The optimum position of the patient is facing the examiner with the leg externally rotated. The right index and third fingers are used to percuss the vein as it is felt behind the femoral condyle. The left index and third fingers are placed at the inferior aspect of Scarpa's triangle, attempting to reach the apex of the triangle eight to ten centimeters below the inguinal ligament. This is the junction of the medial border of the sartorius muscle with the lateral border of the abductor longus muscle. In examining the short saphenous vein, it is best to have the patient slightly flex the knee while keeping the heel on the ground.
Attention is focused at the popliteal fossa.
It is best to trace the vein from its origin around the lateral malleolus across the Achilles tendon superiorly, up to the mid-calf. This is where the short saphenous vein emerges from the muscular fascia and is often times found to be dilated when incompetent. The location of the vein at this site makes it easy to trace on continuous wave Doppler and serves as a good point to isolate short saphenous vein flow and distinguish it from the deeper popliteal vein that can be heard in the popliteal fossa when a complete calf compression is done. The patient with a thick leg and a small caliber vein presents a challenge for clinical examination of the short saphenous vein. Where the short saphenous vein re-emerges at the popliteal fossa, it is sometimes possible that the vein is enlarged and the transmitted pulsation easy to feel.