From less common (hEDS) to more common HSD to very common asymptomatic joint hypermobility, many authorities consider them as one disease process in the continuum. This is controversial. Regardless, P&S dysfunctions are common in all three types because of connective tissue abnormalities. Based on an individual patient’s history, when the primary or only identifiable cause of P&S dysfunction is hypermobility (typically from early childhood), we generally conclude that the P&S dysfunction is due to a connective tissue abnormality. Furthermore, since there is yet no known cure for connective tissue disorders in general, we do not obsess over whether a patient meets stringent criteria. The main exception is vEDS to ensure as early an identification as possible to help minimize morbidity and mortality risks. kEDS would be another exception. Primary care physicians should be acquainted with the five questions for detection of joint hypermobility. Because range of motion decreases with advancing age, this questionnaire is very helpful in older patients. Patients with hypermobility do not have joint synovitis; however, they may have tenderness with mild swelling, and if synovitis is present, consider rheumatoid arthritis, especially if there are swan neck deformities of the fingers.