Ask pt to stand.

Light torch from above and see for varocosities.

Tap test.

Palpate for cough thrill.

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Ask to lie down.

Pigmentation.

Lipodermatosclerosis.

Ulcers.

Lift the leg

Empty the veins

If can’t empty – – > secondary varicose (IVC obstruction)

Tourniquet at mid thigh.

Ask to stand.

If slow filling – perforator incompetence

Rapid filling when tourniquet is removed – SF incompetence

Along the territory of greater or lesser saphenous vein.

Symptomatic

Bursting type pain when standing.

Complicated

Oedema

Lipodermatosclerosis (skin thickening)

Ulceration