The relationship between lower limb symptoms and superficial and deep venous reflux on duplex ultrasonography: The Edinburgh Vein Study

Background: Previous work from this group has demonstrated the relationship s between lower limb symptoms and the presence and severity of trunk varico se veins as seen on clinical examination to be generally weak, symptom spec ific, and gender dependent. Objective: This study was undertaken to investigate the relationships in th e general population between lower limb symptoms and the presence of superf icial or deep venous reflux. Methods: A cross-sectional study was made of an age-stratified random sampl e of 1566 subjects (699 men and 867 women) aged 18 to 64 selected from 12 g eneral practices in Edinburgh, Scotland. Subjects completed a self-administ ered questionnaire regarding symptoms (heaviness/tension, a feeling of swel ling, aching, restless legs, cramps, itching, tingling) and underwent duple x ultrasound examination of the superficial and deep venous systems of both legs. Reflux of 0.5 seconds or greater was considered pathologic. Deep ven ous reflux was defined as reflux in at least the popliteal vein. Results: There was a significant positive relationship between isolated sup erficial reflux and the presence of heaviness/tension (P < .025, both legs) and itching (P = .002, left leg) in women. Isolated superficial reflux in men tvas not significantly positively associated with any symptom. Isolated deep venous reflux was not significantly related to any symptom in either leg in either sex. Combined reflux was related to a feeling of swelling (P = .018, right leg; P = .0022, left leg), cramps (P =.0049, left leg) and it ching (P = .0043, left leg) in men, and aching (P = .03, right leg) and cra mps (P = .026, left leg) in women. Conclusion: In the general population, only certain lower limb symptoms wer e related to the presence of reflux on duplex ultrasound scanning. The stro ngest relationships were observed in the left legs of men with combined sup erficial and deep reflux.