Snapshot A 77-year-old woman presents to her primary care physician for varicose veins. She reports that she has had these for a few months now and hopes to improve their appearance. She also states that her legs often feel restless and heavy and that she often has nocturnal cramping of her calves. She has a past medical history of obesity, hypertension, and previous deep venous thromboses after periods of long travel. On physical exam, her bilateral lower legs are edematous with brown hyperpigmentation around the ankles. There are no ulcers. She is scheduled for a duplex ultrasound. Introduction Clinical definition login to view 1 more bullet Associated conditions login to view 1 more bullet Epidemiology Demographics login to view 1 more bullet Risk factors login to view 4 more bullets Etiology Primary venous disease login to view 1 more bullet Secondary venous disease login to view 2 more bullets Pathogenesis login to view 3 more bullets Presentation Symptoms login to view 8 more bullets Physical exam login to view 9 more bullets Imaging Duplex ultrasound login to view 5 more bullets Differential Congestive heart failure login to view 2 more bullets Pressure ulcers login to view 2 more bullets Lymphedema login to view 4 more bullets DIAGNOSIS Making the diagnosis login to view 1 more bullet Treatment Conservative login to view 7 more bullets Non-operative login to view 3 more bullets Operative login to view 3 more bullets Complications Dermatitis Prognosis Likely to recur even after treatment