Which of the following best describes the physical findings of peripheral arterial disease?

• A. Weak/absent peripheral pulses, poor wound healing, cool pallid skin, shiny skin, missing hair
• B. Pitting edema with warm skin
• C. Dilated veins and leg heaviness
• D. Hyperpigmented, edematous ankles

Answer: (B)

Peripheral arterial disease reflects reduced arterial blood flow to the legs, so the physical findings are those of impaired perfusion rather than fluid overload. The hallmark signs are weak or absent pulses distal to the blockage, cool or pale skin, shiny and hairless skin, and delayed capillary refill. Ulcers, when present, tend to occur on the toes or other areas exposed to pressure and have well-defined edges. Edema is not a prominent feature of PAD; if edema is present, it’s usually mild and vascular insufficiency is still the underlying issue, whereas pitting edema with warm skin points more toward venous problems.