Approach to Lower Extremity Edema
Tóm tắt
Lower extremity edema is extremely common among patients seen across multiple specialties. The differential diagnosis is broad and ranges from simple dependent edema to more complex conditions such as chronic venous disease and lymphedema. Several key features from the history and physical exam can assist with the diagnosis. Imaging is rarely necessary at the initial visit unless venous thromboembolism is suspected. Treatment is specific to the etiology of the edema, but compression stockings, elevation, exercise, and weight loss remain the cornerstone in most cases.
Tài liệu tham khảo
Meissner MH, Moneta G, Burnand K, Gloviczki P, Lohr JM, Lurie F, et al. The hemodynamics and diagnosis of venous disease. J Vasc Surg. 2007;46(Suppl S):4S–24S.
•• Evans NS, Ratchford EV. The swollen leg. Vasc Med. 2016;21(6):562–4. An excellent resource for patients.
Semel JD, Goldin H. Association of athlete’s foot with cellulitis of the lower extremities: Diagnostic value of bacterial cultures of ipsilateral interdigital space samples. Clin Infect Dis. 1996;23(5):1162–4.
Philipson H, Ekman I, Forslund HB, Swedberg K, Schaufelberger M. Salt and fluid restriction is effective in patients with chronic heart failure. Eur J Heart Fail. 2013;15(11):1304–10.
Bartalena L, Fatourechi V. Extrathyroidal manifestations of Graves’ disease: a 2014 update. J Endocrinol Invest. 2014;37(8):691–700.
http://labeling.pfizer.com/showlabeling.aspx?id=562#section-6. Accessed December 2, 2016.
https://www.pfizermedicalinformation.com/en-us/neurontin#AdverseReactions. Accessed December 2, 2016.
Frishman WH. Effects of nonsteroidal anti-inflammatory drug therapy on blood pressure and peripheral edema. Am J Cardiol. 2002;89(6A):18D–25D.
Rockson SG. Current concepts and future directions in the diagnosis and management of lymphatic vascular disease. Vasc Med. 2010;15(3):223–31. This article provides an excellent overview of lymphedema.
• Rockson SG. Lymphedema. Vasc Med. 2016;21(1):77–81. An indispensable resource for patients with lymphedema.
Evans NS, Ratchford EV. Vascular disease patient information page: the post-thrombotic syndrome. Vasc Med. 2014;19(4):331–3.
•• Eberhardt RT, Raffetto JD. Chronic venous insufficiency. Circulation. 2014;130(4):333–46. This article provides a thorough review of the condition.
Berrington De Gonzalez A, Hartge P, Cerhan JR, Flint AJ, Hannan L, MacInnis RJ, et al. Body-mass index and mortality among 1.46 million white adults. N Engl J Med. 2010;363(23):2211–9.