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Musculoskeletal screening examination (pGALS) for school-age children based on the adult GALS screen

Lookup NU author(s): Emerita Professor Helen Foster, Dr Lesley Kay, Dr David Coady, Dr Andrea Myers


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Objective. To develop and validate a musculoskeletal screening examination applicable to school-age children based on the adult Gait, Arms, Legs, Spine (GALS) screen. Methods. Adult GALS was tested in consecutive school-age children attending pediatric rheumatology clinics and was compared with an examination conducted, on the same day, by a pediatric rheumatologist who classified children as having abnormal or normal joints. Adult GALS was tested for validity compared with the pediatric rheumatologist's assessment and deficiencies in adult GALS were identified. Experts proposed amendments to adult GALS, achieving consensus by modified Delphi techniques. The resultant pediatric screening tool (pGALS) was tested (methodology identical to the testing of adult GALS) in an additional group of children. Results. Adult GALS was tested in 50 children (median age 11 years, range 4-16), of whom 37 (74%) had juvenile idiopathic arthritis. Adult GALS missed important abnormalities in 18% of children, mostly at the ankle, foot, and temporomandibular joints. The pGALS was tested in 65 children (median age 13 years, range 5-17 years) and demonstrated excellent sensitivity (97-100%) and specificity (98-100%) at all joints, with high acceptability scored by child and parent/guardian. The median time to perform pGALS was 2 minutes (range 1.5-3 minutes). Conclusion. The pGALS musculoskeletal screening tool has excellent validity, is quick to perform, and is acceptable to school-age children and parents/guardians. We propose that pGALS be incorporated into undergraduate and postgraduate medical training to improve pediatric musculoskeletal clinical skills and facilitate diagnosis and referral to specialists. © 2006, American College of Rheumatology.

Publication metadata

Author(s): Foster HE, Kay LJ, Friswell M, Coady D, Myers A

Publication type: Article

Publication status: Published

Journal: Arthritis Care and Research

Year: 2006

Volume: 55

Issue: 5

Pages: 709-716

ISSN (print): 0893-7524

ISSN (electronic): 0004-3591

Publisher: Arthritis Care and Research


DOI: 10.1002/art.22230

PubMed id: 17013854


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