Leg Elevation in Surgery — 62yo Man | Vascular Surgery | SMLE Q#822
SMLE Question #822
Surgery
Vascular Surgery
Last updated: February 2026
A 62-year-old man has a 4-month history of a painful ulcer on the medial lower left leg just above the ankle. He has long-standing varicose veins and progressive leg swelling that worsens by the end of the day and improves with leg elevation. Examination shows a shallow, irregular ulcer with granulation tissue in the medial gaiter area, surrounded by hyperpigmented, indurated skin and mild pitting edema. Dorsalis pedis and posterior tibial pulses are palpable and symmetric bilaterally. What is the most likely underlying cause of this ulcer?
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