%, while it was 18.4% using the 4 point scale. The sensitivity was 85% and the specificity was 91%. Stratified by gender, the sensitivity and specificity were 76% and 97%, respectively, for males, and 90% and 87%, respectively, for females. The 4 point method can be accomplished in just over a minute, versus 3 minutes for the full Beighton, and the subject does not need to remove clothing or get out of a chair. Conclusions: The shortened Beighton demonstrated good sensitivity and specificity and can be done easily and quickly. It is more convenient and hence may be used as a substitute for the full Beighton scoring examination in research studies. Support: P01 DE 08773 and K12 DE 14069.