Gastrocnemius compression sign in arterial insufficiency of the leg.

A simple bedside diagnostic maneuver, consisting of a bimanual compression of the gastrocnemius muscle and its use in the assessment of lower limb ischemia, are described. The compression evokes a pain response in the ischemic muscles and, when positive, is strongly suggestive of vascular insufficiency and, when absent, suggests a nonvascular etiology. Thus, the test is useful for the differentiation of vascular from nonvascular leg pain and is recommended as a diagnostic screening maneuver. Further diagnosis requires appropriate clinical judgment and the use of confirmatory tests.