04/22/2026    Paul Kesselman, DPM

Arterial and Venous Duplex Scanning for Podiatrists - Part 1

It was wonderful to read Dr. Shapiro first
installment on duplex scanning an invaluable
diagnostic test for those providing any wound care
therapy or seeing patients with a potential DVT.
The loss of invaluable time especially when
dealing with patients with a possible DVT, as this
if left not promptly diagnosed and treated may
lead to loss of life. For patients requiring vein
ablations, vein mapping can be incorporated into
the study. For those with venous leg ulcers,
duplex venous scanning along with other
noninvasive testing, can be invaluable for
predicting whether conservative therapy (and which
one) may be successful. For arterial ulcers and
DFU, arterial duplex scanning complements
arterial doppler, PPG and PCR along with several
other tests that offer insights into
microcirculation, thus providing guidance for
therapeutic interventions.

These tests can be used as part of an
armamentarium to support the use of HBO, hyperoxic
therapy, NPWT, and cellular tissue products.
All third-party payers are currently scrutinizing
several of these procedures closely due to abuse.
Sonographic visualization of extremity veins and
arteries is not limited to radiologists and
vascular surgeons. But whoever performs this
valuable service should be trained properly and
have the capability to reproduce both reliable
color images and reports In other words, the
report and images from a podiatrist should look no
different than those performed by a competent
vascular surgeon, radiologist. or their extenders.

A weekend course from a diagnostic company is
unlikely to provide anyone with the minimum skills
necessary to perform Duplex or any of these tests
at a responsible level. Most technicians take
weeks or months of course work to master
administering both arterial and vascular non
invasive testing. As for the physicians
Interpreting these tests and composing proper
reports also takes more than two days time to
master.

One additional note: Normal variables must be
included in these reports in addition to values
provided at the various anatomical sites being
tested.

Before learning more about these valuable tests,
research your state boards to ensure your state
licensure permits you to perform them.
If so, ensure that Medicare and other third-party
payers are legally mandated to reimburse
adequately trained DPMs, equivalent to other
qualified health care providers. .

Can't wait to read installment number 2.

Paul Kesselman, DPM, Oceanside, NY

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