Understand | diagnose | change

Whether you are looking to learn more about paediatric musculoskeletal problems, or are involved in the care of children, then PMM and PMM-Nursing will help you change your clinical practice for the better. PMM is free and open to all !

Learning Outcomes

History Taking

  • Describe ‘red flags’ symptoms for infection (including reactive arthritis), malignancy, significant systemic disease and non-accidental injury. 
  • Recognise the importance of a travel history to consider infections in endemic areas.
  • Recognise that the history may be vague and the site(s) of pathology may not be clear from the history alone; there is need to supplement history with a musculoskeletal examination and assessment starting with pGALS.
  • Demonstrate knowledge of the gross motor milestones within childhood development and that normal variants can occur.
  • Perform an effective pain history (site, onset, character, radiation, associated features, duration of symptoms, exacerbating and relieving factors, impact on sleep).
  • Recognise features within the history that aid in distinguishing mechanical from inflammatory musculoskeletal pathology.


  • Use the pGALS assessment as a basic musculoskeletal examination and recognise that positive findings must lead to more detailed examination (pREMS).
  • Describe the leg alignment and foot posture changes that occur with normal growth and recognise normal variants.
  • Identify clinical features of an inflamed joint.
  • Describe ‘red flags’ and clinical features suggestive of infections with musculoskeletal features, malignancy and non-accidental injury.
  • Recognise that children have increased joint flexibility compared to adults (hypermobility).
  • Describe Marfan’s and Ehler’s Danlos syndromes and their important extra-articular features.
  • Be aware that a neurological examination may be indicated in the context of musculoskeletal presentations (e.g., limp, delayed walking) and be aware of proximal myopathy.
  • Be aware of the clinical features of muscle disease (e.g., weakness, gait disturbance, abnormal development [delay or regression]).
  • Describe the clinical features of muscular dystrophies (e.g., Duchenne, Becker) and myopathies.

The learning outcomes for each module within pmm have been compiled into one document within the site resources section.