What are the recommended assessment tools for diagnosing venous ulcers in primary care?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Recommended assessment tools for diagnosing venous ulcers in primary care include:

  • Clinical examination: Assess the presence of a break in the skin below the knee that has not healed within 2 weeks, along with signs of chronic venous insufficiency such as pigmentation or eczema on the lower limb skin .
  • Duplex ultrasound: Use duplex ultrasound to confirm venous incompetence and the extent of reflux, which helps to confirm the diagnosis of venous disease underlying the ulcer and to plan treatment .
  • Referral criteria: Refer patients with a venous leg ulcer or healed venous leg ulcer to a vascular service for further assessment and management .

There is no specific mention of standardized scoring tools for venous ulcers in the provided guidelines, but clinical assessment combined with duplex ultrasound is the recommended approach in primary care to diagnose venous ulcers and assess venous pathology.

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