How Is the Beighton Score Calculated for an EDS Diagnosis?

The Beighton score is a 9-point physical test used by doctors to measure generalized joint hypermobility, a key feature of Ehlers-Danlos Syndrome (EDS). It is calculated by performing five specific physical maneuvers that test how far certain joints can bend backward or stretch. Because our bodies naturally become stiffer as we age, the score required for an EDS diagnosis changes depending on how old you are when the test is given.

Please note: Do not force your joints into these extreme positions at home just to check your score, as this can cause severe pain, subluxations, or permanent injury. This test should be performed by a medical professional.

The 9-Point Scoring System

The test measures hypermobility in both sides of your body and your spine. You earn one point for each side that meets the criteria, plus one point for the spine maneuver, adding up to a maximum of 9 points ^[1]. A doctor typically uses a tool called a goniometer to measure the exact angles ^[1].

The five maneuvers are:

• Pinky fingers: Pulling your pinky finger back past 90 degrees while your hand and forearm rest flat on a table (1 point for each side) ^[1].
• Thumbs: Pulling your thumb forward to touch the flexor aspect (inside) of your forearm (1 point for each side) ^[1].
• Elbows: Hyperextending your elbow so it bends backward more than 10 degrees (1 point for each side) ^[1].
• Knees: Hyperextending your knee so it bends backward more than 10 degrees while standing (1 point for each side) ^[1].
• Spine/Hips: Bending forward at the waist with your knees completely, strictly straight and placing both palms flat on the floor (1 point) ^[1].

What about injured or surgical joints?
If you have a joint that cannot be tested due to past surgeries, fusions, or severe injuries (like frequent dislocations that destroyed the joint), it generally cannot earn a point on the Beighton score. However, a knowledgeable doctor will factor this into your overall clinical picture and rely more heavily on your history of hypermobility.

How Age Affects Your Score

It is extremely common to become less flexible as you get older. A test measuring joint mobility at a single point in time might miss hypermobility that was very present in your youth ^[2]. To account for this natural stiffening, the 2017 international criteria for EDS use age-specific cutoffs ^[3]:

• Children and young teens (prepubertal): A score of 6 or more is required ^[3].
• Adults up to age 50 (pubertal through age 50): A score of 5 or more is required ^[3].
• Adults over age 50: A score of 4 or more is required ^[3].

The 5-Point Questionnaire (5PQ)

If your current Beighton score is exactly one point below the cutoff for your age, doctors use the 5-Point Questionnaire (5PQ) to capture your history of hypermobility ^[4]. If you answer “yes” to two or more of the following five questions, you can still meet the hypermobility requirement for an EDS diagnosis ^[5]:

1. Can you now (or could you ever) place your hands flat on the floor without bending your knees?
2. Can you now (or could you ever) bend your thumb to touch your forearm?
3. As a child, did you amuse your friends by contorting your body into strange shapes, or could you do the splits?
4. As a child or teenager, did your shoulder or kneecap dislocate on more than one occasion?
5. Do you consider yourself “double-jointed”?

The Beighton Score Across EDS Subtypes

While the Beighton score is most famous as a strict requirement for diagnosing Hypermobile EDS (hEDS), generalized joint hypermobility can be a feature of many other EDS subtypes ^[6]. However, the Beighton score alone cannot differentiate between them.

For subtypes like Classical EDS (cEDS), Vascular EDS (vEDS), Classical-like EDS (clEDS), Spondylodysplastic EDS (spEDS), and Dermatosparaxis EDS (dEDS), doctors rely on other distinct clinical features ^[7]. These might include extreme skin stretchiness, life-threatening blood vessel fragility, abnormal “cigarette-paper” scarring, or specific facial characteristics ^[8]. Unlike hEDS, which is diagnosed purely through clinical evaluation, these rarer subtypes are definitively diagnosed through genetic testing ^[6][9]. Therefore, while a high Beighton score points toward an EDS evaluation, your complete medical and family history will determine which specific subtype you are tested for.