Following pGALS, the observer is directed to a more detailed examination of the relevant area(s).
pREMS (paediatric Regional Examination of the Musculoskeletal System) is based on the ‘look, feel, move, function’ principle similar to that of adult REMS for each joint or anatomical region, with active movements performed first and then passively by the examiner; the addition of ‘measure’ for some joints is relevant as are additional options pending the clinical scenario (e.g., checking for pulses or more detailed muscle or neurological assessment).
pREMS is relevant to paediatric rheumatology although clearly many components are relevant to paediatric orthopaedics and can be used by doctors and allied health professionals.
More information about pREMS is available and includes descriptions of pREMS for each joint.
A pdf proforma for pREMS 'Record your Findings' is available.