“GALS” Screening Exam


Inspect Gait
  • Symmetry, smooth movement, normal stride length, normal phases of gait.
Inspect from behind
  • Spine
  • Legs
  • Scoliosis, symmetrical paraspinal muscles, shoulder and gluteal muscles, level iliac crests.
  • No popliteal swellings, normal knee alignment, no hindfoot swelling / deformity.
Inspect from the side
  • Spine
  • “Touch Toes”
  • Normal cervical and lumbar lordosis, mild thoracic kyphosis.
  • Normal spine and hip flexion.
Inspect from the front
  • Legs
  • Normal quadriceps mass/symmetry, normal knee alignment, no swelling,
  • Normal ankle alignment, no swelling, normal forefoot, arch, toe alignment.


“Tilt head to shoulders”
  • Normal cervical lateral flexion.
“Arms behind head”
  • Normal shoulder movement.
“Arms straight”
  • Full elbow extension.
“Hands in front”
  • No wrist/finger swelling or deformity, able to extend fingers.
“Make a fist”
  • Normal power grip, flexion of MCPs, no swelling of troughs between MCPs.
“Fingers on thumb”
  • Normal fine precision pinch / dexterity.
“Turn hands over”
  • Normal supination/pronation, no erythema, swelling, muscle wasting in palms.
Gently squeeze across MCPs
  • Identify pain of synovitis


Palpate knees
  • No warmth, no effusions, normal muscle bulk.
Flex each hip and knee
  • Normal flexion of hips, knees, no flexion contractures, no crepitus, no pain.
Rotate each hip in flexion
  • Normal rotation of hips.
Gently squeeze across MTPs
  • Identify pain of synovitis.
Inspect soles of feet
  • No callosities to suggest abnormal weight bearing.

Reference: Doherty M, Dacre J, Dieppe P, et al. The ‘GALS’ locomotor screen. Ann Rheum Dis. 1992; 51(10): 1165-9. http://dx.doi.org/10.1136/ard.51.10.1165.Medline:1444632