Leg Ulcers Flashcards
What is the definition of a chronic leg ulcer?
Open lesion between knee and ankle
Remains unhealed for at least 4 weeks
What are some causes of chronic leg ulcers?
Venous (most common) Arterial Mixed Diabetes Rheumatoid arthritis Vasculitis Trauma Malignancy Infection
Which conditions would make you suspicious of a venous ulcer?
DVT
Varicose veins
Same side fracture/surgery
Which conditions would make you suspicious of an arterial ulcer?
Smoking
PVD
IHD
Stroke
Which other conditions should you ask about in a patient with an ulcer?
Diabetes
RA
Vasculitis
Which examination features would suggest venous disease?
Varicose veins Venous/varicose/stasis eczema Oedema Haemosiderin staining Lipodermatosclerosis
Which examination features would suggest arterial disease?
Pale, cold limb
Absent/reduced pulses
Delayed cap refill
Hair loss
Describe a classic venous ulcer
Lower ankle/leg
Shallow
Flat edge
Describe a classic arterial ulcer
Pressure points (bony prominences)
May be multiple
Deep, punched out
May expose underlying structures
Which type of ulcer is classically most painful?
Arterial
What are the classic features of vasculitis ulcers?
Bilateral
Multiple small round lesions on calves
May coalesce or show necrosis
Surrounding skin normal
What is the most important investigation to do in a patient with an ulcer?
ABPI
- guides use of compression
How do you calculate ABPI?
Highest foot reading divide by highest brachial reading
What is a normal ABPI?
1.0
Which values of ABPI would indicate use of compression bandages?
0.8 - 1.3
