Which finding is most characteristic of peripheral arterial insufficiency?

Which finding is most characteristic of peripheral arterial insufficiency?

• A. Paleness when elevated
• B. Redness when lowered
• C. Edema with warmth
• D. Brown pigmentation around the ankles

Answer: (A)

When arterial blood flow to a limb is reduced, lifting the leg makes the already limited inflow even worse, so the skin appearance blanches or becomes pale. This pallor with elevation is a classic sign of peripheral arterial insufficiency and reflects insufficient perfusion when gravity reduces arterial filling. In contrast, lowering the limb can cause a red flush due to reactive hyperemia, but the defining feature remains the pale color produced by elevation.

Other signs don’t fit arterial disease as neatly. Edema with warmth suggests venous problems rather than arterial insufficiency, where warmth is not typical and the limb is often cool due to poor perfusion. Brown pigmentation around the ankles points to chronic venous stasis and is not characteristic of arterial insufficiency.