Signs
 

Absent Lower Limb Pulses

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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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