Arterial Doppler of Upper and Lower Extremities: What To Expect?


A doppler ultrasound is a simple, non-invasive diagnostic test that uses ultrasound (high-frequency sound waves) to notice changes in the blood flow within the arteries and veins of the arms or legs. An attached computer generates blood flow anomalies based on the data from the returning sound waves from the vessels, which appears on a graph. 

Arterial doppler of upper and lower extremities helps diagnose various conditions of the arms and legs, including:

  • Arterial occlusion 
  • Atherosclerosis 
  • Peripheral artery disease (reduced blood flow in legs)
  • Thrombi and emboli (blood clots)
  • Venous insufficiency (poor flow of blood in the veins)

This non-invasive test is beneficial in diagnosing arterial pathologies, especially of the heart. Arterial doppler lower extremities enable the doctors to investigate the cause of compromised blood flow in the legs. 

Conditions Diagnosed Using Arterial Doppler 

Arterial doppler of the upper and lower extremities can diagnose the following conditions:


Atherosclerosis is a disease characterized by the narrowing of the arteries due to plaque buildup. The over-time buildup of plaque in the inner layer of arteries (tunica intima) leads to the hardening and thickening of the vessel. 

In most cases, the cause is high blood pressure and cholesterol that accumulates and leads to the narrowing of the blood passage in the vessels. That could cause a heart attack or stroke.

Peripheral Artery Disease (PAD)

Peripheral artery disease is when atherosclerosis affects the lower extremities, especially the legs. PAD is a common manifestation of systemic atherosclerosis. It is characterized by compromised blood flow in the upper and lower limbs. 

Timely diagnosis and treatment of atherosclerotic PAD are crucial. Research suggests that the condition has a link to a high rate of heart pathologies (cardiovascular events) and death.

The most commonly involved arteries in atherosclerosis lower extremity arteries are popliteal arteries and superficial femoral arteries.

According to a study, affected popliteal arteries in PAD patients are subject to multiple deformations. The extent of deformity is directly proportional to the amount of calcification. The iliac artery bifurcation and distal aorta (in the upper body) can also be affected. 

Doppler ultrasonography plays a crucial role in the diagnosis of PAD. Handheld doppler ultrasound has proven to be a simple and reliable method of diagnosing PAD. 

According to a cross-sectional study, continuous wave arterial doppler for lower extremities is a time-saving and highly accurate diagnostic test for PAD. The test is effective in detecting PAD among diabetes patients.

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In some cases, PAD is asymptomatic. Reduced blood flow in the extremities can manifest itself as different symptoms. You should get an arterial doppler for the upper or lower extremities if experiencing any of the following symptoms: 

Fatigue and Muscle Cramps 

Atherosclerosis-induced PAD leads to acute limb ischemia. The ischemic muscles are prone to fatigue and cramping. Frequent muscle cramps and fatigue are usually the initial symptoms of PAD. 

A 2018 study shows PAD affects the lower extremities more than the upper extremities. The study also concludes that a cramping sensation and recurrent leg fatigue are common.

Intermittent Claudication 

The most commonly observed symptom of atherosclerosis in the peripheral arteries is intermittent claudication. It is the name given to a combination of uneasy feelings, including pain, numbness, burning, and tingling. 

People suffering from intermittent claudication (or claudication pain) experience pain in the calves and thighs. This discomfort is most noticeable during walking/exertion. Several individuals complain of having to limp with leg pain. An arterial doppler lower extremities can help diagnose the condition.

Pain During Rest 

PAD patients often experience symptoms even at rest. The reduction of blood flow in the arteries of the lower extremities can lead to symptoms at rest. Patients complain of aching and burning sensations which may be accompanied by pain. The symptoms are present in the heel and toes. 


Upper extremity atherosclerosis causes tissue necrosis of the digits, i.e., digital gangrene. Examination of PAD patients' fingers (especially fingertips) reveals tissue damage.

Compromised blood flow leads to the death of tissues and bacterial infection. Dry gangrene ensues in the advanced stage of PAD. 

Risk Factors 

Researchers have identified certain risk factors and groups at a greater risk of developing PAD. These risk groups must get arterial doppler of the upper and lower extremities if experiencing any of the symptoms mentioned above. 

The risk factors for extremity atherosclerosis include:

Age and Sex

The prevalence of intermittent claudication increases with increasing age. Men above 50 are more prone to claudication than younger people.

High Cholesterol 

Individuals having deranged lipid profiles have a high risk of developing arterial constrictions. A 2022 study shows that people with elevated cholesterol levels have a five-fold higher risk of PAD. 

Such patients are also one step closer to having an ischemic stroke and heart attack. Thus, hypercholesterolemia patients must get an arterial doppler ultrasound test if experiencing any symptoms.


Diabetes mellitus patients are affected by a reduction in blood flow. The most affected regions are the vessels of the extremities. Efforts are being made to create awareness about the early diagnosis of PAD in diabetics. Critical limb ischemia and leg ulcers are more common in such patients.


Persistent high blood pressure can damage the blood vessel walls. That can lead to plaque deposition in the arterial walls (atherosclerosis). Thus, hypertensive people should get regular checkups for early diagnosis. 


There is a direct association between smoking and PAD risk. The proportion of smokers experiencing leg and claudication pain is higher than non-smokers. The disease gravely impairs the quality of life and can cause limb amputation. 

What Happens During the Exam?

An arterial doppler ultrasound exam is a safe and non-invasive procedure that checks abnormal blood circulation to the arms and legs without painful needles or catheters. A sonographer performs the test, which usually lasts for an hour. 

For arterial doppler lower extremities, you must remove the clothing (waist down) and lie on the exam table. The sonographer applies gel on the skin parts to be examined.

That is followed by delivering high-frequency, painless sound waves to the arm or leg using a transducer. The transducer also receives the sound waves, and a machine records the changes in blood circulation in images or graphs. It examines the circulation of extremities, detecting a blockage in the leg or arm arteries. 

You can get the results in a couple of days. Discuss them with your physician, who will guide you regarding the appropriate treatment or refer additional tests.

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