Skip to main content
Journal of the Royal Society of Medicine logoLink to Journal of the Royal Society of Medicine
. 1983 Dec;76(12):1011–1014. doi: 10.1177/014107688307601206

Venous distension in the diabetic neuropathic foot (physical sign of arteriovenous shunting).

J D Ward, A J Boulton, J M Simms, D A Sandler, G Knight
PMCID: PMC1439498  PMID: 6672192

Abstract

A new physical sign is described in the feet of a group of diabetic patients with ulcerating neuropathic problems, in which major venous distension of the veins on the dorsum of the foot and lower calf is seen. Elevation of the leg is required to an average height of 32.3 cm to cause collapse of these distended veins. It is suggested that this clinical sign indicates the presence of arteriovenous shunting in such neuropathic legs, and as such is a simple and useful measure of this abnormality.

Full text

PDF
1011

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Boulton A. J., Scarpello J. H., Ward J. D. Venous oxygenation in the diabetic neuropathic foot: evidence of arteriovenous shunting? Diabetologia. 1982 Jan;22(1):6–8. doi: 10.1007/BF00253861. [DOI] [PubMed] [Google Scholar]
  2. Cronenwett J. L., Lindenauer S. M. Direct measurement of arteriovenous anastomotic blood flow after lumbar sympathectomy. Surgery. 1977 Jul;82(1):82–89. [PubMed] [Google Scholar]
  3. Edmonds M. E., Archer A. G., Watkins P. J. Ephedrine: a new treatment for diabetic neuropathic oedema. Lancet. 1983 Mar 12;1(8324):548–551. doi: 10.1016/s0140-6736(83)92809-x. [DOI] [PubMed] [Google Scholar]
  4. Emanuele M. A., Buchanan B. J., Abraira C. Elevated leg systolic pressures and arterial calcification in diabetic occlusive vascular disease. Diabetes Care. 1981 Mar-Apr;4(2):289–292. doi: 10.2337/diacare.4.2.289. [DOI] [PubMed] [Google Scholar]
  5. Gundersen H. J. Peripheral blood flow and metabolic control in juvenile diabetes. Diabetologia. 1974 Jun;10(3):225–231. doi: 10.1007/BF00423039. [DOI] [PubMed] [Google Scholar]
  6. Partsch H. Neuropathien vom ulzero-mutilierenden Typ. Klinik, Klassifikation, Durchblutungsmessungen. Vasa Suppl. 1977;6:1–48. [PubMed] [Google Scholar]
  7. SHERMAN J. L., Jr NORMAL ARTERIOVENOUS ANASTOMOSES. Medicine (Baltimore) 1963 Jul;42:247–267. doi: 10.1097/00005792-196307000-00001. [DOI] [PubMed] [Google Scholar]
  8. Scarpello J. H., Martin T. R., Ward J. D. Ultrasound measurements of pulse-wave velocity in the peripheral arteries of diabetic subjects. Clin Sci (Lond) 1980 Jan;58(1):53–57. doi: 10.1042/cs0580053. [DOI] [PubMed] [Google Scholar]
  9. Timperley W. R., Ward J. D., Preston F. E., Duckworth T., O'Malley B. C. A reassessment of vascular factors in relation to intravascular coagulation. Diabetologia. 1976 Jul;12(3):237–243. doi: 10.1007/BF00422090. [DOI] [PubMed] [Google Scholar]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press

RESOURCES