Summary of Common Conditions Seen in OSCEs
| Pathology | Notes |
| Varicose veins | Abnormal dilatation and tortuosity of superficial venous circulation due to incompetent valves and resulting venous hypertension |
| Saphena varix | Dilatation of saphenous vein at the SFJ |
| May have a cough impulse and can be differentiated from a femoral hernia by its blue colour and the fact that it disappears when the patient lies flat | |
| Chronic venous insufficiency | Presence of valvular dysfunction and chronic venous hypertension will cause a number of trophic changes to occur |
| See the above checklist for features of trophic disease | |
| Venous ulcers | See Chapter 14 for notes on arterial examination |
Hints and Tips for the Exam
Venous examination of the lower limb is fairly straightforward and is likely to appear as these patients have a chronic illness and are plentiful in number. To do well at this station, you must first have a sound understanding of the venous anatomy of the legs, and then demonstrate it during the examination. For example, when palpating the vasculature, remember to go from the feet upwards (as the veins take blood towards the heart!).
Inspect Thoroughly
Inspect the room carefully for any walking aids. If you manage to complete your examination in good time, you can try to perform a functional assessment to show the examiner you are trying to clarify the level of disability caused by the disease. This can also guide management as painful varicose veins are an indication for surgical treatment.
Figure 15.1 illustrates various features of chronic venous disease, including thread veins, lipodermatosclerosis and haemosiderin deposition.
Figure 15.1 (a, b) Features of chronic venous disease
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