Severe varicose vein disease with leg ulcers

This patient had severe varicose veins disease. 

Causes: 1) Sapheno-femoral junction incompetence. Pretty severe. More than 3 seconds of reversed flow on valsalva. 

2) Cockett perforators incompetence in lower 3rd of leg. Two perforators showed dilation and reversed flow on color Doppler ultrasound. Seen as red color on color Doppler ultrasound. 

Result:

Inguinal lymphadenitis:

See more at:

Color Doppler ultrasound in varicose veins disease