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| Swollen extremity is a common ED presentation requiring evaluation for dangerous vascular, infectious, and musculoskeletal causes.
| | #REDIRECT[[Unilateral_leg_swelling]] |
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| ==Differential Diagnosis==
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| ===Unilateral Upper or Lower Extremity===
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| *[[Deep venous thrombosis]]
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| *[[Cellulitis]] / soft tissue infection
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| *[[Abscess]]
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| *[[Compartment syndrome]]
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| *Fracture
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| *[[Septic arthritis]]
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| *Baker cyst rupture (posterior knee)
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| *Lymphedema (post-surgical, radiation)
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| *Venous insufficiency
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| *Post-thrombotic syndrome
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| ===Bilateral Lower Extremity===
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| *[[Congestive heart failure]]
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| *Venous insufficiency (chronic)
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| *Nephrotic syndrome
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| *Cirrhosis
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| *Medication-related (CCBs, NSAIDs)
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| *[[Hypothyroidism]]
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| *[[Preeclampsia]] (in pregnancy)
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| ===With Pain and Erythema===
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| *[[Cellulitis]]
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| *[[Necrotizing fasciitis]] - surgical emergency
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| *[[Gout]] / [[Pseudogout]]
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| *[[Septic arthritis]]
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| *[[DVT]]
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| *[[Compartment syndrome]]
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| ==Evaluation==
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| *Assess for red flags: pain out of proportion, crepitus, rapidly spreading, hemodynamic instability
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| *Compare to contralateral extremity
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| *Unilateral leg swelling: apply Wells criteria, obtain D-dimer or compression [[DVT ultrasound|ultrasound]]
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| *If infection suspected: CBC, BMP, lactate, blood cultures if septic
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| *Compartment pressures if compartment syndrome suspected
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| *Joint aspiration if septic arthritis on differential
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| *X-ray if fracture suspected
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| ==Management==
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| *DVT: [[Anticoagulation]] per protocol
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| *Cellulitis: [[Antibiotics]] (see [[Skin and soft tissue antibiotics]])
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| *Necrotizing fasciitis: emergent surgical consultation, broad-spectrum antibiotics
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| *Compartment syndrome: emergent fasciotomy
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| *Heart failure: [[Furosemide]], treat underlying cause
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| ==Disposition==
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| *Admit for necrotizing fasciitis, compartment syndrome, septic arthritis, or sepsis
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| *Admit for severe cellulitis requiring IV antibiotics
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| *Consider admission for proximal DVT in high-risk patients
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| *Discharge with close follow-up for uncomplicated DVT on anticoagulation
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| *Discharge with PCP follow-up for bilateral edema with stable vitals
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| ==See Also==
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| *[[Deep venous thrombosis]]
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| *[[Cellulitis]]
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| *[[Compartment syndrome]]
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| *[[Unilateral leg swelling]]
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| *[[Edema]]
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| ==References==
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| <references/>
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| [[Category:Symptoms]]
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| [[Category:Orthopedics]]
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