Approach to leg edema of unclear etiology american board. She first noticed these symptoms 4 years ago after giving birth to her second child. There was no history of shortness of breath, palpitation, cough headache, seizures, weight loss, fever, night sweats, skin rash, intermittent claudication, raynauds phenomenon and trauma. Differential diagnostic issue other than deep vein thrombosis. Diagnosis and management of common causes of localized edema. Unusual presentation of nonhodgkins bcell lymphoma with. Many factors varying greatly in seriousness can cause leg swelling. What is the mechanism of amlodipine induced edema legs. Lowerextremity edema during late pregnancy gynecology. Differential diagnosis of the swollen leg mainly unilateral dvt pts cvi angiodysplasias cellulitis, arthritis aca baker cyst lymphedema mainly bilateral lipedema cyclic idiopathic cardiac, renal, hepatic, dysproteinemic drugs.
Pdf edema is defined as a palpable swelling caused by an increase in interstitial fluid volume. Hanging the leg over the side of the gurney will make the leg color change to a deep red or purple color. Unilateral leg swelling secondary to venous insufficiency. Unilateral lower extremity oedema can be classified into acute or chronic duration. Dependent rubber this is due to also reduce blood flow and vasodilatation of the arterioles. It tends to be unilateral and the extent, site and number of previous episodes will determine the degree of swelling.
Basically the only single leg exercises used during the 19601990 era were the lunge and bench steps, which in my opinion not fully unilateral movements. There was no history of fever, trauma, local foot infection, pain in the limb or difficulty in walking. Bilateral edema can be due to a local cause or systemic disease, such as heart failure or. Common and important causes of unilateral leg swelling for doctors and medical students this page is currently being written and will be available soon. It appeared grossly swollen as compared to right lower limb. Practical approach to lower extremity edema anmed health. In addition to the lack of hip dominant exercises on offer, there were virtually no hip dominant unilateral leg options. Examine the joints for swelling and range of motion evaluate range of motion to all upper and lower extremities including bilateral shoulders, elbows, wrists and fingers, hips, knees, ankles, and toes. Shunichi shimano, md, phd,1teizo taya, md, phd,1satoshi imai, md,2.
The calcium channels are primarily arteriolar dilators. It may be an indication of the deep venous thrombosis. The acute onset of unilateral leg oedema can point to a. This facilitates flooding of venules and leaks into the peri venular interstitial space. Do not confuse severe arterial insufficiency with cellulites, the leg will not become pale with elevation. The right leg looks like pa kettle and the left leg looks like hoss cartwright. Unilateral leg edema is a frequent clinical problem, usually reflecting underlying vascular disease. Keywords component, unilateral leg edema, nonhodgkins bcell lymphoma, inguinal lymphadenopathy 1. While it is common to have swollen lower extremities postpartum as fluid shifts occur after delivery, this is usually bilateral. It didnt help and the entire right leg up till my knee soon went numb. Right leg pain and swelling and redness and warmth 46 yo female with sudden onset right lower leg pains and chills.
Nonhodgkins bcell lymphoma should be considered in the differential diagnosis in patients with unilateral leg edema when the swelling is chronic and deep venous thrombosis is promptly excluded. A young female presenting with unilateral sacroiliitis. There is little guidance for the utility of bnp levels in identifying hf in patients that present primarily with leg edema and without dyspnea. The incidence of deep venous thrombosis in children is low and lymphoedema may be a more appropriate diagnosis. Unilateral leg swelling is a common clinical presentation, with deep vein thrombosis dvt often the top differential. As a rare cause of unilateral leg swelling, extrinsic vein compression caused by intraperitoneal, retroperitoneal, or inguinal lesions has been noted. The table provides tips to minimize leg swelling during travel. Lower extremity pain clinical guidelines for workup. Unilateral definition of unilateral by merriamwebster. If your legs remain swollen or you develop leg pain hours or days after the flight, contact your healthcare provider. The most common causes of unilateral leg swelling are deep vein thrombosis dvt, bakers cyst, and cellulitis. The patient had noticed this swelling since 3 days. Pdf most of the documents on the racgp website are in portable document format pdf.
Treatment is based on addressing underlying disease process. This list does not constitute medical advice and may not accurately represent what you have. Dengue is a common arthropodborne viral infection in sri lanka which is spread by the mosquitos of the genus aedes. Unilateral leg swelling differential diagnosis free questions and answers for doctors and.
The mechanism of pedal edema in amlodipine it is primarily a local phenomenon. Unilateral lower extremity lymphoedema has been reported as a rare initial presentation for lymphoma, mostly in women, usually without bsymptoms, and often with inguinal lymphadenopathies or abdominal masses. Leg swelling caused by the retention of fluid in leg tissues is known as peripheral edema. Differential diagnosis for unilateral leg swelling oxford medical. The unilateral lymphedema of the lower limb has rarely been reported as an initial presentation for lymphoma, especially in females, usually without classic signs or. Unilateral pitting edema of the leg as a manifestation of. My doctor thought it was a torn nerve and gave naproxen. Physiologic edema results from hormoneinduced sodium retention. Unilateral leg swelling caused by common femoral vein. Assessment and management of lower extremity vascular. It typically involves the lower extremities but occasionally appears as swelling or puffiness in the face or hands. It can be caused by a problem with the circulatory system, the lymphatic system or the kidneys. Pdf unilateral leg swelling and hydronephrosis mohamad.
Hypertrophy of soft tissue or bone klippeltrenaunay syndrome overgrowth of body part proteus syndrome postthrombotic syndrome. Unilateral swelling from compression or compromise of venous or lymphatic drainage can result from dvt, venous insufficiency, venous obstruction by tumor e. Unilateral leg swelling wiley online library unilateral leg swelling. An obscure cause of leg edema, nonhodgkins lymphoma. Find, read and cite all the research you need on researchgate. Continued swelling and pain can be signs of a blood clot dvt. No fevers and reports she gets chills at times but doesnt feel well right now. If you do not have it you can download adobe reader free of charge.
Differential diagnosis for unilateral leg swelling. Evaluation of the swollen leg american society of podiatric. Clinical differential diagnosis of the swollen leg. To open a pdf file you will need compatible software such as adobe reader. She had unilateral, right, lower limb oedema extending upto the knee and pitting in nature. To correctly identify the etiology of the edema and then properly manage the cause is not always easy. These files will have pdf in brackets along with the filesize of the download.
Most unilateral lower limb swelling is the result of deep vein thrombosis or lymphatic disorders. Children who present with unilateral or bilateral swelling of the legs are often suspected of having a deep venous thrombosis. Please see a sports medicine or musculoskeletal specialist. Since the venules lack much muscle they are not much affected by the amlodipine. A 38yearold caucasian woman presented to the outpatient clinic with symptoms of hyperthyroidism lasting for approximately five months. It started with a horrendous muscle cramp in the left ca read more. It tends to be unilateral and the extent, site and number of previous episodes will determine the degree of. Journal of medical case reports a young female presenting with unilateral sacroiliitis following dengue virus infection. Leg swelling isnt always a sign of a heart or circulation problem. This condition though common in the lower limbs does occur in the upper limbs as well. This is really strange, but one of my legs is swelling during the day.
In three of these patients, the diagnosis of lymphoma was overlooked during the initial presentation, and appropriate therapy not given at that time. Request pdf on jan 1, 2005, samer homsi and others published unilateral leg swelling. The clinical presentation of unilateral lower limb swelling is diagnostically helpful, suggesting lo calized venous compression, venous hypertension, lymphedema. Deep venous thrombosis dvt is a prominent cause of lower limb swelling. It is not unusual to have unilateral swelling involving one limb, which may be of sinister significance. Obesity is associated with sleep apnea and venous insufficiency. In clinical practice and setting of general practice it is common to see patients with leg edema. This article describes an uncommon cause of this presentation, malignant lymphoma, in ten cases. Yasufumi matsuura, md, phd,2and akira hasegawa, md, phd3. Unilateral leg swelling and redness digital nomad physician. However, not infrequently, a range of pathologies are instead diagnosed. How to lose stubborn belly fat in 3 steps and how long it will take you duration. This is common and is not usually a sign of a problem. Acute dvt is an important public health problem because it affects over 20 million individuals yearly in the united states.
Discuss causes of both unilateral and bilateral leg swelling. Painless, unilateral upper extremity swelling chun, jordan md. Brawny, nonpitting skin with edema characterizes lymphedema, which can present in one or both lower extremities. Graves hyperthyroidism has a number of wellrecognized but relatively rare extrathyroid manifestations such as thyroid acropachy, pretibial myxedema, and congestive heart failure. Unilateral leg lymphoedema may occur secondary to radiation, surgery, compression by a tumour or early filariasis infection. However, studies have demonstrated that congestion may precede symptoms of hf by 7 to 10 days and that rising bnp levels in patients with chf are at higher risks for decompensation. If the swelling is unilateral andor accompanied by pain, would recommend seeking evaluation to confirm not a. Common and important causes of unilateral leg swelling for doctors and. Leg swelling causes mayo clinic mayo clinic mayo clinic. An international journal of medicine on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips. For full access to this pdf, sign in to an existing account, or purchase an annual subscription. Swelling of the both lower limbs is usually associated with heart disease, kidney disease and also. Edema may also occur when the enlarged uterus intermittently compresses the. Doctors give trusted, helpful answers on causes, diagnosis, symptoms, treatment, and more.
Peripheral edema refers to swelling in your lower legs or hands, and it can have a variety of causes ranging from mild to serious. Diagnosis and management american family physician. Department of hospital medicine, cleveland clinic foundation, 9500 euclid avenue, mail code a, cleveland, oh 44195, usa. Unusual presentation of nonhodgkins bcell lymphoma. Acute unilateral limb swelling is a clinical problem that can be categorized as one of two major groups, the majority of them is compatible with acute deep venous thrombosis dvt and actually the patients dont have venous thrombosis but readily have another disorder e. Leg edema is a common problem with a wide range of. Differential diagnosis of the swollen leg mainly unilateral dvt pts cvi. My 61 year old brother has a left leg, ankle and foot swelling.
Unilateral numbness, stiffness, and swelling neurology. Unilateral leg swelling secondary to venous insufficiency margaret clarke tracci and julie armatas presentation a 33yearold woman with no past medical history presents with pain, swelling, and heaviness of her left leg. Swelling in one leg during pregnancy doctor answers. Unilateral leg edema in the absence of dvt is often due to a localized leg problem such as muscle injury. Challenges in developing unilateral leg exercise options. Read unilateral leg swelling and hydronephrosis, qjm. To be updated when it is complete please like us on facebook, follow us on twitter or subscribe on youtube using the follow us buttons. Unilateral numbness, stiffness, and swelling whyme0506.