To identify the cause of a leg ulcer, our specialists will take a full history and perform a clinical examination. In the vast majority of cases this will enable the doctor to make a diagnosis of the type of ulcer involved. The specialist Vascular Surgeon may then order the following tests to confirm the diagnosis and identify the best method of treating the underlying condition.

A duplex scan or "ultrasound" is the most common test ordered. This involves an ultrasound of your blood vessels. Your specialist may order 2 different types of scans. These scans are performed at our vascular laboratory, Western Vascular Diagnostics which is staffed by full time vascular technologists. An arterial duplex scan is used to look at the arteries or a venous duplex scan to investigate the vein. 

An arterial duplex scan looks to see the actual blood flow through a vessel and can establish the speed of the red blood cells as they travel down the leg. From this speed we can determine the range of narrowing of the artery. This information will be used plan treatment options.

A venous duplex scan aims to assess both the deep, superficial and perforating veins in the leg paying particular attention to the function of valves. Venous incompetence or "valve failure" is identified by the demonstration of reversal of blood flow in a downward direction following the brief increase in upward blood flow caused by squeezing the calf. 

To assess the adequacy or otherwise of the blood flow to the leg the arterial blood pressure in your leg is and compared to the blood pressure in your arm. This is called the Ankle-Brachial Index (ABI). Sometimes this is unsuccessful in diabetics.

Rarely a biopsy of the ulcer is required. This involves removing a small piece of skin under local anaesthetic and sending the tissue to a Pathology laboratory for further investigation.