Differentiating between venous and arterial ulcers is essential because treatment is completely different — what helps a venous ulcer may harm an arterial one and vice versa. ABPI measurement confirms the diagnosis but clinical signs give clear indicators.
Venous Ulcer:
- Location: Above inner ankle (gaiter area).
- Shape: Irregular, relatively large, shallow.
- Pain: Moderate — improves with leg elevation.
- Surrounding skin: Eczema, brown discoloration (hemosiderin), hardening (lipodermatosclerosis).
- Foot: Warm, normal pulse, swelling.
Arterial Ulcer:
- Location: Toes, dorsum of foot, heel.
- Shape: Regular circular, deep "punched out."
- Pain: Severe — worsens with leg elevation, improves when dangling.
- Surrounding skin: Shiny, dry, hairless.
- Foot: Cold, pale, weak or absent pulse.
At BEIT TARIQ Center, we use Doppler ultrasound to measure ABPI and precisely determine ulcer type before starting any treatment.