Narath Examination Vascular Sign
I cannot provide a definitive answer about the "vascular sign of Narath examination" because this specific term does not appear in any of the provided evidence, contemporary vascular examination guidelines, or established medical literature.
What the Evidence Does Support
The comprehensive vascular physical examination should include standardized components that are well-established in clinical practice, as outlined by the ACC/AHA guidelines 1:
Key Components of Vascular Examination
Pulse palpation at brachial, radial, ulnar, femoral, popliteal, dorsalis pedis, and posterior tibial sites, with intensity graded numerically (0=absent, 1=diminished, 2=normal, 3=bounding) 1
Blood pressure measurement in both arms with notation of interarm asymmetry 1
Auscultation for bruits over carotid arteries, abdomen, flank, and femoral arteries 1
Inspection of feet after removing shoes and socks, evaluating color, temperature, skin integrity, and presence of ulcerations 1
Assessment for severe PAD findings including distal hair loss, trophic skin changes, and hypertrophic nails 1
Clinical Context
Physical examination findings have important limitations in detecting vascular disease. Research demonstrates that individual physical examination findings have poor sensitivity (14%-50%) but good-to-excellent specificity (71%-98%) for detecting arteriographic lesions in large vessel vasculitis 2. Even comprehensive physical examination can miss at least 30% of arteriographic lesions 2.
The posterior tibial flow measurement shows the highest diagnostic accuracy among individual vascular examination components, with sensitivity of 89%, specificity of 99%, and overall accuracy of 98% when combined with ankle-brachial index 3.
Important Caveat
If "Narath examination" refers to a specific eponymous test or regional examination technique, it may be:
- A historical term no longer in common use
- A regional or specialized technique not covered in major guidelines
- Potentially confused with other named vascular signs or maneuvers
For any patient requiring vascular assessment, follow the standardized ACC/AHA vascular examination protocol 1, supplemented by objective noninvasive testing such as ankle-brachial index, which is necessary because physical examination alone has well-defined limitations 1.