Limb examination

Lower leg changes associated with venous hypertension and chronic venous insufficiency

  • Swelling of the limb – possibly pitting, due to increased capillary permeability.

Leg Ulcer 2

  • Lipodermatosclerosis (LDS) -  is the overall term used for the clinical presentation of venous hypertension. Part of which is an area of tight painful skin with hardened fibrotic subcutaneous tissue just above the ankle. This is due to the infiltration of fibrin and inflamamation and results in the leg shape resembling an inverted champagne bottle.

 Leg Ulcer 6lEG uLCER 5

In addition the following are found in LDS, however the patient may present with one or more signs of LDS

  • Hyperpigmentation. This is an irreversible reddish brown discolouration of the skin, due to the deposition of haemosiderin in the skin.

Leg Ulcer 3

  •  Ankle flare. Superficial dilated veins around the medial or lateral aspects of the malleolus; due to venous hypertension.

Leg Ulcer 4


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