Practical tips and pGALS

When to perform pGALS:

• Unwell child with pyrexia.
• Child with limp.
• Delay or regression of motor milestones.
• The ‘clumsy’ child.
• Child with a chronic disease and Inflammatory Bowel Disease.

Practical tips in performing pGALS:

• 'Copy me' approach. Stand or sit in front of the child and get them to copy you.
• Look for verbal and non-verbal clues of discomfort (e.g., facial expression, withdrawal of a limb).
• 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.

Documentation of pGALS should follow the suggested proforma using the example of a swollen right knee.