A foot circulation assessment is a set of tests that shows whether enough blood reaches the foot for wounds to heal. In Amman, it starts with checking the pulses and the foot, may include a Doppler ultrasound and other tests, and guides the plan for treating the wound or the arteries.
Note: If your foot suddenly becomes cold, pale and painful, or you lose feeling or movement in it, this may be a sudden artery blockage. Go to the emergency department straight away.
When is a circulation assessment needed?
- A foot wound or ulcer that is not healing.
- Leg pain when walking that eases with rest.
- Foot pain at rest or at night.
- A cold or discoloured foot, or weak foot pulses.
- Before planning foot surgery in a person with diabetes.
- As part of regular check-ups for people with diabetes at risk of foot problems.
Why does circulation to the foot get weaker?
- Hardening and narrowing of the arteries, which is more common with diabetes and smoking, as in leg artery blockage.
- Disease of the smaller arteries of the lower leg and foot in people with diabetes.
- High blood pressure and high cholesterol.
- In advanced cases, critical limb ischemia may develop.
What the assessment includes
The assessment starts with questions about your symptoms and an examination of the foot, skin and pulses. The doctor then decides which tests suit your case.
- Feeling the pulses in the foot and leg.
- Comparing blood pressure at the ankle and the arm (ankle-brachial index, ABI), which can be less reliable in some people with diabetes.
- Measuring toe pressure in some cases.
- Your doctor may request a Doppler ultrasound to look at the arteries and blood flow.
- CT, MRI or catheter angiography when needed to plan treatment.
What happens after the assessment
The results guide the next step, from the simplest to the most invasive:
Your doctor will explain your results and what they mean for you before suggesting any treatment.
- If circulation is adequate: focusing on wound care, offloading and daily foot care.
- Managing risk factors: stopping smoking and controlling blood sugar, blood pressure and cholesterol with your doctor.
- Regular walking as advised by your doctor, if there is no wound that prevents it.
- Opening narrowed arteries with peripheral artery angioplasty if poor blood flow is stopping healing.
- Bypass surgery in some cases where angioplasty is not suitable.
On the day and after
Most basic circulation tests need no special preparation and no incision. You may be asked to lie down for a while during pressure measurements or scans.
- You can usually return to your normal activities after non-invasive tests.
- If a scan with contrast dye is needed, your doctor will explain the preparation, especially if you have kidney problems.
- The results are discussed with you and a treatment and follow-up plan is agreed.
When to book an appointment
- A foot wound that is not healing.
- Leg pain when walking, or foot pain at rest.
- A cold or discoloured foot.
- A doctor has mentioned amputation; see limb salvage.