Discussed Neurology – Lower limb examination of a 4 year old boy with finding in keeping with Right side hemiplegia.
Good discussion and a easy to follow flow chart for Gait:
- Gait – Normal or Abnormal. i.e. Y or N
- Wide based Gait – both limbs to be affected
- Leg – Side affected: Left or Right
- Tone: Increased or Decreased on affected side
- Reflexes: Increased – easy to be sure. If Difficult to elicit – Jendrassik manoeuver
Child with a Limp – painful joint will not want to run. Guide you to MSK.
Learning points were:
- General examination is part of all stations.
- Stand back for 30 seconds and observe child and surroundings
- Upper limbs and face – not to miss
- Ask parents to expose legs – keep observing the child during this
- Do not make up signs – reflexes to fit your ‘mental’ diagnosis