title: Joint hypermobility: the use of a new assessment tool to measure lower limb hypermobility.
abstract: OBJECTIVE
  The aim of the study was to compare the use of a new assessment tool for diagnosis of hypermobility in the lower limb to the Beighton score for generalised hypermobility.
  
  
  METHODS
  Three groups of children were compared (n = 225) and included a "normal" population of 116 school children, a "possible hypermobile" group of 88 children attending afoot and gait clinic and a "known hypermobile" group of 21 children referred from a paediatrician or rheumatologist. The Beighton score was used to measure generalised hypermobility. The Lower Limb Assessment Score was used to measure hypermobility in the lower limbs.
  
  
  RESULTS
  The Lower Limb Assessment Score was able to distinguish between the three groups of children better than the Beighton score. At a threshold of 5/9 indicating hypermobility, the Beighton score identified hypermobility in 34% of school children; the lower limb score identified hypermobility in 21% of school children after a threshold was identified. There was disagreement between the scores in school children where 26.7% of children appeared to have a positive Beighton score that was not accompanied by a positive lower limb score. In the "known hypermobile" group the Beighton score was positive in only 10% of children when the lower limb score was negative for hypermobility.
  
  
  CONCLUSIONS
  In this group of school children, the Beighton score appeared to over-diagnose hypermobility at the threshold of 5/9. Specific thresholds for diagnosis need to be set dependant on the age and ethnic group of the population being studied. The Lower Limb Assessment Score may be a useful score for health professionals specifically interested in lower limb hypermobility.
authors.affiliation: Department of Podiatry, School of Health and Bioscience, University of East London, UK. j.ferrari@uel.ac.uk
authors.forename: J
authors.initials: J
authors.lastname: Ferrari
authors.forename: C
authors.initials: C
authors.lastname: Parslow
authors.forename: E
authors.initials: E
authors.lastname: Lim
authors.forename: A
authors.initials: A
authors.lastname: Hayward
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology*; D035002:Lower Extremity / Q000503:physiopathology*; D008297:Male; D012372:ROC Curve; D016059:Range of Motion, Articular / Q000502:physiology; D012219:Rheumatology / Q000379:methods*; D012720:Severity of Illness Index