pGALSplus is a ‘toolkit’ based on pGALS, and includes questions and assessments to help identify children with more serious pathology.
pGALSplus aims to help clinicians determine if a child with a musculoskeletal problem will need specialist referral or not and if so whether to rheumatology, orthopaedics or neurology/neurodisability. A Model of Care involving triage is called RightPath and further information is available:
- Children with musculoskeletal problems access healthcare in many different ways. For many children, particularly young children, presentations can be vague; an example is the clumsy child where it is often not clear if the problem is related to musculoskeletal, neurological or developmental difficulties.
- pGALS as a musculoskeletal assessment is useful to identify areas that may be abnormal (such as a restricted wrist, or a swollen ankle). However as a 'stand alone' assessment it does not give information as to the likely cause of the abnormality and which may be needed to guide ongoing referrals.
- pGALSplus was developed as a tool for clinicians who may be asked to assess children with problems such as limp, clumsiness and or joint pain.
- The addition of specific manoeuvres to pGALS support the clinician to differentiate between certain conditions and is focussed on exemplar presentations;
- Common conditions (such as hypermobility and developmental co-ordination disorder),
- Less common but eminently treatable conditions (such as juvenile idiopathic arthritis) and,
- Very rare but life-changing conditions (such as muscular dystrophy and the mucopolysaccharidoses).
Resources to demonstrate pGALSplus can be found below:
- Basic Instructions for assessment using pGALSplus
- pGALSplus checklist
- pGALSplus proforma (5-10 years)
- pGALSplus preschool proforma (2-4 years)
- pGALSplus red flags
- pGALSplus DCD example form
- pGALSplus DMD example form
- pGALSplus Hypermobility example form