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:
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.
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 study.
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 check, 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.
Referral to a specialist
In some cases, your GP or nurse may decide to refer you to a specialist in conditions affecting the blood vessels (vascular specialist).
For example, 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, diabetes or rheumatoid arthritis.
After taking your medical history and examining you, the vascular specialist may need to arrange further investigations to plan your treatment.