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Paediatric Rheumatology

 

Joint hypermobility: The use of a new assessment tool to measure lower limb hypermobility


J. Ferrari, C. Parslow, E. Lim, A. Hayward

 

CER2546
2005 Vol.23, N°3
PI 0413, PF 0420
Paediatric Rheumatology

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Abstract

OBJECTIVES:
The aim of the study was to compare the use of a new assessment tool for diagnosis of hypermobility in the lower limb to the Beighton score for generalised hypermobility.
METHODS:
Three groups of children were compared (n = 225) and included a "normal" population of 116 school children, a "possible hypermobile" group of 88 children attending afoot and gait clinic and a "known hypermobile" group of 21 children referred from a paediatrician or rheumatologist. The Beighton score was used to measure generalised hypermobility. The Lower Limb Assessment Score was used to measure hypermobility in the lower limbs.
RESULTS:
The Lower Limb Assessment Score was able to distinguish between the three groups of children better than the Beighton score. At a threshold of 5/9 indicating hypermobility, the Beighton score identified hypermobility in 34% of school children; the lower limb score identified hypermobility in 21% of school children after a threshold was identified. There was disagreement between the scores in school children where 26.7% of children appeared to have a positive Beighton score that was not accompanied by a positive lower limb score. In the "known hypermobile" group the Beighton score was positive in only 10% of children when the lower limb score was negative for hypermobility.
CONCLUSIONS:
In this group of school children, the Beighton score appeared to over-diagnose hypermobility at the threshold of 5/9. Specific thresholds for diagnosis need to be set dependant on the age and ethnic group of the population being studied. The Lower Limb Assessment Score may be a useful score for health professionals specifically interested in lower limb hypermobility.

Rheumatology Article