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