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Following pGALS, the observer is directed to a more detailed examination of the relevant area(s). 

pREMS (paediatric Regional Examination of the Musculoskeletal System) is based on the ‘look, feel, move, function’ principle similar to that of adult REMS for each joint or anatomical region, with active movements performed first and then passively by the examiner; the addition of ‘measure’ for some joints is relevant as are additional options pending the clinical scenario (e.g., checking for pulses or more detailed muscle or neurological assessment). 

pREMS is relevant to paediatric rheumatology although clearly many components are relevant to paediatric orthopaedics and can be used by doctors and allied health professionals.

The following are links to video demonstrations of pREMS:

pREMS - Hand and wrist           pREMS - Elbow           pREMS - Shoulder
pREMS - Foot and ankle           pREMS - Knee           pREMS - Hip
pREMS - Spine           pREMS - Gait           pREMS - Hypermobility
pREMS - Enthesitis           pREMS - Complete demonstration  


A pdf proforma for pREMS 'Record your Findings' is available.

The diagrams used in the pREMS videos to demonstrate surface anatomy and ranges of movement are available. The details of pREMS checklist for each joint are available in resources.


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