6. GALS screen

Question 1

What does GALS stand for?

Answer 1

Gait
Arms
Legs
Spine

Question 2

Recall 3 elements of gait that need to be observed in the GALS screen

Answer 2

Smoothness of movement
Stride length
Ability to turn quickly

Question 3

Recall 3 elements of “arms” that need to be observed in the GALS screen

Answer 3

Examine elbow joint 
- full extension
Examine shoulder joints 
- hands behind head and push
Examine hands  
-supination and pronation
-Grip - normal and precision 
- Squeeze test (test MCP joint )

Question 4

Recall elements of “legs” that need to be observed in the GALS screen

Answer 4

Knee/foot deformity?
Assess Flexion of hip/knee
Knee swelling?
Metatarsal squeeze test (test MTP joint)
Soles- rashes ?

Question 5

Recall elements of “spine” that need to be observed in the GALS screen

Answer 5

• Spine straightness and check if curvatures are normal
• Iliac crests level
• Are paraspinal, shoulder and gluteal muscle bulks symmetrical?
• assess lumbar and hip flexion by asking them to bend forward
• check lateral cervical flexion

Question 6

How many joints must be damaged in order to indicate polyarthritis?

Answer 6

> 4

Question 7

What name is given to arthritis of 2-4 joints

Answer 7

Oligoarthritis

Question 8

Define arthritis

Answer 8

Definite inflammation of a joint

Question 9

Define arthralgia

Answer 9

Refers to pain within a joint without any demonstrable inflammation through physical examination

Question 10

What name is given to a partial dislocation of a joint?

Answer 10

Subluxation

Question 11

Define dislocation

Answer 11

articulating surfaces are displaced and no longer in contact

Question 12

What is a varus deformity?

Answer 12

Distal part of lower limb directed towards midline

Question 13

What is a valgus deformity?

Answer 13

Distal part of lower limb directed away from midline

Question 14

Summarise how GALS fits into the overall examination

Answer 14

1. Screening test - GALS test to quickly identify any abnormalities
2. Once identified using GALS, you do a detailed examination of the abnormal joint:
   - nature
   - extent (polyarthritis etc)
   - other clinical features of diagnostic importance eg rheumatoid nodes