Malek Sabeeha, Reinhold Emma J, Pearce Gemma S
Centre for Mechanochemical Cell Biology, Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.
Royal College of General Practitioners, London, UK.
Rheumatol Int. 2021 Oct;41(10):1707-1716. doi: 10.1007/s00296-021-04832-4. Epub 2021 Mar 18.
The Beighton Score (BS) is a set of manoeuvres in a nine-point scoring system, used as the standard method of assessment for Generalised Joint Hypermobility (GJH). It was originally developed as an epidemiological tool used in screening large populations for GJH, but later adopted as a clinical tool for diagnostic purposes. Its ability to truly reflect GJH remains controversial, as joints within the scoring system are predominantly of the upper limb and disregard many of the major joints, preventing a direct identification of GJH. Furthermore, a consistent finding in the literature whereby the BS failed to identify hypermobility in joints outside the scoring system suggests its use as an indirect indicator of GJH is also not viable. As such, the collective findings of this review demonstrate a need for a change in clinical thinking. The BS should not be used as the principle tool to differentiate between localised and generalised hypermobility, nor used alone to exclude the presence of GJH. Greater emphasis should be placed on a clinician's judgement to identify or exclude GJH, according to its full definition.
贝ighton评分(BS)是一种九点评分系统中的一组动作,用作全身性关节活动过度(GJH)的标准评估方法。它最初是作为一种流行病学工具开发的,用于在大量人群中筛查GJH,但后来被用作诊断目的的临床工具。其真正反映GJH的能力仍存在争议,因为评分系统中的关节主要是上肢关节,忽略了许多主要关节,从而无法直接识别GJH。此外,文献中的一项一致发现是,BS未能识别评分系统以外关节的活动过度,这表明将其用作GJH的间接指标也是不可行的。因此,本综述的综合研究结果表明需要改变临床思维。BS不应作为区分局限性和全身性活动过度的主要工具,也不应单独用于排除GJH的存在。应更加重视临床医生根据GJH的完整定义来识别或排除GJH的判断。