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 scope | HSD, hEDS |
|---|---|
| Date | 2017-03 |
| Criteria era | international-2017 |
| Reviewed | 2026-09-16 |
Evidence
clinicalconsensus statement
clinicalcohort study
The 2025 German cohort keeps hEDS/HSD together precisely because the boundary is porous.