Ehlers-Danlos and the Beighton Score: What the Nine Points Measure

Updated 10 October 2026

A Beighton score may appear in a letter from a rheumatologist, a physiotherapist, a geneticist or a school nurse, and each time the number can arrive without the detail of how it was reached. That detail is what makes a score comparable from one exam to the next.

This guide sets out what the Ehlers-Danlos Society, Cleveland Clinic, a 2023 review, a health news site and a case report say about the nine-point score, then offers a table, a score sheet, a word list, four steps and a one-page summary. What the score means for you belongs to your clinician.

What the Ehlers-Danlos Society, Cleveland Clinic and published reviews say about the Beighton score

The Ehlers-Danlos Society says: "The Beighton Scoring System measures joint hypermobility on a 9-point scale." It lists the joints assessed as the knuckle of both little fingers, the base of both thumbs, the elbows, the knees and the spine, and notes: "Where applicable, range of movement is measured using a goniometer, an instrument that measures the joint angle."

On cut-offs, the Society's assessment page states: "A positive Beighton score is any score greater than or equal to 5/9 points in adults, 6/9 points in children (before puberty), and 4/9 points in adults over age 50."

Cleveland Clinic writes: "The test uses a nine-point scoring system that measures the flexibility of certain joints." It adds: "The higher your score, the more flexible your joints are," and "A positive Beighton score means you likely have joint hypermobility syndrome."

A 2023 review of pediatric hypermobility says that "Generalized joint hypermobility (GJH) is a prerequisite for hEDS and generalized HSD," and that "Diagnosis is currently clinical in the absence of biomarkers." It also notes that cut-offs developed for adults are difficult to use in children and biologically immature adolescents.

Medical News Today says: "The Beighton score is one measure of hypermobility, but a person will likely need other tests to confirm a diagnosis." A 2022 case report explains that the score was introduced in 1973 and that joint mobility decreases with age, which is why age-specific cut-offs exist.

Taken together, the sources describe a clinician-performed exam that yields a number from 0 to 9 and that is one part of an assessment. None of them presents the score as a diagnosis by itself. The detail matters because a number can arrive on a letter without its parts, and a total of five can be built from very different joints. A reader who knows which joints scored, and under which cut-off, can compare your result with an earlier one fairly, and can judge it alongside the history, the family story and the other features a clinician looks for. That wider context is the reason this guide asks for the components and for your own account of everyday movement, in addition to the number from the exam room.

Each exam result can be dated in the Daily Journal within Ehlers-Danlos Journey (by Health Journey Labs), with the clinician and setting noted beside the score.

A table of the nine points: what each maneuver checks and how a clinician scores it

The Ehlers-Danlos Society describes five maneuvers. Four are tested on both sides, and one is a single forward bend, which gives a maximum of nine points.

Nine-point score table, by Ehlers-Danlos Journey

Total possible: 9. The age cut-offs from the Society are 5/9 or more in adults, 6/9 or more in children before puberty and 4/9 or more in adults over 50.

The table describes how an exam is scored, and a clinician performs and records it. Your own joints are not to be pushed beyond comfort in an attempt to reproduce it at home. The guide to comparing Ehlers-Danlos and the hypermobility spectrum covers how diagnoses relate, and this table concerns the exam score itself.

The table's rows can be mirrored in Ehlers-Danlos Journey: one dated entry per exam, with the five maneuvers listed beneath the total.

A score sheet to file each exam and bring to a rheumatology or genetics visit

A total on its own can mislead, because a score of 5 can come from different joints. The sheet below records the components. Sample rows are invented and show the layout only.

Exam score table, by Ehlers-Danlos Journey

Copy the joint points exactly as the examiner gives them, and ask for them if only a total was written. Note which age cut-off the examiner used, since the Society lists different ones for children, adults and adults over 50. If a goniometer was used, say so.

Differences between two exams may or may not reflect a change in your joints: examiners, positions and the time of day can all differ. The sheet makes such differences visible so they can be discussed. Keep the original letters or reports where you can find them, and photograph each one on the day it arrives, since a score that was only ever said aloud is hard to verify years later. If a school, a sports club or an employer asked for the score, note who asked and why, so the page also shows where copies went. Ask the examiner to record the joint points on the report, because a total without its parts cannot be compared fairly with the next one. The guide to starting an Ehlers-Danlos symptom log for your doctor covers the symptom side that goes with the score.

The score sheet can be stored in My Labs of Ehlers-Danlos Journey, with a photo or typed copy of the examiner's letter.

Words for the clinician about exam results, joint movement and your own history

A shared vocabulary helps the clinician link the exam to your story.

Words for exams, joints and context

Ehlers-Danlos Journey records how each exam was done, in set words.

• Exam words: total as written, joint points given, goniometer used, age cut-off used.
• Joint words: fingers, thumbs, elbows, knees, spine, either side, both sides.
• Context words: warm day, stiff morning, after a flare, after activity, rested.
• History words: could touch palms to floor as a child, joints pop, dislocations, long-standing flexibility.
• Question words: which joints scored, which cut-off, what else is assessed.

Pick the words that fit, and add the date. History words are useful because the exam is a snapshot of one day. The list records what happened and offers no reading of the score. If a joint slips out of place, pain is severe or you feel faint, seek care and call your local emergency number if needed before using any sheet. A word list is only a convenience, and the order of priorities is care first and notes second. When the situation has settled, a few words and a date are enough to record what happened, and details can be added at leisure once you are rested and the immediate worry has passed.

The next exam entry in the Daily Journal of Ehlers-Danlos Journey can reuse these same words unchanged.

Four steps to prepare for a visit where a Beighton score will be discussed

A visit that includes the exam is brief, and the score is one item among many. Four steps help.

Steps before a Beighton score discussion

These steps, written by Ehlers-Danlos Journey, gather earlier scores and family history before the joint assessment.

1. Copy any earlier scores with their joint points and dates.
2. Write your joint history in a few lines.
3. Add the family history you know.
4. List two or three questions about what else is assessed.

From Ehlers-Danlos Journey, we recommend building the page the evening before (Ehlers-Danlos Journey checklist), so that the history is on paper when the exam begins.

Plain questions work well: which joints scored, which cut-off was used, and what other features the clinician will look at. If more than one specialist is involved, ask who will hold the overall picture, so that the score is not reported to three offices in three different ways. Take a list of the joints that trouble you most, because a clinician with limited time may focus on those, and the exam score then has your own priorities beside it. Medical News Today notes that other tests are likely needed to confirm a diagnosis, and the clinician explains which apply. The guide to preparing a short genetics or rheumatology visit covers the rest of the appointment.

In the appointment, jot each reply below its question and record when you next expect to hear from the clinic. If the exam is done by a colleague of your usual clinician, note the name, so the score is attributed to the right person.

List each question under the matching clinician in My Care Team of Ehlers-Danlos Journey and it is there on the day.

A one-page summary for the clinician: scores, joints, history and questions

One page lets a reader compare exams quickly, with the letters behind it.

One-page exam summary, by Ehlers-Danlos Journey

• Exam dates, who examined and the age cut-off used.
• Joint points and totals, copied as given.
• Your joint history in a few lines.
• Family history you know.
• Questions for this visit.

Hand over the page at the start, and offer to read it row by row. Write each reply with its date. If a different clinician sees you next, the page lets that person compare your exams without a long retelling, and it gives you something to point to when a question comes up about a score from years ago.

The page copies what was recorded. What a score means and what follows belong to your clinician, and no source, page or app decides it. For a dislocation, severe pain or fainting, call your local emergency number first.

Since the exam entries are kept in Ehlers-Danlos Journey, its Doctor Report can lay out this page on demand.

How Ehlers-Danlos Journey can help

A score is easier to use when its joints and date are written beside it. If you want your exam history kept in one place, the best Ehlers-Danlos apps guide compares the options.

Ehlers-Danlos Journey is a personal ehlers-danlos tracker from Health Journey Labs on the App Store and Google Play. A total with its joint points gives a fuller account than a total alone. What a score means for you is for the clinicians who examine you, and the sheet puts the facts in order for them. Below is what you can use and how each part helps.

• Flare Tracker — Logs flag a day clearly worse than the usual hard week, onset, intensity, short note; read together with history across weeks (one-off spike vs repeating pattern).
• Daily check-in — Logs physical symptoms, emotional state, nutrition, sleep, exercise, meds, external factors; app-specific items: joint pain, instability, fatigue, activity cost; read together with the rest of the logged history.
• Daily Journal — Logs free-text notes, voice entry; app-specific items: what the day limited, partner talks, visit debriefs, leftover guilt after you canceled, a brace/PT homework line; read together with scores and other logged history (adds context).
• My Meds — Logs medicine names, timing, dose; app-specific items: pain relief, autonomic meds, other options you actually use; read together with joint weeks, sleep, energy, the rest of the tracked history.
• My Labs — Logs result dates; app-specific items: blood counts, imaging, genetic tests, other workups; read together with symptoms, function.
• Weekly Goals — Logs one small aim, whether it held; read together with real check-ins.
• Learn — Logs short education topics, prompts; app-specific items: pacing, instability, fatigue, visit prep, pain others cannot see; read together with your own logged weeks.
• AI companions — Logs Clara (general chat), specialist companions; app-specific items: knowledge, fitness, nutrition, relationships; read together with your logged history (companions already see it); used for: visit wording; a calm partner script; a soft rain-check line; a listening ear after a subluxation day.
• My Assessments — Logs structured check-ins beyond daily scores, onboarding life and social context; read together with ongoing history.
• My Care Team — Logs clinicians, short visit notes; app-specific items: tends to ask mainly about one loud joint rather than fatigue or function; read together with logged history; used for: visit prep (what to ask and bring); notes during the visit; review afterward.
• Doctor Report — Logs one-page summary exported from logged history; app-specific items: dates, joints and instability, fatigue, activity cost, how you functioned; read together with the history already logged.
• Food Tracker — Logs meal or drink lines; read together with pain, energy, autonomic, GI, joints, sleep.
• Weight Tracker — Logs scale or body notes; read together with energy, sleep, joint weeks.
• Period Tracker — Logs start and stop dates, flow, how heavy or light bleeding felt; read together with pain, instability, energy, everything else logged.

Everything you log builds one history, and insights get stronger as it grows. Custom symptoms let you add your own labels.

Sources

• The Ehlers-Danlos Society: the Beighton scoring system
• The Ehlers-Danlos Society: assessing joint hypermobility
• Cleveland Clinic: Beighton score
• Orphanet Journal of Rare Diseases 2023: pediatric joint hypermobility diagnostic framework (PubMed 37143135)
• Medical News Today: the Beighton score
• BMJ Case Reports 2022: video demonstration of the Beighton score

FAQ

The answers below draw on the sources cited in this guide, and the app they mention is Ehlers-Danlos Journey (by Health Journey Labs).