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