What is the medical term for an absent dorsalis pedis (DP) pulse?

Medical Terminology for Absent Dorsalis Pedis Pulse

An absent dorsalis pedis (DP) pulse is medically termed "absent pedal pulse" or "pulselessness," and when documented in the clinical context of peripheral arterial disease, it is specifically described as "diminished or absent pulsation of the dorsalis pedis artery." 1

Clinical Context and Terminology

The absence of the dorsalis pedis pulse is documented using standardized pulse grading scales in medical practice:

• Pulse grading system: 0 (absent), 1 (diminished), 2 (normal), or 3 (bounding) 2
• When both dorsalis pedis and posterior tibial pulses are absent in the same limb, this constitutes "absent pedal pulses" and is a key physical finding in peripheral arterial disease (PAD) 1

Important Clinical Considerations

The dorsalis pedis artery is congenitally absent in 10-15% of healthy individuals, making an isolated absent DP pulse unreliable as a sole diagnostic finding 1, 3. This anatomical variation means:

• Always assess the posterior tibial pulse as well, which has greater diagnostic reliability 4, 3
• An absent DP pulse alone has only 50% sensitivity for detecting PAD 1
• When both pedal pulses (dorsalis pedis AND posterior tibial) are absent in the same leg, sensitivity increases to 58.2% with 98.3% specificity for PAD 5

Diagnostic Terminology in Different Clinical Scenarios

The medical terminology varies based on the underlying pathology:

• "Absent pedal pulses" - general term for absent dorsalis pedis and/or posterior tibial pulses 1, 2
• "Pulselessness" - one of the "6 P's" of acute limb ischemia (pain, pallor, pulselessness, paresthesias, paralysis, poikilothermia) 4, 3
• "Diminished or absent pulsation of the dorsalis pedis artery" - specific epidemiological terminology used in prevalence studies 1

Critical Distinction: Acute vs. Chronic

When documenting an absent DP pulse, the clinical context determines urgency:

• Acute presentation (sudden onset over hours to days with pain): termed "acute limb ischemia" with pulselessness as a cardinal sign requiring emergency intervention 4
• Chronic presentation (gradual onset, asymptomatic or claudication): termed "lower extremity arterial disease (LEAD)" or "peripheral arterial disease (PAD)" with absent pulses as a screening finding 1

Documentation Standards

In clinical documentation, absent dorsalis pedis pulse should be recorded as:

• "Dorsalis pedis pulse: 0/3 bilaterally" or "absent bilaterally" 2
• Must include assessment of posterior tibial pulse to avoid misdiagnosis 4, 3
• Should note whether finding is unilateral or bilateral, as bilateral absence may indicate chronic PAD rather than acute occlusion 4