Diagnosis and classification

HSD was created as the residual category beside hEDS

establishedfinding

The 2017 framework (Castori et al.) separated symptomatic joint hypermobility into hEDS when the strict criteria are met and HSD when they are not. The boundary is contested — the criteria were designed for research homogeneity, not to declare HSD benign, and the hEDS/HSD criteria review study is ongoing.

Subtype scopeHSD, hEDS
Date2017-03
Criteria erainternational-2017
Reviewed2026-09-16

Evidence

clinicalconsensus statement
clinicalcohort study

The 2025 German cohort keeps hEDS/HSD together precisely because the boundary is porous.