Benign joint hypermobility syndrome (BJHS): A public health clinical brief

Objectives: Healthy People 2020 list musculoskeletal disorders among the most common causes of disability in the United States. Benign Joint Hypermobility Syndrome (BJHS) is an underdiagnosed disorder in which many of the associated clinical symptoms can be reduced or treated if recognized early. Chiropractic physicians and manual therapists should recognize that BJHS may be a relative contraindication to high-velocity, low amplitude manipulation. The purpose of this presentation is to provide a narrative overview of BJHS and review the Beighton score. Methods: A search for the terms benign joint hypermobility syndrome, Brighton criteria, Beighton hypermobility score and chiropractic on PubMed yielded 77 reports including history, clinical presentation, diagnosis, treatment, and prognosis. We surveyed 22 articles that focused on evaluation and diagnostic criteria for BJHS. Results: BJHS is diagnosed by patient history and using Brighton criteria, which consists of the presence of 2 major criteria; 1 major criterion plus 2 minor criteria; or 4 minor criteria. The Beighton hypermobility score can also be used in assessing for hypermobility of peripheral joints and the spine. One point is awarded for the ability to perform each of 4 maneuvers (bilaterally) and 1 point for having an unusually flexible spine with a total of 9 possible points, with a score of 4 or more, in adults indicating joint hypermobility. Conclusion: With an increasing public health concern of musculoskeletal disorders, BJHS should be properly diagnosed. Chiropractic physicians should be aware of this clinical presentation to improve clinical outcomes in accordance with Healthy People 2020 goals.