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Beyond pGALS: the need for a multifaceted musculoskeletal decision-making tool ('pGALSplus') in community-based clinical practice

Lookup NU author(s): Vicky Mercer, Dr Sharmila JandialORCiD, Professor Michela GuglieriORCiD, Emerita Professor Helen Foster



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© The Author(s) 2024. Published by Oxford University Press on behalf of the British Society for Rheumatology. Musculoskeletal (MSK) problems in children are common, and health-care professionals must identify those requiring onward referral. Paediatric gait, arms, legs and spine (pGALS) is an MSK assessment to discern abnormal joints. We aimed to identify MSK assessments to add to pGALS (pGALSplus) to facilitate decision-making in the context of exemplar conditions representing a spectrum of MSK presentations, namely JIA, mucopolysaccharidoses, muscular dystrophy and developmental co-ordination disorder. A literature review identified 35 relevant articles that focused on clinical assessments [including questionnaire(s), physical examination and functional tests] used by health-care professionals in the context of the exemplar conditions. We provide a description of these assessments and the rationale regarding how they, or components of such tools, might be useful within pGALSplus. This process provides a foundation for further work to develop and validate pGALSplus.

Publication metadata

Author(s): Mercer V, Smith N, Jandial S, Guglieri M, Jones SA, Foster HE

Publication type: Review

Publication status: Published

Journal: Rheumatology Advances in Practice

Year: 2024

Volume: 8

Issue: 1

Print publication date: 27/01/2024

Online publication date: 23/01/2024

Acceptance date: 28/12/2023

ISSN (electronic): 2514-1775

Publisher: Oxford University Press


DOI: 10.1093/rap/rkae004