Paediatric Gait, Arms, Legs and Spine examination (pGALS) - a case based discussion

We describe the application of pGALS (paediatric Gait, Arms, Legs and Spine) as a simple and quick musculoskeletal (MSK) assessment to help distinguish abnormal from normal joints in children and young people (CYP). The use of pGALS is aimed at the non-specialist in paediatric MSK medicine, and through four clinical cases we show its application in the primary care, acute and general paediatric settings. It is hoped that improved knowledge and skills in the MSK assessment of CYP will lead to greater awareness about what is normal, when to be concerned, and facilitate prompt referral to specialist teams to optimise clinical outcomes.