Physical examination maneuver
Physical Exam
Lower Extremity Inspection and Palpation
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Video coming soon
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 18 of 25 findings
Achilles Tendon Rupture
Palpable gap in Achilles tendon
Rule in
Helpful
Rule out
Somewhat helpful
Evidence:Moderate
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:Moderate
Ulcer area greater than 2 cm²
Rule in
HelpfulWide CI
Rule out
Somewhat helpfulWide CI
Evidence:Moderate
Ulcer area of 4 cm² or larger
Rule in
HelpfulDerived CI
Rule out
Somewhat helpfulDerived CI
Evidence:Moderate
Erythema, swelling, or purulence around the ulcer
Rule in
InconclusiveWide CI
Rule out
Not helpful
Evidence:Moderate
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:Moderate
Palpable warmth over the knee
Rule in
Minimally helpfulNo CI
Rule out
Somewhat helpfulNo CI
Evidence:Moderate
Varus deformity
Rule in
Somewhat helpfulNo CI
Rule out
Not helpfulNo CI
Evidence:Moderate
Valgus deformity
Rule in
Minimally helpfulNo CI
Rule out
Not helpfulNo CI
Evidence:Moderate
Meniscal Tear
Joint line tenderness
Rule in
Somewhat helpfulDerived CI
Rule out
Somewhat helpfulDerived CI
Evidence:Strong
Peripheral Artery Disease
Cool skin temperature of the affected leg or foot on palpation
Rule in
Helpful
Rule out
Not helpful
Evidence:Moderate
Wounds or sores on foot
Rule in
Helpful
Rule out
Not helpful
Evidence:Moderate
Absent or diminished pedal pulse (dorsalis pedis and/or posterior tibial)
Rule in
Somewhat helpful
Rule out
Somewhat helpful
Evidence:Strong
Foot color abnormally pale, red, or blue
Rule in
Somewhat helpful
Rule out
Not helpful
Evidence:Moderate
Pulmonary Embolism
Unilateral leg swelling
Rule in
Somewhat helpful
Rule out
Not helpful
Evidence:Strong
Related Bedside Tests
🎬Video coming soon
Edema Assessment
Rule in:SHAscites, SHCirrhosis, SHCushing Syndrome +14 more
Rule out:HAscites, MHHeart Failure, NHCirrhosis +14 more
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Oxygen Saturation
aka Pulse oximetry
Rule in:HMortality, SHPneumonia, MHCardiac Tamponade +8 more
Rule out:ICCardiac Tamponade, NHHepatopulmonary Syndrome, NHMortality +8 more
🎬Video coming soon
Jugular Venous Pressure
Rule in:VHShock, HRight Ventricular Infarction, SHElevated Pulmonary Capillary Wedge Pressure +14 more
Rule out:HRight Ventricular Infarction, SHElevated Pulmonary Capillary Wedge Pressure, SHPulmonary Hypertension +14 more
🎬Video coming soon
Lung Auscultation
Rule in:VHChronic Obstructive Pulmonary Disease, VHPneumothorax, HMainstem Bronchus Intubation +29 more
Rule out:VHChronic Obstructive Pulmonary Disease, HPleural Effusion, SHInterstitial Lung Disease +28 more
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Respiratory Rate
Rule in:HReduced Left Ventricular Ejection Fraction, SHCardiopulmonary Arrest, SHPneumonia +10 more
Rule out:MHCardiopulmonary Arrest, MHPulmonary Embolism, NHPneumonia +10 more
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Cardiac Auscultation
Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy +37 more
Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy, VHRight-sided Valvular Lesion +37 more