The Schwartz Test diagnostic tests for varicose veins of the lower extremity

The Schwartz Test

This test was described by C. E. Schwartz, a French surgeon, in the latter part of the 19th century. It is helpful in outlining the course of the main saphenous trunks when they are not visible or readily palpable. It also helps to determine whether the main trunks of the long and short saphenous vein have competent valves.

    • This shows one method of performing the test. The fingers of the right hand are placed over the course of the long saphenous vein in the proximal thigh, then a large varix in the lower leg is tapped sharply with the fingers of the left hand. If an impulse is felt over the upper thigh with each tapping with the fingers, this means that the long saphenous trunk is varicosed and incompetent. This test also proves useful in detecting the location of the main trunk.
    • This demonstrates a more conclusive method of performing this test to deter­mine the competence of the saphenous vein trunks. This is done by tapping the dilated veins in the proximal thigh, with the fingers of the other hand resting over the veins in the lower leg. If an impulse is detected in the lower leg veins with each tap, this demonstrates without doubt that the venous valves are incompetent. Were they competent, the impulse would travel only to the next competent valve, as the venous lumen is partitioned off between each set of valves. In some pa­tients, however, it may be hard to find an enlarged vein in the proximal thigh to tap over, as the main trunk sometimes lies very deep, especially in obese persons.

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