Introduction: While various sets of diagnostic criteria for hypermobility have been published, to date there is no recommended gold-standard, and diagnosis of hypermobility in children and their diagnosis is generally based on clinical judgement.

Objectives: The aims of this study were to test the inter-rater reliability of the Hospital Del Mar criteria, assessing the reliability of the total score as well as individual components of the score.

Methods: Secondary analysis of data was carried out from a retrospective study on a cohort of children under the age of 16 years, related to a joint clinic assessment. Two clinical evaluators examined those subjects using the Hospital Del Mar criteria [1] for diagnosing joint hypermobility (JH). Each evaluator also classified the subject as either hypermobile or normal based on their overall clinical findings. The Kappa statistic was used to calculate the level of agreement between the two evaluators.

Results: Thirty subjects were included in the study ranging in age from 3 to 12 years (mean = 7.02, ±2.47 SD). Of the 30 subjects assessed, 21 (30%) were classified as hypermobile. Overall, the prevalence of JH in this study was higher in boys than in girls.

Conclusion: In this group of children, the Hospital Del Mar criteria appeared to be reliable tool for diagnosing hypermobility. Inter-rater reliability was good to excellent when assessing JH. Specific thresholds for diagnosis need to be set dependant on the age and ethnic group of the population being studied.

Keywords: Children; Joint hypermobility; Diagnostic criteria; Iter-rater reliability; Validity; Reproducibility