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pGALS (paediatric Gait, Arms, Legs and Spine) is an evidence-based approach to basic musculoskeletal assessment in children and is widely taught to medical students and healthcare professionals in primary care, paediatrics and orthopaedics.  In advanced nursing assessment clinical nurse specialists and nurse practitioners will find pGALS a useful tool to adopt.


  • pGALS is simple, quick and easy. pGALS is not diagnostic but distinguishes abnormal from normal joints.
  • 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 such as facial expression.
  • "Practice makes perfect" - consider attending outpatients, physiotherapy clinics and rheumatology clinics to increase confidence in examining children's joints.
  • A 'copy me' approach is useful.

More information is available: 

pGALS - a simple musculoskeletal assessment for children. Foster HE and Jandial S. Pediatric Rheumatology Online 2013

Check out the pGALS app - it's free and has information on how to perform pGALS, what to look out for and examples of abnormalities. There are also many language translations and a version of pGALS for telemedicine (called V-pGALS). 


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