Dorsalis pedis arterial pulse: palpation using a bony landmark

Area of Science:

• Vascular Surgery
• Anatomy
• Diagnostic Techniques

Background:

• The posterior tibial pulse is easily located, but the dorsalis pedis pulse location is often vague.
• Variability in examiner technique contributes to the unreliability of foot pulse examinations.

Purpose of the Study:

• To describe and validate a novel physical examination method for locating the dorsalis pedis pulse.
• To improve the reliability of assessing dorsalis pedis artery patency.

Main Methods:

• A novel palpation technique using the dorsal most prominence of the navicular bone as a landmark was employed.
• Measurements of the dorsalis pedis pulse location were taken in 41 patients and compared with Doppler ultrasound.
• Two blinded examiners confirmed the measurements to ensure reliability.

Main Results:

• The dorsalis pedis artery was palpable in 78% of extremities and detected by Doppler in 95%.
• Palpation measurements closely correlated with Doppler ultrasound findings for both left and right feet.
• No significant differences were found between palpation and Doppler, between contralateral feet, or between examiners.

Conclusions:

• The dorsal most prominence of the navicular bone serves as a dependable anatomic landmark for locating the dorsalis pedis artery.
• Utilizing this landmark enhances the reliability of the physical examination for assessing dorsalis pedis artery patency.