GALS
Questions
- Do you have any pain or stiffness in your muscles, joints and back?
- Can you dress yourself completely without any pain or difficulty dressing yourself?
- Do you have any pain or difficulty walking up and down stairs?
Gait
"Can you please walk to the other side of the room for me, and then come back?" Watch for:
- Symmetry
- Smoothness
- and Ease of Turning.
Back view
Inspect for:
- Shoulder muscle bulk
- Straight, central spine.
- Level Iliac crests
- Gluteal muscle bulk
- Popliteal swelling
- Calf muscle bulk
- Hind foot abnormalities.
Side view
Inspect for normal:
Hip and Lumbar Flexion
"Can you please try to touch your toes?" Let them do it with two of your fingers on the lumbar spine; there should be some separation of your fingers during flexion.
Front view (anatomical position)
Inspect for:
- Level Shoulders
- Bilateral Muscle Bulk
- Elbow extension
- Quadriceps bulk and symmetry
- Knee swelling and deformity
- Foot arches, and any midfoot or forefoot deformity.
Head and Neck
"Try to touch your ear to your shoulder, on both sides."
- Lateral flexion of the cervical spine
"Open jaw wide, and move it side to side."
- Assessment of the tempero-mandibular joint
"Arms behind head, then down again, with elbows by side, then turn around to the front, end with palms facing down."
- Full shoulder abduction, then external rotation, and finally supination at the elbow.
Hands
- Inspect for swelling and deformity of wrists and hands
- Inspect the palms of the hands for muscle bulk, and any visual deformities
"Can you clench your fist?"
- Looking for dupiter’s contracture
- Assesses wrist and hand mobility
"Can you squeeze my fingers?"
- Tests Power
"Can you touch fingers together one after another?"
- Hand-joint movement
- Co-ordination
- and Concentration
Finally, gently squeeze the metacarpal pharyngeal joints
- Screening for inflammatory joint disease
Hip
Whilst patient is on examination couch, lift the leg with a bent knee, to test hip extension and knee flexion, and whilst up turn it, to check internal and external rotation.
Feet and Legs
Perform a patella tap
- To exclude knee effusions.
Examine soles of feet
- Looking for callus formation.
Finally squeeze metatarsals.
- To screen for inflammatory arthritis