Clinical investigations from the RACP

Assessing leg ulcers

Jeff Rowland, David Veselic



Leg ulcers are a common source of morbidity in our community, typically having a chronic course and a propensity to recur. History and examination provide the most valuable diagnostic information, but the judicious use of simple investigations can help in diagnosis and also guide further management.

Key Points

  • Treatment of a leg ulcer depends on the underlying aetiology.
  • Most chronic leg ulcers are due to venous and/or arterial disease.
  • Malignancy can mimic or coexist with the common causes of leg ulceration.
  • If an ulcer fails to heal, review the diagnosis and consider a tissue biopsy.
  • In leg ulcer management, failure to heal is the most common reason for specialist referral of patients.