Doppler ultrasound exam of an arm or leg

  • Definition
    • This test uses ultrasound to look at the blood flow in the large arteries and veins in the arms and legs.

  • Alternative Names
    • Peripheral vascular disease - Doppler; PVD - Doppler; PAD - Doppler; Blockage of leg arteries - Doppler; Intermittent claudication - Doppler; Arterial insufficiency of the legs - Doppler; Leg pain and cramping - Doppler; Calf pain - Doppler

  • How the Test is Performed
    • The test is done in the ultrasound or radiology department or in a peripheral vascular lab.

      During the exam:

      • A water-soluble gel is placed on a handheld device called a transducer. This device directs high-frequency sound waves to the artery or veins being tested.
      • Blood pressure cuffs may be put around different parts of the body, including the thigh, calf, ankle, and different points along the arm.
      • A paste is applied to the skin over the arteries being examined. Images are created as the transducer is moved over each area.
  • How to Prepare for the Test
    • You will need to remove clothes from the arm or leg being examined.

  • How the Test will Feel
    • Sometimes the person performing the test will need to press on the vein to make sure it does not have a clot. Some people may feel slight pain.

  • Why the Test is Performed
  • Normal Results
    • A normal result means the blood vessels show no signs of narrowing, clots, or closure, and the arteries have normal blood flow.

  • What Abnormal Results Mean
    • Abnormal results may be due to:

      • Blockage in an artery by a blood clot
      • Blood clot in a vein (DVT)
      • Narrowing or widening of an artery
      • Spastic arterial disease (arterial contractions brought on by cold or emotion)
      • Venous occlusion (closing of a vein)
      • Venous reflux (blood flow going the wrong direction in veins)
      • Arterial occlusion from atherosclerosis

      This test may also be done to help assess the following conditions:

  • Risks
    • There are no risks from this procedure.

  • Considerations
    • Cigarette smoking may alter the results of this test. Nicotine can cause the arteries in the extremities to constrict.

      Quitting smoking lowers the risk of problems with the heart and circulatory system. Most smoking-related deaths are caused by cardiovascular problems, not lung cancer.

  • References
    • Cosgrove DO, Eckersley RJ, Harvey CJ, Lim A. Ultrasound. In: Adam A, Dixon AK, Gillard JH, Schaefer-Prokop CM, eds. Grainger & Allison's Diagnostic Radiology: A Textbook of Medical Imaging. 6th ed. New York, NY: Elsevier Churchill Livingstone; 2015:chap 3.

      Creager MA, Libby P. Peripheral artery diseases. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 58.

      Rooke TW, Hirsch AT, Misra S, et al. Management of patients with peripheral artery disease (compilation of 2005 and 2011 ACCF/AHA Guideline Recommendations): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013;61(14):1555-1570. PMID: 23473760