When talking to patients about their vein problems one of the areas that is often missed by the patient is ankle swelling. I know it sounds crazy but many people have ankle swelling that is undiagnosed or unidentified.
It is not uncommon for a typical sclerotherapy patient to come in and have spider veins on the surface of the thigh or and calf. They state that they don't have vein disease but want to improve the appearance of their legs, and who can blame them right? During the assessment the patient states that they don't have pain and don't have any swelling. They noticed the spider veins after child birth or simply after gaining a winter coat.
During the physical exam it is noted that there are sock lines at the ankles but again the patient states that although this is common it is not swelling. They also note knee pain that is chronic in nature and that long travel bothers them.