GALS Screening

Question 1

What is GALS screening

Answer 1

Its a screening examination for MSK disorder with takes 1-2 minutes. It involves three questions, inspecting carefully for joint swelling, abnormal posture and assessing joints for normal movement.

Question 2

Key questions in GALS

Answer 2

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?

Question 3

If the patient answers the questions negatively

Answer 3

They are unlikely to be suffering from any significant MSK disorder

Question 4

GALS

Answer 4

Gait
Arms
Legs
Spine

Question 5

Gait

Answer 5

Ask the patient to walk a few steps, turn and walk back. Observe the patients gait for symmetry and smoothness and their ability to turn quickly.

Question 6

Standing from the front

Answer 6

Look for alignment of the elbow, quadriceps size and symmetry, forefoot abnormalities

Question 7

Standing from behind

Answer 7

Examine shoulder bulk and symmetry, spinal alignment, gluteal muscle bulk and symmetry, popliteal swelling or abnormalities, calf muscle bulk and symmetry and hindfoot abnormalities

Question 8

Observing from the side

Answer 8

Cervical lordosis
Thoracic kyphosis
Lymbar lordosis
Knee flexion

Question 9

Arms

Answer 9

Ask the patient to put their hands behind their head.
Assesses shoulder abduction and external rotation, and elbow flexion (these are often the first movements to be affected by shoulder problems).

With the patient’s hands held out, palms down, fingers outstretched observe the backs of the hands for joint swelling and deformity.

Ask the patient to turn their hands over.
Look at the palms for muscle bulk and for any visual signs of abnormality.

Ask the patient to make a fist.
Visually assesses power grip, hand and wrist function, and range of movement in the fingers.

Ask the patient to squeeze your fingers.
Assesses grip strength.

Ask the patient to bring each finger in turn to meet the thumb.

Assess fine precision pinch
important functionally

Gently squeeze across the metacarpophalangeal (MCP)
pain suggesting inflammatory joint disease.

Question 10

Spine

Answer 10

With the patient standing, inspect the spine
from behind for scoliosis
from the side for abnormal lordosis or kyphosis.

Ask the patient to tilt their head to each side
Assesses lateral flexion of the neck
Sensitive in the detection of early neck problems

Ask the patient to bend to touch their toes
Assess by placing two or three fingers on the lumbar vertebrae

Question 11

Legs

Answer 11

Knee
Assess full flexion and extension of both knees
Feel for crepitus.

Hip and knee flexed to 90º
assess internal rotation of each
often the first movement affected by hip problems

Perform a patellar tap check for a knee effusion

Inspect the feet for
Swelling
Deformity
Callosities on the soles.

Squeeze across the metatarsophalangeal (MTP)
tenderness suggesting inflammatory joint disease and Morton’s Neuroma