Referral Criteria

Only refer if suspected Marfans

Please refer to rheumatology detailing Marfanoid features

Please also request echo, so result is available at first appointment


 Primary Care Management

There is no pathway for secondary care referral of hypermobility or suspected Ehlers Danlos syndrome type III.

Please refer to physio if Beighton Score  5/9 or over AND  joint pain without synovitis

Beighton Score

  • one point if you can place your palms on the ground while standing with your legs straight 
  • one point for each elbow that bends backwards
  • one point for each knee that bends backwards
  • one point for each thumb that touches the forearm when bent backwards
  • one point for each little finger that bends backwards beyond 90 degrees


Synovitis – described as soft rubbery swelling which bounces back when compressed



Date Reviewed                        07/08/2019

Date Next Review                   07/08/2020

Author                                     Dr B Wesson ( RMS GP lead for Rheumatology)


Version No.     1.1