The optimal positioning for viewing the veins of the lower extremity is:

• Supine position with the head of the bed elevated
  • For assessing reflux: standing, sitting and/or reverse Trendelenburg (at least 15 degrees) is used to maintain lower extremity dependency.
• Leg being examined, externally rotated
• A lateral decubitus or prone position may be utilized to visualize the popliteal vein, peroneal and proximal posterior tibial veins, small saphenous vein and soleal veins.