Module 3: Examination

Module 3 focuses on vascular examination for physiotherapists, especially when assessing leg pain that may be masquerading as a musculoskeletal problem. It explains how to examine for signs of peripheral artery disease in a practical, clinically relevant way, while staying within professional competence. The examination begins with inspection and observation of the legs and feet, including hair loss, skin dryness, shininess, discoloration, nail changes, ulceration, gangrene, and the “sunset foot” appearance linked to chronic ischemia. It then covers palpation, particularly skin temperature and pedal pulses, with emphasis on keeping pulse assessment simple: present or absent. Key objective tests are outlined, including ankle brachial pressure index measurement, Buerger’s test, and exertional provocation tests such as calf raises, cycling, treadmill walking, and the 6-minute walk test. The teaching also highlights important differentials like venous insufficiency and spinal stenosis, plus clues from smoking, cholesterol signs, diabetes, hypertension, and aneurysm risk. A strong theme throughout is clinical reasoning: do simple tests well, recognise red flags, understand limitations, and escalate or refer when needed.