MSK History

Question 1

What is GALS?

Answer 1

Screening questions for MSK history as part of the systematic enquiry

Gait
Arms
Legs
Spine

Question 2

What questions are in the GALS?

Answer 2

• Any pain / stiffness in muscles, joint or back?
• Can you dress without difficulty?
• Can you walk up and down stairs without any difficulty?

Question 3

What are the cardinal ortho symptoms?

Answer 3

Something feels wrong (pain, dysaesthesiae, weakness)
Something moves wrong (stiffness, reduced ROM, limp, instability and crepitus)
-Something looks wrong (swelling, deformity, wasting, shortening, discolouration and wounds)

Question 4

What questions to ask in the history of a typical day?

Answer 4

Wake by pain?
How is it in the morening
-Take long to get going?
-Have to excercise?
Dressing
Cut own toenails?
Get in and out of bath?
Distance walking on flat
Driving? 
Shopping?
Work / hobbies?

Question 5

What are red flag symptoms in ortho history taking?

Answer 5

Worsening pain
Night pain
Non-mechanical pain
General malaise, febrile and rigors
Weight loss
Night sweats
PMH of malignant disease

Question 6

How do you carry out an examination of MSK?

Answer 6

Expose and compare R+L legs standing + lying

Question 7

What are the steps in MSK examination?

Answer 7

Look
Feel
Move

Question 8

What do you do in look of the clinical examination?

Answer 8

Posture 
Not relevant negatives
Gait
Skin = scars, colour, swelling
Wasting
Deformity
Limb lengths

Question 9

What do you do in Feel of the clinical examination?

Answer 9

Skin = temp, sweating and cap refill
Tenderness
Swelling
Deformity - landmarks in the write place

Question 10

What do you do in move of the clinical examination?

Answer 10

Active
Passive
Special tests

Range, rhythm, rate
Pain/stiffness?
Smoothness - laxity or hypermobility
Muscle tone
Power / strength