How are leg ulcers diagnosed?

Venous skin ulcer: The appearance of a venous leg ulcer looks different than ulcers caused by other problems such as poor circulation or nerve problems. To rule out poor circulation as a cause, it is usual for a doctor or nurse to check the blood pressure in the ankle and in the arm. The ankle blood pressure reading is divided by the arm blood pressure reading to give a blood pressure ratio called the Ankle Brachial Pressure Index (ABPI). If the ratio is low, it indicates that the cause of the ulcer is likely to be poor circulation rather than venous problems. This is very important to know as the treatments are very different. An ABPI may be checked routinely to make sure the circulation to the legs remains adequate.

Routine blood and urine tests may also be done to rule out diseases that may cause or aggravate skin ulcers, such as anemia, diabetes, kidney failure, or arthritis.

Pressure ulcers: Pressure sores (bedsores) are usually unmistakable, even in the initial stages, but a doctor is likely to order blood tests to check the individual's nutritional status and overall health. Other tests may include: urine analysis and culture, stool culture, and a wound biopsy. A wound biopsy is a sample of tissue is taken from wounds that do not heal or from chronic (long-term) pressure sores. The tissue may also be checked for cancer, which is a risk in individuals with chronic wounds.

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