Diagnosis - Venous leg ulcer

See your GP if you think you have a venous leg ulcer. The ulcer is unlikely to heal without specialist treatment.

Diagnosis is largely based on your symptoms and examination of your affected leg, although additional tests may be required.

Medical history and examination

Your GP or practice nurse will ask whether you have any other symptoms associated with venous leg ulcers, such as:

• swelling in your ankles
• discoloured or hard skin

They'll try to determine the cause of the ulcer by asking about underlying conditions or previous injuries, such as:

• diabetes
• deep vein thrombosis (DVT)
• injury or surgery in the affected leg
• a previous leg ulcer

They'll also examine your leg, both when you're standing up and lying down. 

Varicose veins will be more obvious when you're standing up, and it'll be easier to look at the ulcer when you're lying down.

They'll also feel your pulse at your ankles to make sure the arteries in your leg are working properly.

Doppler test

To rule out peripheral arterial disease (a condition affecting the arteries) as a possible cause of your symptoms, your GP or nurse will carry out a test known as a Doppler test.

This involves measuring the blood pressure in the arteries at your ankles and comparing it to the pressure in your arms. 

If you have peripheral arterial disease, the blood pressure in your ankles will be lower than your arms.

It's important to carry out this test, as the main treatment for venous ulcers is compression bandages or stockings to improve the vein circulation in your legs.

It's not safe to apply compression if the ankle artery pressures are low.

Find out how venous leg ulcers are treated

Referral to a specialist

In some cases, your GP or nurse may decide to refer you to a specialist, such as a vascular specialist who treats conditions affecting the blood vessels.

You may be referred to a vascular specialist if your GP or nurse is unsure about your diagnosis, or if they suspect your ulcer may be caused by artery diseases.

If they think it's caused by diabetes or rheumatoid arthritis, they may refer you to a diabetes ulcer clinic or a rheumatologist (a specialist who treats conditions affecting the bones, joints and muscles).

After taking your medical history and examining you, the specialist may need to arrange further investigations to plan your treatment.