Tools

hEDS diagnostic criteria checker

The 2017 international criteria for hypermobile Ehlers-Danlos syndrome, one criterion at a time

Hypermobile Ehlers-Danlos syndrome (hEDS) is diagnosed clinically against the criteria published by the International Consortium on the Ehlers-Danlos Syndromes in 2017. There is no genetic test. The criteria are usually distributed as a one-page PDF checklist written for clinicians. This page walks through the same three criteria interactively, in plain language, showing you at each step which items you meet, which you do not, and which can only be settled by a doctor. Notably, POTS, fatigue, and gut symptoms are common alongside hEDS but are not part of the criteria.

hEDS needs all three criteria at once. Criterion 1 is generalised joint hypermobility on the Beighton score, with the five-part questionnaire filling in when your score is one point short of the age cut-off. Criterion 2 asks for two of three features: systemic signs of a connective tissue disorder, family history, and musculoskeletal complications. Criterion 3 is a set of exclusions that only a clinician can confirm.

Joint hypermobility is common in people with POTS and other forms of dysautonomia, and a hypermobility assessment is a reasonable part of a post-viral work-up when joints, skin, or pain fit the picture. If you only want the hypermobility score, use the Beighton tool; if you completed it recently on this device, this page will offer to reuse your score.

This is not a diagnostic tool. It reproduces published diagnostic criteria so you can see how your own history maps onto them. Several items need physical examination, an echocardiogram, or genetic testing, and Criterion 3 requires a clinician to exclude other conditions. Meeting the pattern here does not mean you have hEDS; not meeting it does not rule out a hypermobility-related condition. The 2017 criteria are the current published international criteria. The Ehlers-Danlos Society has announced that revised criteria for all EDS types and HSD are due for publication in December 2026, with care pathways to follow in 2027; this page will be revised when they appear. Wording here is paraphrased from: Malfait F, Francomano C, Byers P, et al. The 2017 international classification of the Ehlers-Danlos syndromes. Am J Med Genet C Semin Med Genet. 2017;175(1):8–26, and the Ehlers-Danlos Society diagnostic checklist.
Step 1 of 4
Criterion 1

Generalised joint hypermobility

Criterion 1 uses the Beighton score with an age-dependent cut-off. If your score is exactly one point below the cut-off, the five-part questionnaire can make up the difference.

Which group applies to you?

Your Beighton score (0–9)

Don't know it? Work through the nine manoeuvres with illustrations, then come back. Your score will be offered here automatically.

Understanding your hEDS criteria checklist result

What the score measures

There is no score: the checklist records which of the three 2017 criteria your answers meet (Malfait et al. 2017; Ehlers-Danlos Society checklist).

The 2017 international criteria for hypermobile Ehlers-Danlos syndrome need all three of: Criterion 1, generalised joint hypermobility on the Beighton score (6 or more for pre-pubertal children and adolescents, 5 or more from puberty to age 50, 4 or more over 50, with the five-part questionnaire used when the score is one point short); Criterion 2, two or more of Feature A (at least five of 12 signs of a wider connective tissue disorder), Feature B (a first-degree relative who meets the criteria) and Feature C (chronic limb or widespread pain, or recurrent dislocations or instability without injury); and Criterion 3, no unusual skin fragility and the exclusion of other connective tissue disorders and other causes of hypermobility.

Score bands

Each criterion shows as met, not met or needs a clinician, meaning it depends on something unknown, such as a sign needing examination or an exclusion not yet assessed. Criterion 3 will usually show this, because only a clinician can confirm the exclusions, and the diagnosis is theirs to make.

The 2017 framework uses the term hypermobility spectrum disorder (HSD) for symptomatic joint hypermobility that does not meet the criteria for hEDS or another syndrome. The Ehlers-Danlos Society says the principles and types of management are currently the same for HSD and hEDS. The hEDS criteria were made strict on purpose, to define a more uniform group and help research into its cause.

What a change in score means

Your result should change only when your answers do, for example after an examination confirms a Feature A sign. The criteria will change too: new criteria for all types of EDS and for HSD are due on 1 December 2026 (Ehlers-Danlos Society news, 2026).

What it does not measure

No. The 2017 paper lists fatigue, sleep problems, postural orthostatic tachycardia, dysautonomia, functional gut disorders, anxiety and depression as features described in hEDS that are not specific or sensitive enough to be criteria. They may be more disabling than the joint symptoms, and their presence may prompt a clinician to consider hEDS, but they cannot count towards it.

For those symptoms, see the COMPASS-31 and the NASA lean test.

Taking this to your GP or consultant

No. Several Feature A signs, such as atrophic scarring, mitral valve prolapse and aortic root dilatation, need examination or an echocardiogram, and Criterion 3 needs a clinician to rule out other conditions, sometimes with genetic testing. There is no genetic test for hEDS itself, so a doctor makes the diagnosis clinically. This checklist helps you have an informed conversation.

Bring the copied summary with its date, your Beighton score, the Feature A signs marked present or unknown, any family diagnoses, and a short history of pain and dislocations. Ask which unknowns can be checked and who should assess the exclusions, often a rheumatologist or clinical geneticist. See also preparing for a GP appointment.

Sources