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Diagnosing Venous Insufficiency

When evaluating a patient for venous insufficiency, physicians utilize several methods to examine the patient. Most physicians start with the patient’s presenting complaint and its history. Next, the physician may perform a physical exam followed by a duplex ultrasound evaluation.


  • Includes general medical and surgical information, as well as specific information about vascular disease
  • Onset of the problem
  • Predisposing or aggravating factors of symptoms
  • Patients are specifically asked about the common symptoms seen with venous insufficiency, such as leg heaviness, aching, itching, pain, fatigue, and swelling

Physical Examination

While a physical examination should not be used as the sole evaluation, there are several physical findings that are associated with venous reflux:

  • Asymmetry of the limbs (size, length, ankle diameter)
  • Scars (previous venous surgery or ulcers)
  • Skin changes
  • Lower limb swelling (edema)
  • Skin ulcers

A common physical exam that physicians may use to assess a patient is the Trendelenburg Exam. More information about this type of exam and sample forms for completing a patient's history can be found after logging into our media site. A physician may also perform a palpation of arterial pulses to confirm that there is not another underlying disease.