Five-part questionnaire for hypermobility (5PQ)

Five yes/no questions that pick up hypermobility, including hypermobility you used to have

The five-part questionnaire was published by Alan Hakim and Rodney Grahame in 2003 as a quick way to identify generalised joint hypermobility without a physical examination. It asks five yes/no questions, and two or more "yes" answers is a positive screen. In the original study of 212 hypermobile patients and 57 controls it had a sensitivity of 84% and a specificity of 89%; a replication cohort gave 84% and 80%.

Its particular value is the phrase "or could you ever". The Beighton score measures joint range today, and joints stiffen with age, injury, and surgery. Someone who was markedly hypermobile at 20 can fail the Beighton cut-off at 45 while still carrying the connective tissue that caused it. The 5PQ was written to capture that history, which is why the 2017 hEDS criteria use it: if your Beighton score is exactly one point below the age cut-off, a positive 5PQ makes up the difference for Criterion 1.

It takes under a minute. If you screen positive, the next steps are the Beighton score for today's joint range and, if hEDS is a question, the 2017 hEDS criteria checker, which uses both.

This is not a diagnostic tool. A positive screen suggests generalised joint hypermobility is likely; it does not diagnose hypermobile EDS, a hypermobility spectrum disorder, or anything else. The validation studies were in adults, mostly women attending rheumatology clinics, and later general-population studies found lower specificity (61–77%), so false positives are common. Discuss your result with your doctor. Based on: Hakim AJ, Grahame R. A simple questionnaire to detect hypermobility: an adjunct to the assessment of patients with diffuse musculoskeletal pain. Int J Clin Pract. 2003;57(3):163–166.

Answer each question yes or no. "Could you ever" means at any point in your life, not just now.

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”?