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SCREENING FOR GENERALISED HYPERMOBILITY IN PATIENTS WITH LOW BACK PAIN



Abstract

Background: Generalised joint hypermobility (GJH) has a prevalence of approximately 5% in the general population. There might be an association between GHJ and some low back pain. The Beighton Criteria are 9 tests that are widely used to diagnose GJH but it is time-consuming to perform all nine tests.

Purpose: To evaluate which of the nine Beighton tests is the most accurate as a screening test for GHJ. To investigate the relationship between hypermobility and age, gender, and ethnicity.

Methods: From the last 10 years archives at the Back Centre Funen 17,117 patient records were examined. All nine Beighton tests had been performed in 4,062 patients. Data on the nine Beighton tests and age, gender, and ethnicity were extracted.

Results: There was a selection bias in this clinical sample, as the prevalence of GJH was 14.6%. All tests showed an overall accuracy of > 85.2 % as single-item screening tests for GJH in low back pain patients. Extension of the dominant elbow > 10o was the most accurate screening test with an overall accuracy of 93.9 %, sensitivity 76.6 % specificity 96.9 %. There was a higher prevalence of GJH in women (22.8%) than men (3.8%) and in young patients (28.0%) than in older patients (2.5%). No difference in the prevalence of GJH was observed between the patients with Danish ethnicity and non-Danish ethnicity.

Conclusion: Extension of the dominant elbow > 10o was the single most accurate of the nine Beighton tests as a screening test for GJH in patients with low back pain.

Correspondence should be addressed to SBPR at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE, England.