Dear All

Thank you for particpating in the session today.

In RRR we discussed:

• ALL – Symptoms & Signs
• Delayed Puberty
• Acute Abdomen – abdominal pain

The clinical station was of a 6 year old whose parents are concerned that she is clumsy. You are asked to do a MSK examination. Dr A took the Hotseat. He started well with screening questions, then moved to gait and inspection and followed the pGALS instructing the child. He overran and completed the examination in over 9 minutes. Dr P attempted the station after some feedback from all and did the examination in 6 minutes but missed a few minor points.

Remeber – you may be asked to demnstrate a sign or technique of doing a particular test i.e. detection of effusion in knee.

The Learning points are:

• Prepare a DD of 3 for any given scenario
• Do not go in with only 1 diagnosis
• pGALS can be done in any order – complete all.
• Expose the parts – legs and arms in this instance.
• Be systematic in your exam and slick
• Spine – a mild scoliosis is ‘physiological’ when upright – check when touching toes
• Practice finishing the exam in 5 minutes
• Investigations – mention with expected results

Please visit www.mrcpchonline.org to add your comments or points I may have missed.

Anil Garg