Inspection:
- varicosity
- distrubution over great or short saphenous
- evidence of chrnoic venous insufficiency:
- ulceration - gaiters
- haemosiderin deposition
- venous stars
- pitting oedema
- lipodermatosclerosis - palpate
- cough - saphena varix
Palpation:
- evidence of thrombophebitis
- erythema
- tenderness
- increased temperature
- fascial defects - site of perforators
- tap test
check level of incompetence
- tourniquet test - saphenofemoral junction located 2cm below and lat to pubic tubercle
check deep venous system
Ix:
- pre-operative duplex ultrasound
- documentation
- confirm deep venous system
SFJ tributaries
- anteromedial vein of thigh
- posterolateral vein of thigh
- superficial circumflex iliac vein
- superficial inferior epigastric vein
- supericial external pudendal vein
- deep external pudendal vein
saphenopopliteal junction
- short saphenous runs with sural nerve
- posterior to lateral malleolus
- lateral border of achilles tendon
- between 2 heads of gastrocnemius
- popliteal fossa - popliteal vein
