Physical exam. There are many differences between arterial and venous foot ulcers but there is also overlap. The standard answer is that an arterial ulcer usually occurs on the toes which would be the areas most distal to the heart and, thus, receiving the least arterial blood while medial/lateral ankle ulcers are usually venous. Physical exam should be the keyv to distinguish the underlying cause of the ulcer.
Ulcer artery vs vein. Venous ulcers are due to high blood pressure of the veins resulting in the leakage of fluid into the tissues of the legs. Compression of the lower extremities and surgery on the veins can correct this. Ischemic ulcers are due to problems with arteries. There are larger arteries and small microscopic ones and either or both can have blockages. They usually can be discerned from each other.
One is. Caused by arterial dz generally affecting the foot. The other is due to venous dz affecting the ankle area.
Location. Venous stasis ulcers occur on the medial (inside side) of ankle with a long history of swollen legs. They may be itchy or painful or both. Often there is a history of a blood clot (phlebitis) or that a vein was removed for coronary bypass surgery. An arterial ulcer due to poor blood supply is found on another part of the foot or leg on a person with cold leg which is purple when down & pale when r.
Arterial vs. venous. Venous ulcers are usually on the inside or outside of the ankle, have irregular edges, are often painless (although they can also hurt too), and are associated with varicose veins in the legs and other skin changes besides the ulcer. Compression helps. Arterial ulcers generally always hurt. They are often smaller and very regular round punched out looking borders. They are seen with pad.
In vs. out flow. Venous ulcers result from valve dysfunction in the venous system. This causes the pressure in the veins just under the skin to become too high resulting in swelling of the veins. These veins enlarge and become varicose, leak water causing leg swelling, leak blood resulting in skin discoloration and possibly ulcers. Arterial ulcers result from artery blockages stopping inflow of blood.
Pain, Both ulcers are caused by poor circulation. In venous ulcers the veins are incompetent or varicose and the blood is stagnant causing swelling and a stretching and thinning of the skin which breaks down. Arterial ulcers mean inadequate circulation and could result in loss of a limb. A proper diagnosis and treatment is essential with vascular surgeon.