Remvig Lars
H:S Rigshospitalet, Klinik for Medicinsk Ortopaedi og Rehabilitering, København Ø.
Ugeskr Laeger. 2005 Nov 21;167(47):4443-8.
The clinician's evaluation of the presence of joint hypermobility is most often performed through application of a joint mobility scoring system. Several systems are available, all of them based on tests of selected joints or movements. In most cases, a positive test is based on a range of motion at or above the mean range of motion +3 SD. The tests' reproducibility is good when performed by an experienced rheumatologist; however, their validity is unknown as there are no gold standards. The British Society of Rheumatology has recommended Beighton's scoring system and the level > or =4 positive tests out of 9 as the criterion for general hypermobility. The reproducibility of the criterion has been examined only once, and only with the cut level of > or =6/9 tests. At this level, the intra- and interobserver variability was 0.75 and 0.78, respectively. In another study it was demonstrated that the Beighton scoring system correlates well with a global joint mobility index and shows good agreement with two other scoring systems. The diagnostic specificity is poor with regard to the criteria for benign joint hypermobility syndrome.
临床医生对关节活动过度的评估通常是通过应用关节活动度评分系统来进行的。有几种系统可供使用,所有这些系统都基于对选定关节或动作的测试。在大多数情况下,阳性测试基于处于或高于平均活动范围+3标准差的活动范围。当由经验丰富的风湿病学家进行测试时,其可重复性良好;然而,由于没有金标准,其有效性尚不清楚。英国风湿病学会推荐了贝顿评分系统,并将9项测试中≥4项阳性测试作为全身活动过度的标准。该标准的可重复性仅被检验过一次,且仅检验了≥6/9项测试的临界值。在此水平上,观察者内和观察者间的变异性分别为0.75和0.78。在另一项研究中表明,贝顿评分系统与整体关节活动度指数相关性良好,并且与其他两种评分系统显示出良好的一致性。就良性关节活动过度综合征的标准而言,诊断特异性较差。