GALS (Gait, Arms, Leg, Spine)

Introduces self	0	1
Confirms name & age of patient	0	1
Explains & gains consent	0	1
Asks if patient suffers from pain or stiffness in muscles or joints	0	1
Asks if patient is able to walk up and down stairs without problems	0	1
Asks if patient has any difficulty dressing themselves	0	1
Washes hands	0	1
Exposes patient fully and asks them to stand	0	1
General inspection around bed and patient (walking aids, obvious scars, wasting or deformities)	0	1
Asks patient to walk to the end of room and turn	0	1
Comments on patient’s speed, the phases of walking, stride length and arm swing	0	1	2
Inspects front for shoulder/hip alignment, limb-limb discrepancy, varus/valgus deformity	0	1
Inspects back for wasting of muscles (trapezius, paraspinal, gluteal, calf), scoliosis, skin changes, scars, hindfoot deformities	0	1
Inspects sides for fixed flexion deformities and increased kyphosis or lordosis	0	1
Feels for tenderness over mid-supraspinatus and swelling in the popliteal fossa	0	1
Checks lateral flexion of the neck	0	1
Checks for spinal flexion using the modified Schober’s test	0	1
Inspects arms for wasting, swelling, deformities, rheumatoid nodules, nodes	0	1
Squeezes metacarpophalangeal joints	0	1
Assesses movements of the hands, (grip and pincer), wrist (prayer and reverse prayer) and shoulder	0	1	2
Performs metatarsophalangeal joint squeeze	0	1
Checks patella for tap test and bulge test for effusions	0	1
Checks hip and knee flexion and hip rotation	0	1	2
Offers specific exam of regions with abnormality, neurovascular exam and history	0	1
Thanks patient and offers help to redress	0	1
Washes hands	0	1
Offers next step (imaging: 2 plain x rays for bony pathology, MRI for soft tissue)	0	1
Summarises appropriately with only key findings	0	1
Offers appropriate differential diagnoses	0	1

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