OnExam

Assesses the competency of the valves in communicating veins and the saphenous system.

Performing the Test

  1. With patient supine, raise one leg to 90 degrees (empties the venous blood).
  2. Compress the great saphenous vein in the upper thigh. This can be done with your hand or with a tourniquet (make sure not to occlude the arterial circulation)
  3. Patien stands
  4. Keep vein compressed and watch for venous filling in the leg. This usually takes 30-35 seconds as the leg fills from below. Rapid filling above the tourniquet or hand indicates valve incompetency and/or retrograde filling above the level of occlusion.
  5. Release the pressure from the saphenous vein. (Sudden distal filling, this indicates incompetent saphenous vein valves.)

Note: A tourniquet can be used above or below the knee to test both long and short saphenous incompetence.

References

  1. Bickley L, Hoekelman R. Bates’ Guide to Physical Examination and History Taking. Philadephia, Pa: Lippincott; 2009.