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pGALS (paediatric Gait Arms Legs Spine)

pGALS - an evidence-based approach to basic musculoskeletal assessment and widely taught to medical students and physicians in primary care, paediatrics and orthopaedics. 

  • pGALS is a fundamental clinical skill in the assessment of children.
  • pGALS is simple, quick and easy.
  • pGALS is not diagnostic but discerns abnormal from normal joints.
  • pGALS is an integral skill used within the examination of all children (...just like examining the heart, chest or abdomen!)
  • pGALS is similar to adult GALS, with a few simple additional manoeuvres. 
  • It is important to assess all joints as the history may not localise the site of the problem.
  • Check for non-verbal clues of discomfort. 
  • "Practice makes perfect" - opportunities to assess children's joints are numerous (consider physiotherapy outpatients and not just rheumatology clinics!)
  • A 'copy me' approach is useful to help engage children in performing pGALS.

  • The pGALS App - Google Play and Apple Store - with multiple language translations, explanatory notes, images, and relevant links to pmm. 

Recording pGALS findings - a simple format is proposed with the example below:

 Appearance Movement
   Gait     Swelling behind L knee Normal       
Arms Normal Normal
Legs Swelling behind L knee Normal                           
Spine Normal Normal

Photo below shows a swelling behind the left knee (Baker's cyst)

 

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