The physical examination should include the same requirements as the inflammatory
arthritis and musculoskeletal examinations for adults as described in DI 22510.023 and DI 22510.027, where indicated, except motor skills should be assessed according to age-appropriate
activities. For children too young to assess the inability to ambulate effectively,
or the inability to perform fine and gross manipulations, consideration must be given
to assessment of limitations in the ability to perform comparable age-appropriate
activities in the upper and lower extremities, given normal developmental expectations.