Does dorsal pedal pulse palpation predict hand-held Doppler measurement of ankle-brachial index in leg ulcer patients?
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Correlation between dorsal pedal pulse palpation and hand-held Doppler measurement of ankle pressure in patients referred to a specialized leg and foot ulcer clinic at a dermatological department was investigated. Complete data regarding palpable dorsal pulse and ankle-brachial index (ABI) was available for 510 patients. Palpable dorsal pedal pulse was present in 337 patients and absent in 173. Mean ABI in patients with palpable pulses was 1.07 (median 1.07, range 0.35-1.79). Mean ABI in patients without palpable pulses was 0.79 (median 0.80, range 0.22-1.31). The difference was significant (p < 0.0001). In the group without palpable pedal pulses, 39.8 percent had an ABI > 0.9. In the group with palpable pedal pulses, 52 patients (15.4%) had an ABI less than or equal to 0.9. While there is a strong association between ABI and palpable pedal pulse, the latter delivers 40-percent false negative predictions in alerting professionals to the presence of arterial disease as defined by ABI : 0.9. Measurement of the arterial circulation using a hand-held Doppler is thus considered mandatory at first visit in all patients seeking advice for leg and foot ulcers.