These American Heart Association scientific statements are really quite lovely. Although much of the scientific discussion in this article pertains to the diagnosis of chronic vascular disease in the outpatient setting, measuring the ankle-brachial index has a place the the Emergency Department as well.
While most of the studies included in their mini-systematic review report AUCs for chronic peripheral vascular disease, the same principles apply for determination of acute peripheral vascular disease – relevant after lower-extremity penetrating trauma or fracture. And, if you’re going to use a test, sometimes it’s fun to know all the gritty details underpinning the evidence, how the cut-offs were determined, the difference between doppler and oscillometric devices, how discrepancies between legs should be handled, etc.
In any event, an interesting piece of literature to skim and save as a reference.
“Measurement and Interpretation of the Ankle-Brachial Index : A Scientific Statement From the American Heart Association”