Major criteria:
(1) Breighton score >= 4 (out of 9)
(2) arthralgia for > 3 months in >= 4 joints
Minor criteria:
(1) Breighton score 1 to 3 (out of 9)
(2) arthralgia in 1 to 3 joints <NA if major criteria #2 is present>
(3) history of joint dislocation
(4) soft tissue lesions > 3
(5) Marfanoid habitus
(6) skin striae, hyperextensibility of skin, or scarring
(7) eye signs, lid laxity
(8) history of varicose veins, hernia or visceral prolapse
where:
• In the Table in Beighton et al the major criteria for arthralgia was "> 4". Based on the minor criteria I made this ">= 4".
• I assume that the minor criteria for arthralgias also includes a duration > 3 months. There may be a place for >= 4 arthralgias lasting <= 3 months.
Diagnostic requirements:
(1) one of the following, AND
(a) both major criteria
(b) one major and 2 minor criteria
(c) four minor criteria
(2) absence of any systemic rheumatologic disease
Limitations:
• The accuracy of the diagnosis depends on how well other conditions have been excluded.
• I would think that Marfan's syndrome and Ehlers-Danlos syndromes would be included in the systemic rheumatologic disease.
