Physical examination maneuver

Physical Exam

Calf Circumference

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Video coming September 2026

How to Perform

Measure the circumference of each calf 10 cm below the tibial tuberosity. Keep the tape level and snug without compressing the soft tissue. Compare the two sides.

How to Interpret

Showing 3 of 5 findings

Deep Vein Thrombosis

Asymmetric calf swelling with a measured calf-circumference difference
Rule in
Minimally helpful
Rule out
Minimally helpful
Evidence:Strong

Lumbosacral Radiculopathy

Ipsilateral calf wasting
Rule in
HelpfulDerived CI
Rule out
Minimally helpfulDerived CI
Evidence:Limited

Sarcopenia

Reduced calf circumference
Rule in
Somewhat helpful
Rule out
Somewhat helpful
Evidence:Strong

References

  • Goodacre S, Sutton AJ, Sampson FC. Meta-analysis: the value of clinical assessment in the diagnosis of deep venous thrombosis. Ann Intern Med. 2005;143(2):129-139. PMID: 16027455. doi:10.7326/0003-4819-143-2-200507190-00012.
  • van der Windt DAWM, Simons E, Riphagen II, Ammendolia C, Verhagen AP, Laslett M, et al. Physical examination for lumbar radiculopathy due to disc herniation in patients with low-back pain. Cochrane Database Syst Rev. 2010;(2):CD007431. doi:10.1002/14651858.CD007431.pub2. PMID: 20166095.
  • Kerr RSC, Cadoux-Hudson TA, Adams CBT. The value of accurate clinical assessment in the surgical management of the lumbar disc protrusion. J Neurol Neurosurg Psychiatry. 1988;51(2):169-173. PMID: 3346682.
  • Qian S, Zhang S, Lu M, Chen S, Liu L, Liu S, Jiang F, Zhang J. The accuracy of screening tools for sarcopenia in older Chinese adults: a systematic review and meta-analysis. Front Public Health. 2024;12:1310383. doi:10.3389/fpubh.2024.1310383. PMC10876058.
  • Reimers CD, Schlotter B, Eicke BM, Witt TN. Calf enlargement in neuromuscular diseases: a quantitative ultrasound study in 350 patients and review of the literature. J Neurol Sci. 1996;143(1-2):46-56. PMID: 8981297.
  • McGee S. Evidence-Based Physical Diagnosis. 6th ed. Philadelphia, PA: Elsevier; 2025.

Research last updated September 9, 2026.

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