title: Dorsalis pedis arterial pulse: palpation using a bony landmark.
abstract: BACKGROUND
  The unreliability of the pulse examination of the foot has primarily been due to variability of technique between examiners. Whereas the groove between the medial malleolus and the Achilles tendon more readily defines the location of the posterior tibial pulse, the location of the dorsalis pedis pulse remains vague. In this paper a novel method of locating the dorsalis pedis pulse by physical examination is described.
  
  
  METHODS
  Forty one consecutive patients admitted to a general surgery service of a tertiary medical centre within a two month period were examined. Using the dorsal most prominence of the navicular bone as a landmark, the distance to the dorsalis pedis pulse in bilateral lower extremities was measured by palpation and compared to Doppler ultrasound. Measurements were confirmed by two separate examiners blinded to each others' results.
  
  
  RESULTS
  The dorsalis pedis artery was palpable in 78% of extremities and present by Doppler ultrasound in 95%. The location of the left dorsalis pedis artery was a mean (SD) 9.8 (1.4) mm by palpation and 11.1 (2.1) mm by Doppler ultrasound from the dorsal most prominence of the navicular bone. The right dorsalis pedis artery was 10.4 (3.4) mm by palpation and 11.5 (0.7) mm from the dorsal most prominence of the navicular bone. No significant differences in location of the dorsalis pedis artery were observed bilaterally between Doppler ultrasound and palpation; No significant differences were observed comparing contralateral dorsalis pedis arteries nor any differences between the examiners' results.
  
  
  CONCLUSIONS
  The dorsal most prominence of the navicular bone provides a bony landmark to readily locate the dorsalis pedis artery. Reliability of the examination may be increased as to the patency of the dorsalis pedis artery by using this dependable anatomic landmark.
authors.affiliation: Southern Illinois University, The Plastic Surgery Institute, Springfield, Illinois 62794-1511, USA.
authors.forename: A
authors.initials: A
authors.lastname: Mowlavi
authors.forename: J
authors.initials: J
authors.lastname: Whiteman
authors.forename: B J
authors.initials: BJ
authors.lastname: Wilhelmi
authors.forename: M W
authors.initials: MW
authors.lastname: Neumeister
authors.forename: R
authors.initials: R
authors.lastname: McLafferty
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries / Q000502:physiology; D005260:Female; D005528:Foot / Q000098:blood supply*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010173:Palpation / Q000379:methods*; D011674:Pulse / Q000379:methods*; D018608:Ultrasonography, Doppler