[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Clinical exam](https://durgical.com/en/clinical-exam/) › [Cardiovascular system](https://durgical.com/en/clinical-exam/#a-cardiovascular) › Varicose veins: the Trendelenburg (Brodie–Trendelenburg) test [Clinical exam](https://durgical.com/en/clinical-exam/) · [Cardiovascular system](https://durgical.com/en/clinical-exam/#a-cardiovascular) # Varicose veins: the Trendelenburg (Brodie–Trendelenburg) test - Maneuver Emptying the veins with the leg raised, applying a tourniquet and watching how they fill on standing shows where the valves fail. Updated 2026-11-01 **See it in 3D:** [Great saphenous vein](https://durgical.com/en/anatomy/great-saphenous-vein/) · [Small saphenous vein](https://durgical.com/en/anatomy/small-saphenous-vein/) · [Femoral vein](https://durgical.com/en/anatomy/femoral-vein/) · [Popliteal vein](https://durgical.com/en/anatomy/popliteal-vein/) ## Key points - Leg raised, tourniquet high on the thigh, stand and watch. - Filling on release = incompetent saphenofemoral junction. - Filling with the tourniquet on = incompetent perforators below it. - Duplex ultrasound has replaced it in practice. ## What it is The Brodie–Trendelenburg test localizes reflux in varicose veins: at the saphenofemoral junction or in the perforating veins. It is a classic exam maneuver; duplex ultrasound now replaces it for treatment decisions, but it is still an exam question. ## The anatomy it tests - The great saphenous vein runs up the medial leg and thigh and joins the femoral vein at the saphenofemoral junction; the small saphenous drains into the popliteal. - Perforating veins connect the superficial and deep systems; their valves let blood pass inward only. - With competent valves the superficial veins fill slowly from below, from capillary arterial inflow. ## How to do it - Inspect the legs with the patient standing: course of the varicosities, edema, color changes, eczema, ankle ulcers. - Lay the patient down and raise the leg to about 45 degrees to empty the superficial veins (stroking toward the thigh helps). - Apply a tourniquet (or finger pressure) high on the thigh, below the saphenofemoral junction, without occluding the arteries. - Ask the patient to stand and watch the veins fill for about 30 seconds with the tourniquet on. - Remove the tourniquet and watch whether the veins fill suddenly from above. ## What a positive result means - Veins empty with the tourniquet that fill suddenly on release: saphenofemoral junction incompetence. - Veins that fill quickly even with the tourniquet on: incompetent perforators below the tourniquet (or the small saphenous). - Rapid filling in both phases: combined incompetence. - Slow filling from below over about 30 seconds or more: competent valves. ## Usefulness and limits - It is imprecise and operator-dependent; duplex ultrasound localizes reflux and assesses the deep system. - Not done with acute venous thrombosis or infected ulcers; watch for dizziness on standing. ## Test yourself Think of the answer, then tap the question to see it. ## Where is the tourniquet placed in the Brodie–Trendelenburg test? High on the thigh, below the saphenofemoral junction, with the leg raised and the veins emptied. ## What does rapid filling with the tourniquet still on indicate? Incompetent perforators below the tourniquet (or reflux through the small saphenous vein). ## Which test now replaces this maneuver? Venous duplex ultrasound, which localizes reflux and assesses the deep veins. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/clinical-exam/varicose-veins-the-trendelenburg-test/) ## See it in 3D The structures of Durgical's 3D anatomy where it is found. - [Great saphenous vein](https://durgical.com/en/anatomy/great-saphenous-vein/) - [Small saphenous vein](https://durgical.com/en/anatomy/small-saphenous-vein/) - [Femoral vein](https://durgical.com/en/anatomy/femoral-vein/) - [Popliteal vein](https://durgical.com/en/anatomy/popliteal-vein/) ## Related - [Signs of deep vein thrombosis: Homans and the Wells score](https://durgical.com/en/clinical-exam/signs-of-deep-vein-thrombosis-homans-and-the-wells-score/) - [Edema: pitting, grading and distribution](https://durgical.com/en/clinical-exam/edema-pitting-grading-and-distribution/) - [Peripheral pulses and the ankle–brachial index](https://durgical.com/en/clinical-exam/peripheral-pulses-and-the-ankle-brachial-index/) ## Related conditions - [Varicose veins](https://durgical.com/en/conditions/varicose-veins/) - [Chronic venous insufficiency](https://durgical.com/en/conditions/chronic-venous-insufficiency/) - [Venous leg ulcer](https://durgical.com/en/conditions/venous-leg-ulcer/) - [Deep vein thrombosis](https://durgical.com/en/conditions/deep-vein-thrombosis/) [← All of the clinical exam](https://durgical.com/en/clinical-exam/) Educational content on the clinical exam; it is learned and practised under supervision. It does not replace assessment by a health professional and is not for self-diagnosis. Sources: [Varicose veins: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/001109.htm) (MedlinePlus, U.S. National Library of Medicine, 2026); [6.4 Bedside Physical Assessment in Medical-Surgical Nursing - Medical-Surgical Nursing | OpenStax](https://openstax.org/books/medical-surgical-nursing/pages/6-4-bedside-physical-assessment-in-medical-surgical-nursing) (OpenStax (Rice University), 2024). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/clinical-exam/varicose-veins-the-trendelenburg-test/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/clinical-exam/varicose-veins-the-trendelenburg-test/