What do the 2017 diagnostic criteria for hypermobile EDS require, and what are their limits?

The 2017 criteria combine generalized hypermobility, clinical features and the exclusion of other diagnoses. They are not a self-test.

10 sources
5 min read
Clinical review
Verified 9 November 2026

Key points

In biologically mature adults, a clinical diagnosis of hypermobile Ehlers-Danlos syndrome (hEDS) requires all three criteria to be met at the same time: generalized joint hypermobility, at least two of three groups of clinical features, and the exclusion of other diagnoses ^{[1, 2]}.
These criteria are a checklist intended for physicians: they assume a clinical examination, sometimes additional tests such as an echocardiogram, and the ruling out of other conditions. They cannot be used to assess yourself ^[2].
The hypermobility cutoff used depends on age; the 2017 criteria should not be applied as such to biologically immature children and adolescents, for whom a specific pediatric framework was proposed in 2023 ^{[2, 4]}.
Some studies judge these criteria too restrictive, but they are not enough to replace the 2017 consensus ^[5].
A new classification has been announced for early December 2026; as of this writing, the 2017 criteria remain the published reference ^{[9, 10]}.

Important. This page explains how the published criteria are built. It deliberately does not reproduce the assessment checklist and is not a self-diagnosis questionnaire. A diagnosis requires a clinical examination, an assessment of biological maturity, a search for other diagnoses and interpretation by a qualified healthcare professional.

Scope

Criterion 1 — Generalized joint hypermobility

Criterion 2 — At least two of three groups of features

Several of these items come with conditions for interpretation (circumstances of onset, other possible causes, imaging criteria) that belong to the medical examination.

Criterion 3 — Exclusion of other diagnoses

Limits of and debates about the 2017 criteria

Expected update

References and level of evidence

Malfait F, Francomano C, Byers P et al. The 2017 international classification of the Ehlers-Danlos syndromes. American Journal of Medical Genetics Part C, 175(1):8–26 2017. DOI: 10.1002/ajmg.c.31552. PMID: 28306229.(guideline or consensus)
Limitations: Classification consensus; not a prospective diagnostic validation study. Read: abstract.
Declared conflicts of interest: Not reviewed in the part of the source that was read
The Ehlers-Danlos Society / International Consortium on EDS. Diagnostic Criteria for Hypermobile Ehlers-Danlos Syndrome (hEDS) — checklist v9. 2017.(guideline or consensus)
Limitations: Clinical checklist intended for physicians; it is not a screening or self-assessment tool.
Declared conflicts of interest: Not applicable
Carroll MB. Hypermobility spectrum disorders: A review. Rheumatology and Immunology Research, 4(2):60–68 2023. DOI: 10.2478/rir-2023-0010. PMID: 37637226.(evidence synthesis)
Limitations: Narrative, non-systematic review. Read: full text (PMC10457547).
Declared conflicts of interest: The author declares no conflict of interest
Tofts LJ, Simmonds J, Schwartz SB et al. Pediatric joint hypermobility: a diagnostic framework and narrative review. Orphanet Journal of Rare Diseases, 18(1):104 2023. DOI: 10.1186/s13023-023-02717-2. PMID: 37143135.(guideline or consensus)
Limitations: Pediatric consensus framework; heterogeneous literature, framework still to be tested prospectively. Read: full text (PMC10157984).
Declared conflicts of interest: The authors declare no conflict of interest
Ritelli M, Chiarelli N, Cinquina V, Vezzoli M, Venturini M, Colombi M. Looking back and beyond the 2017 diagnostic criteria for hypermobile Ehlers-Danlos syndrome: A retrospective cross-sectional study from an Italian reference center. American Journal of Medical Genetics Part A, 194(2):174–194 2024. DOI: 10.1002/ajmg.a.63426. PMID: 37774134.(observational study)
Limitations: Retrospective, single-center; 327 patients from 213 families already diagnosed under earlier criteria. Read: abstract.
Declared conflicts of interest: Not reviewed in the part of the source that was read
Carnerup I, Bondesson E, Ahl E, Schouenborg AT, Jöud AS. Prevalence of generalized joint hypermobility, hypermobility spectrum disorders and Ehlers-Danlos syndrome: systematic review and meta-analysis. Rheumatology International, 46(11):306 2026. DOI: 10.1007/s00296-026-06346-3. PMID: 42986321.(evidence synthesis)
Limitations: 17 general-population studies; very high heterogeneity; a single study for HSD and hEDS. Read: full text (PMC13739981).
Declared conflicts of interest: The authors declare no conflict of interest; Swedish public funding
Demmler JC, Atkinson MD, Reinhold EJ, Choy E, Lyons RA, Brophy ST. Diagnosed prevalence of Ehlers-Danlos syndrome and hypermobility spectrum disorder in Wales, UK: a national electronic cohort study and case-control comparison. BMJ Open, 9(11):e031365 2019. DOI: 10.1136/bmjopen-2019-031365. PMID: 31685485.(observational study)
Limitations: Diagnostic codes combining EDS and JHS, period preceding the 2017 classification. Read: full text (PMC6858200).
Declared conflicts of interest: No conflicts declared
French reference center for constitutional bone diseases, OSCAR rare-disease network (published by HAS). Syndrome d'Ehlers-Danlos Non Vasculaire (SED NV) — Protocole national de diagnostic et de soins. 2020.(guideline or consensus)
Limitations: Not validated by the HAS, which did not take part in drafting it. Read: institutional page and excerpts from the PDF.
Declared conflicts of interest: Not reviewed in the part of the source that was read
The Ehlers-Danlos Society. A Major Update Is Coming to EDS and HSD Diagnosis. 2026.(expert opinion)
Limitations: Institutional announcement of a timeline; it is not the scientific publication of the new criteria.
Declared conflicts of interest: Not applicable; the organization is leading the new classification project
The Ehlers-Danlos Society. The Road to 2026 — FAQs. 2026.(expert opinion)
Limitations: Institutional FAQ; the date given (December 2, 2026) differs by one day from the date on the announcement page (December 1).
Declared conflicts of interest: Not applicable; the organization is leading the new classification project

Written by: AI-assisted literature research (ChatGPT) and AI-assisted writing (Claude)
Editor: Jean Viry-Babel
Review status: Clinical review: Dr Françoise Charmoillaux (anesthesiologist)
Approved on: 9 November 2026
Literature search: 8 November 2026
Last verified: 9 November 2026
Geographic scope: international, France, United States
Audience: everyone
Conflicts of interest: No known financial ties. Separately, the publisher is developing a personal approach to these conditions under the name Connected Conditions, which is not cited here (see the legal notice).
Limitations of this page: Explains how the 2017 criteria are structured without reproducing the checklist: the page cannot be used for self-assessment or to make a diagnosis. A new classification has been announced for December 2026; several sources were read from their abstract only. Page not reviewed by a rheumatologist or geneticist.