Introduce yourself, con_rm pt, explain examination & gain consent

1 Expose & position pt (down to pants or shorts, standing)

1 “Are you sore anywhere in your legs or feet?”
u Consider chaperone
Inspection 1 Varicose veins
! Posterior lower leg
! Medial lower leg & thigh
1 Saphena varix
! Blue-ish lump in groin apparent when standing
1 Signs of progressive chronic venous insuf_ciency
! Oedema
! Venous eczema
! Haemosiderosis
p Brown speckled discoloration
p ‘Cayenne pepper petechiae’
p Especially medial gaiter area
! Lipodermatosclerosis
p Scarring of subcutaneous fat
p Skin tight and indurated
p May cause ‘inverted champagne bottle’ legs
! Atrophie blanche
p White scar-like areas
! Ulceration
p Especially medial gaiter area