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Practical tips and pGALS

When to perform pGALS:

  • Unwell child with Pyrexia.
  • Child with limp.
  • Delay or regression of motor milestones.
  • The ‘clumsy’ child in the absence of Neurological Disease.
  • Child with chronic disease and known association with musculoskeletal presentations (such as with Inflammatory Bowel Disease).

Practical tips in performing pGALS:

  • 'Copy me' approach.
  • Look for verbal and non-verbal clues of discomfort (e.g. facial expression, withdrawal).
  • Do the full assessment as extent of joint involvement may not be obvious from the history.
  • Look for asymmetry (e.g. muscle bulk, joint swelling, range of joint movement).
  • Consider clinical patterns (e.g. non-benign hypermobility and Marfanoid habitus or skin elasticity) and association of leg length discrepancy and scoliosis.

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