Pedal Pulses in Diagnosis Of Arterial Disease

To the Editor:—  The letter by Roy E. Christian, MD, entitled "Occlusion of the Dorsalis Pedis Artery in Two Young Women" (209:1366, 1969) suggested that the absence of a palpable dorsalis pedis pulse should be interpreted as indicating the presence of acquired occlusion of that artery. However, arterial occlusion is only one of the causes of an absent dorsalis pedis pulse.It should be emphasized that congenital absence of pedal pulses is a common and clinically insignificant findings. Surveys of 1,000 children hospitalized for noncardiovascular disorders¹ and of 1,014 apparently normal soldiers² revealed one or both dorsalis pedis pulses to be absent in 12% and 17% of the individuals, respectively. On the other hand, congenital absence of a posterior tibial pulse appears to be uncommon in the white race,^1,2 but one study² indicates a congenital absence of one or both posterior tibial pulses in 9%