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Evidence summaries

Physical Examination of Chronic Lower-Extremity Ischemia

Some physical signs, especially the absence of pedal pulses and femoral arterial bruit may have moderate efficacy in the diagnosis of lower-extremity ischaemia. Level of evidence: "C"

A systematic review 1 included 12 studies. The following positive findings were helpful for the diagnosis of arterial disease: abnormal pedal pulses (ankle-arm index <0.5 to 0.9, LR+ = 3.0 to 44.6, LR- = 0.1 to 0.4, sensitivity 0.63 to 0.95, specificity 0.73 to 0.99. Femoral arterial bruit (AAI<0.8 to 0.9, LR+ = 4.7 to 5.7, LR- = 0.7 to -0.8, sensitivity 0.20 to 0.29, specificity 0.95 to 0.96. Venous filling time and colour abnormality had also some predictive power.

    References

    • McGee SR, Boyko EJ. Physical examination and chronic lower-extremity ischemia: a critical review. Arch Intern Med 1998 Jun 22;158(12):1357-64. [PubMed]

Primary/Secondary Keywords