Singh Harjodh, McKay Marnee, Baldwin Jennifer, Nicholson Leslie, Chan Cliffton, Burns Joshua, Hiller Claire E
Faculty of Health Sciences.
Faculty of Medicine, The University of Sydney.
Rheumatology (Oxford). 2017 Nov 1;56(11):1857-1864. doi: 10.1093/rheumatology/kex043.
OBJECTIVES: The primary aim of this study was to evaluate generalized joint hypermobility (GJH) according to the Beighton scoring system in an Australian population. Secondary aims were to identify whether the commonly used Beighton score cut-off of ⩾4 is appropriate, and to suggest age- and sex-specific Beighton score cut-offs across the lifespan. METHODS: A thousand individuals aged 3-101 years were assessed for GJH with the Beighton scoring system. Differences between age, sex and ethnicity were investigated. The appropriateness of the ⩾4 cut-off was investigated with use of a binary logistic regression. Each Beighton score cut-off was established as the nearest Beighton score that delineated the uppermost 5% of the population. RESULTS: Overall, females and non-Caucasians had higher Beighton scores across the lifespan (P < 0.001). Based on a binary logistic regression model, if a cut-off of ⩾4 was utilized, the Beighton scoring system demonstrated a sensitivity of 0.8% and a specificity of 99.3% (P < 0.001). A cut-off of ⩾4 was only found to be appropriate for females aged 40-59 years and males aged 8-39 years. CONCLUSION: Beighton scores varied across the lifespan and were significantly influenced by age, sex and ethnicity. Assessing GJH using the Beighton scoring system required age- and sex-specific cut-off scores based on the uppermost 5% values. This was confirmed by the low sensitivity, high specificity and 60% false-positive rate if a cut-off of ⩾4 was used for both sexes across the lifespan. To lower the risk of a false-positive diagnosis of GJH, further tests of hypermobility need to be utilized.
目的:本研究的主要目的是根据Beighton评分系统评估澳大利亚人群中的全身关节过度活动(GJH)。次要目的是确定常用的Beighton评分临界值≥4是否合适,并提出不同年龄段和性别的Beighton评分临界值。 方法:采用Beighton评分系统对1000名年龄在3至101岁的个体进行GJH评估。调查年龄、性别和种族之间的差异。使用二元逻辑回归研究临界值≥4的适宜性。每个Beighton评分临界值确定为划分人群中最高5%的最接近的Beighton评分。 结果:总体而言,女性和非白种人在整个生命周期中的Beighton评分较高(P<0.001)。基于二元逻辑回归模型,如果使用临界值≥4,Beighton评分系统的敏感性为0.8%,特异性为99.3%(P<0.001)。仅发现临界值≥4适用于40至59岁的女性和8至39岁的男性。 结论:Beighton评分在整个生命周期中有所不同,并受到年龄、性别和种族的显著影响。使用Beighton评分系统评估GJH需要根据最高5%的值确定特定年龄和性别的临界值。如果在整个生命周期中对两性都使用临界值≥4,低敏感性、高特异性和60%的假阳性率证实了这一点。为降低GJH假阳性诊断的风险,需要进一步进行关节过度活动测试。
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