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 to add your comments or points I may have missed.

Anil Garg