Poor Circulation

Venous Insufficiency

When evaluating a patient for venous insufficiency, or poor circulation, physicians utilize several methods to examine the patient. Most physicians start with the patient’s history. Next, the physician may perform a physical exam followed by a duplex ultrasound study.


  • General medical and surgical information, as well as specific information about vascular disease
  • Onset of the problem
  • Predisposing or aggravating factors of symptoms
  • Patients are specifically asked about the common symptoms seen with venous insufficiency, such as leg heaviness, aching, itching, pain, fatigue, and swelling

Physical Examination

While a physical examination should not be used as the sole evaluation, there are several physical findings that are associated with venous reflux:

Asymmetry of the limbs (size, length, ankle diameter)

Scars (previous venous surgery or ulcers)

Skin changes

Lower limb swelling (edema)

Skin ulcers

A common physical exam that physicians may use to assess a patient is the Trendelenburg Exam. A physician may also perform a palpation of arterial pulses to confirm that there is not another underlying disease.