Absent Lower Limb Pulses
Overview
Strong femoral, popliteal, posterior tibial and dorsalis pulses are reassuring, while weak or absent lower limb pulses represent vascular compromise that may be limb-threatening if acute.
Pulses in the Lower Limb
- Femoral - palpate within the inguinal region, halfway between the pubic symphysis and iliac crest.
- Popliteal - bend the patient's knee to 90 degrees, gently grasp both sides of the knee joint and palpate using tips of fingers within the popliteal fossa posteriorly.
- Posterior tibial - palpate posteriorly and inferiorly to the medial malleolus.
- Dorsalis pedis - palpate lateral to the extensor tendon of the great toe. This can be identified by asking the patient to extend their great toe.
Causes of Absent Lower Limb Pulses
- Vascular trauma
- Compartment syndrome
- Peripheral vascular disease
- Abdominal aortic aneurysm
- Shock
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