Today we discussed a boy of 4 years with difficulty in walking and frequent falls. Clinical signs evident were calf hypertrophy and positive Gowers sign.

Diagnosis and identification of Gowers sign was useful. How to approach such a child and how the discussion regarding management should be directed.The main learning points are;

• Practice giving instructions to children in SIMPLE language. Not easy as it seems.
• Management – ideal – Gold standard as in UK protocols but then mention what is available in your own practice.
• Observing muscles, legs, gait be at a level to clearly see child – kneel.
• Do NOT walk in front of child or by his side – you will not be able to observe any signs.
• We will see a video at next session.
• General physical examination is EXPECTED at ALL stations.
• MDT – composition and role of each member – important to know.
• Expose body part in question. Trousers and socks.