Topic Overview

Pulse and blood pressure measurements taken in different areas of the body help diagnose peripheral arterial disease.

Pulse

In the legs, doctors will commonly feel for pulses in the femoral (groin), popliteal (back of the knee), posterior tibial (ankle), and dorsalis pedis (foot) areas. Other pulses often checked include the radial (wrist), brachial (forearm), and carotid (neck) areas.

The pulses are graded for record-keeping purposes so that doctors can keep track of how a person’s pulse changes over time. Your doctor uses a number system to rate your pulse.

Your doctor will listen to your pulse with a stethoscope for a “whooshing” sound called a bruit (say “broo-E”). A bruit might mean there is a blockage in the artery.

Blood pressure

For peripheral arterial disease, blood pressure might be taken at the ankles, toes, legs, and arms.

Blood pressures are typically taken with a blood pressure cuff. But blood pressure can be measured using catheters placed inside the arteries. Because the arteries are punctured, this is known as invasive blood pressure monitoring.

Ankle pressure

In most people, the resting ankle pressure is greater than the pressure at the crook of the arm, known as the brachial blood pressure. The ratio of the ankle pressure to the brachial pressure is called the ankle-brachial index (ABI).

Toe pressure

Toe pressures can be measured with miniature blood pressure cuffs to check for poor blood flow in the toes.

Segmental leg pressures

Arterial pressure can be estimated in the upper thigh, above the knee, and in the upper calf by placing blood pressure cuffs at the appropriate levels. The pressures can be compared between the two legs or at different levels in the same leg.

Arm pressures

Blood pressures can be measured at the elbow (brachial), forearm, or wrist. Large differences between pressures at the various levels suggest arterial blockage. As with toes, finger pressures can be measured.