Bilateral leg swelling

Background

it is the existence of the excess fluid in the lower extremity resulting in swelling of the feet and extending upward. This swelling is further classified as pitting or depress-able and the non-pitting edema.

Mechanisms of Pedal Edema

• Increased hydrostatic pressure
• Decreased oncotic pressure
• Increased capillary permeability
• Lymphatic obstruction

Clinical Features

Pitting pedal edema

• Pedal edema

Differential Diagnosis

Differential Diagnosis of Pedal Edema

• Gravitational
• Venous insufufficiency/thrombophlebitis
• Drugs
  • NSAIDS
  • Birth control
  • Steroids
• CHF
• Lymphedema
• Pretibial myxedema

Evaluation

1. CBC
2. Chem 7
3. PT vs albumin (liver)
4. ECG
5. CXR
6. UA (nephrotic)

External Links

• DDxOf: Differential Diagnosis of Lower Extremity Edema