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Benign familial hypermobility syndrome and Trendelenburg sign in a painting "The Three Graces" by Peter Paul Rubens (1577-1640).

Clinical features suggestive of hypermobility syndrome and a positive Trendelenburg sign are described in a painting "The Three Graces" (1638-1640) by Peter Paul Rubens, Prado, Madrid. The most obvious findings are scoliosis, positive Trendelenburg sign, and hyperextension of the metacarpal joints, hyperlordosis, and flat feet. The sitters, presumably Hélène Fourment (second wife of Rubens) and her sisters, support the hereditary familial aspect of hypermobility. Manifest hypermobility of the hand has also been found in two other ancient paintings: "Saint Cyriaque" in the Heller Retable by Mathias Grünewald (1450-1528), Frankfurt, and "The wounded man" by Gaspare Traversi, Venice (1732-1769). The finding of signs of hypermobility in ancient paintings shows that artists who are keen observers of nature could describe, or at least record, this condition long before doctors did. The art of the past can be a useful tool in the field of paleopathology.