A New-Proposal Physical Examination Test for Unilateral Lower Extremity Edema

Abstract

Objective: Patients with iliac vein compression syndrome (IVCS) usually present to the hospital with left-sided leg edema. We looked for an answer to the question: "Can iliac vein compression syndrome (IVCS) be predicted with a reliable physical examination test in the differential diagnosis?'' Methods: We tested a new physical examination on patients with only left-sided lower extremity edema. In this physical examination the widest area of the calf point (just below tuberosity of the tibia) and medial malleolus was measured in both legs on the Trendelenburg position at 30 degrees and repeated in standing position. Then the iliac venography was performed. Results: The test was performed on 32 (N = 32) patients with left extremity edema. IVCS was observed on 18 (n = 18) (56%) patients. The test was found to have 88% sensitivity and 92% specificity in IVCS. Conclusion: This new physical examination finding, which may be valuable in diagnosing IVCS, is proposed for use in patients with unilateral left-sided edema to preclude unnecessary use of expensive diagnostic imaging methods.