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Examinations

GALS screen

A structured guide to performing the GALS musculoskeletal screening examination.

1. Introduction

GALS stands for Gait, Arms, Legs and Spine. It is a rapid screening examination for musculoskeletal disease and is commonly used in OSCEs to identify whether a more focused joint examination is needed.

2. Screening questions

Start by asking the three standard screening questions: Do you have any pain or stiffness in your muscles, joints or back? Can you dress yourself completely without any difficulty? Can you walk up and down stairs without any difficulty?

3. Gait and arms

Inspect the patient walking, turning and walking back. Assess the arms with the hands behind the head and hands behind the back, inspect the hands, perform squeeze test of the MCP joints and assess power grip and pincer grip.

4. Legs and spine

With the patient lying down, inspect the legs, assess hip internal rotation, knee flexion and extension and look at the feet. For the spine, inspect from behind, assess cervical movements and lumbar flexion and ask about pain.

5. Completion

Any abnormality on the screen should prompt a focused regional examination such as shoulder, hand, hip, knee or spine.

Preparation

Screening questions

Gait

Arms

Legs

Spine

Completion