Bilateral pedal edema

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  • Definition: existence of the excess fluid in the lower extremity resulting in swelling of the feet and extending upward
    • Further classified as pitting (depress-able) and non-pitting

Causes Pedal 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

Bilateral pedal edema

Differential Diagnosis of Pedal Edema


  • CBC
  • Chem 7
  • PT vs albumin (liver)
  • ECG
  • CXR
  • UA (nephrotic)
  • Consider BNP


  • Treatment is based on addressing underlying disease process
    • Idiopathic pedal edema need not to be treated with diuretics


  • If no respiratory symptoms, most patients may be safely discharged home
    • Patients should be followed up in medical clinic for further investigation and care

See Also

External Links


  1. Kay A, Davis CL. Idiopathic Edema. American Journal of Kidney Disease. 1999; 34(3): 405-408.