Physical examination maneuver

Physical Exam

Calf Circumference

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Video coming September 2026

How to Perform

With the patient supine and the leg extended, use a tape measure to measure the circumference of the calf at its widest point, or at a fixed distance below the tibial tuberosity, then measure the same location on the opposite leg and compare the two sides.

How to Interpret

Showing all 1 finding

Deep Vein Thrombosis

Calf circumference asymmetry ≥3 cm (measured 10 cm below the tibial tuberosity)
Rule in
Minimally helpful
Rule out
Minimally helpful
Evidence:Limited

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. [Random-effects meta-analysis, 51 cohort studies, n=10,311; pooled per-feature likelihood ratios. Difference in calf diameter: pooled LR+ 1.80 (95% CI 1.48-2.19), LR- 0.57 (95% CI 0.44-0.72), 8 studies.] Same source and pattern as the edema sibling finding (Limited, #351).
  • McGee S. Evidence-Based Physical Diagnosis. 6th ed. Philadelphia, PA: Elsevier; 2025.

Related Systems / Regions

CardiovascularLower Extremities

Related Bedside Tests

🎬Video coming Sept 2026
Edema Assessment
Rule in:SHCirrhosis, SHHeart Failure, NHDeep Vein Thrombosis +11 more
Rule out:MHHeart Failure, NHDeep Vein Thrombosis, IEBaker Cyst Rupture +10 more
🎬Video coming Sept 2026
Lower Extremity Inspection and Palpation
Rule in:HPeripheral Arterial Disease, SHHeart Failure, MHDeep Vein Thrombosis
Rule out:MHDeep Vein Thrombosis, MHHeart Failure
POCUS
🎬Video coming Sept 2026
Lower Extremity Vein Compression Ultrasound (2-point)
Rule in:IEDeep Vein Thrombosis
Rule out:IEDeep Vein Thrombosis
🎬Video coming Sept 2026
Achilles Deep Tendon Reflex
aka Ankle jerk
Rule in:VHPeripheral Neuropathy, HUpper Motor Neuron Lesion, SHHypothyroidism +5 more
Rule out:VHPeripheral Neuropathy, SHUpper Motor Neuron Lesion, NHS1 Radiculopathy +4 more
🎬Video coming Sept 2026
Ankle-brachial Index
aka Ankle-brachial pressure index; ankle-arm index
Rule in:SHPeripheral Artery Disease, NHMedial Arterial Calcification (Incompressible Vessels), IESevere Peripheral Artery Disease (Critical Limb Ischemia) +1 more
Rule out:SHPeripheral Artery Disease, NHMedial Arterial Calcification (Incompressible Vessels), IESevere Peripheral Artery Disease (Critical Limb Ischemia) +1 more
🎬Video coming Sept 2026
Blood Pressure
Rule in:VHAortic Regurgitation, VHVolume Depletion From Significant Blood Loss, HAcute Aortic Dissection +11 more
Rule out:VHVolume Depletion From Significant Blood Loss, HLow-output State (Low Cardiac Index) Within Established Chronic Heart Failure, SHAcute Aortic Dissection +10 more