Exam - GALS

From CambridgeNotes

  • Three questions: pain or stiffness in muscles, joints or back? can they wash and dress completely without difficulty? can they climb up and down stairs without difficulty?

Gait: walk up, turn, walk back

  • Look: normal stride, symmetry, ability to turn

Spine

  • Look: from side - kyphosis? back - scoliosis? asym? popliteal fossa swelling? valgus or varus deformity?
  • Feel lumbar spine: fingers on adjacent spines, bend down, look for separation (movement from spine)
  • Feel cervical spine: ear on shoulder; pressure over mid superspinatus (trigger point suggests fibromyalgia)

Arms

  • Look: hands out in front - deformity, swelling; supinate – small muscle wasting, radioulnar joints
  • Feel: squeeze across MCPs (early sign of synovitis)
  • Move: power grip, pincer grip; straighten arm for fixed flexion deformity at elbow; hands behind head, elbows back for external rotation and abduction of glenohumeral (first to go)

Legs

  • Look: wasting (particularly of quadriceps), swelling (suprapatella pouch)
  • Feel: joint warmth (run hand down side of knees); fluid shift test
  • Move: bend knee with hand over joint (crepitus?); internally rotate hip (feet out)
  • Look at sole for callus formation (early feet problems); squeeze MTP (synovitis)

References

  1. Dr. Lillicrap
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