Physical examination maneuver
Physical Exam
Lower Extremity Inspection and Palpation
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Video coming September 2026
How to Perform
With the lower extremities adequately exposed, inspect all surfaces of the legs and feet for asymmetry, swelling, changes in skin color or hair distribution, varicose veins, ulcers, rashes or other lesions, and deformity. Note any gross asymmetry in limb length or contour. Palpate the skin and any abnormal areas for temperature, tenderness, and changes in texture or consistency.
How to Interpret
Showing 15 of 25 findings
Achilles Tendon Rupture
Palpable gap in Achilles tendon
Rule in
Helpful
Rule out
Somewhat helpful
Evidence:Limited
Deep Vein Thrombosis
Asymmetric calf swelling with a measured calf-circumference difference
Rule in
Minimally helpful
Rule out
Minimally helpful
Evidence:Strong
Calf pain on passive ankle dorsiflexion (Homans sign)
Rule in
Minimally helpful
Rule out
Not helpful
Evidence:Strong
Diabetic Foot Osteomyelitis
Ulcer area of 5 cm² or larger
Rule in
Very helpfulDerived CI
Rule out
Minimally helpfulDerived CI
Evidence:Limited
Ulcer area greater than 2 cm²
Rule in
Helpful
Rule out
Somewhat helpful
Evidence:Limited
Ulcer area of 4 cm² or larger
Rule in
HelpfulDerived CI
Rule out
Somewhat helpfulDerived CI
Evidence:Limited
Erythema, swelling, or purulence around the ulcer
Rule in
InconclusiveWide CI
Rule out
Not helpful
Evidence:Limited
Heart Failure
Bilateral pitting lower extremity edema
Rule in
Somewhat helpful
Rule out
Minimally helpful
Evidence:Strong
Knee Osteoarthritis
Bony enlargement
Rule in
Very helpful
Rule out
Somewhat helpfulDerived CI
Evidence:Limited
Meniscal Tear
Joint line tenderness
Rule in
Somewhat helpfulDerived CI
Rule out
Somewhat helpfulDerived CI
Evidence:LimitedResearch in progress
Peripheral Artery Disease
Cool skin temperature of the affected leg or foot on palpation
Rule in
HelpfulDerived CI
Rule out
—
Evidence:Limited
Wounds or sores on foot
Rule in
HelpfulDerived CI
Rule out
—
Evidence:Limited
Absent or diminished pedal pulse (dorsalis pedis and/or posterior tibial)
Rule in
Somewhat helpfulDerived CI
Rule out
Somewhat helpfulDerived CI
Evidence:Strong
Foot color abnormally pale, red, or blue
Rule in
Somewhat helpfulDerived CI
Rule out
—
Evidence:Limited
Pulmonary Embolism
Unilateral leg swelling
Rule in
Somewhat helpful
Rule out
Not helpful
Evidence:Strong