Ankle & Foot Neurological & Vascular Evidence: suggestive

Buerger’s Test Special Test

Orthopedic Physical Examination & Clinical Assessment Guide

Buerger’s Test Orthopedic Special Test

What is it used for?

  • Assessing arterial blood supply to the leg (Peripheral Arterial Disease).

How to Perform

  • Step 1 (Elevation): Patient lies supine. Elevate the leg to 45° for 3 minutes. Observe foot color.
  • Step 2 (Dependency): Patient sits up quickly with legs hanging over the edge. Observe the refill time and color return.

Interpretation of Results

  • Positive Test:
    • Elevation: The foot turns pale (pallor) quickly.
    • Dependency: The foot turns bright red (rubor) which is known as "reactive hyperemia."

Clinical Context & Limitations

The Buerger’s Test should be considered as one component of a comprehensive musculoskeletal assessment. No single special test has perfect diagnostic accuracy; thus, clinical decision-making should integrate test results with patient-reported symptoms, mechanism of injury, functional impairment, and relevant imaging.

Clinicians should be aware of potential false-positive results in patients with pain sensitisation, muscle guarding, or poor relaxation. For the Ankle & Foot region, combining the Buerger’s Test with complementary examination tests significantly improves overall diagnostic confidence.

References

  • Magee, D. J. (2021). Orthopedic Physical Assessment (7th ed.). Elsevier.