bilateral lower limb swelling differential diagnosis

Address correspondence to Nirav Shastri, MD, at [email protected]. Armer JM, Stewart BR, Shook RP. Evans AL, Brice G, Sotirova V, Mortimer P, Beninson J, Burnand K, et al. Int J Low Extrem Wounds. 30-Month Post-Breast Cancer Treatment Lymphedema. The diagnosis is usually made with a thorough history and physical examination. Therefore, when you are suffering from swollen feet, eat magnesium-rich foods. Although the swelling persisted throughout the day, it was worse in the evening. Button M, 2012 Jun 7. Greene AK, Sudduth CL. Ann Plast Surg. Myint F, NSAIDS. Pleural effusions can be easily identified on chest radiography, physical examination findings include dullness to percussion, decreased tactile fremitus and decreased (or absent) breath sounds. Int J Obes (Lond). [Medline]. Venous insufficiency is the most common cause of peripheral edema. Pedal edema is the accumulation of fluid in the feet and lower legs. Parasite Immunol. Eat fewer red meats and more lean meats, cold-water fish, tofu (soy, if no allergy), or beans for protein. Zhonghua Yi Xue Yi Chuan Xue Za Zhi. Hemoptysis: Malignancy, PE, TB. It is milder, often bilateral, and symptoms are confined to below the knee. [Medline]. He has had no ... there will be gravity-dependent edema in the lower limbs as well. Lymphology. 77(5):438-52. Primary lymphedema most often follows an autosomal dominant pattern of inheritance.2 Several studies have suggested specific genetic mutations, including that on chromosome 5. Beloncle F, Sayegh J, Eymerit-Morin C, Duveau A, Augusto JF. Conditions to consider in the differential diagnosis of lymphedema include the following: Lipedema - A disease of adipose tissue that in nearly every case is found in obese women; it is manifested by abnormal depositions of subcutaneous fat associated with often mild edema; lipedema occurs from hip to ankle, usually sparing the feet J Cutan Pathol. Diligent skin and nail hygiene is critical in preventing secondary cellulitis, and exercise should be encouraged for weight control and fluid mobilization. It is important to assess both lower limbs, even if the complaint is unilateral. Over the years, the swelling spread up her legs. Initial laboratory investigations included typical findings for electrolytes, aspartate aminotransferase, alanine aminotransferase, total bilirubin, and the international normalized ratio. [Medline]. 2014 Jan. 60(1):30-5. . Ann Rehabil Med. Found inside... of the inferior vena cava: bilateral lower extremity edema of a limb, ... veins DIFFERENTIAL DIAGNOSIS Arterial stroke mimics: complex migraine, ... 2005 Jun. David F Butler, MD Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic, David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa, Rosalie Elenitsas, MD Herman Beerman Associate Professor of Dermatology, University of Pennsylvania School of Medicine; Director, Penn Cutaneous Pathology Services, Department of Dermatology, University of Pennsylvania Health System, Rosalie Elenitsas, MD is a member of the following medical societies: American Academy of Dermatology and American Society of Dermatopathology, Disclosure: Lippincott Williams Wilkins Royalty Textbook editor; DLA Piper Consulting fee Consulting, Amy L Friedman, MD Professor of Surgery, Director of Transplantation, State University, of New York Upstate Medical University College of Medicine, Syracuse, Amy L Friedman, MD is a member of the following medical societies: American College of Surgeons, American Medical Association, American Medical Women's Association, American Society for Artificial Internal Organs, American Society of Transplant Surgeons, American Society of Transplantation, Association for Academic Surgery, Association of Women Surgeons, International College of Surgeons, International Liver Transplantation Society, NewYork Academy of Sciences, Pennsylvania Medical Society, Philadelphia County Medical Society, Society of Critical Care Medicine, and Transplantation Society, John Geibel, MD, DSc, MA Vice Chair and Professor, Department of Surgery, Section of Gastrointestinal Medicine, and Department of Cellular and Molecular Physiology, Yale University School of Medicine; Director, Surgical Research, Department of Surgery, Yale-New Haven Hospital, John Geibel, MD, DSc, MA is a member of the following medical societies: American Gastroenterological Association, American Physiological Society, American Society of Nephrology, Association for Academic Surgery, International Society of Nephrology, New York Academy of Sciences, and Society for Surgery of the Alimentary Tract, Disclosure: AMGEN Royalty Consulting; ARdelyx Ownership interest Board membership, Raphael J Kiel, MD Associate Professor of Medicine, Wayne State University School of Medicine; Associate Professor of Medicine, Oakland University William Beaumont School of Medicine; Consulting Staff, Infectious Diseases Division, William Beaumont Hospital; Consulting Staff, Infectious Diseases Division Providence Hospital, Raphael J Kiel, MD is a member of the following medical societies: American College of Physicians-American Society of Internal Medicine and American Geriatrics Society, Zab Mosenifar, MD Director, Division of Pulmonary and Critical Care Medicine, Director, Women's Guild Pulmonary Disease Institute, Professor and Executive Vice Chair, Department of Medicine, Cedars Sinai Medical Center, University of California, Los Angeles, David Geffen School of Medicine, Zab Mosenifar, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, American Federation for Medical Research, and American Thoracic Society, Don R Revis Jr, MD Consulting Staff, Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Florida College of Medicine, Don R Revis Jr, MD is a member of the following medical societies: American College of Surgeons, American Medical Association, American Society for Aesthetic Plastic Surgery, and American Society of Plastic Surgeons, Sat Sharma, MD, FRCPC Professor and Head, Division of Pulmonary Medicine, Department of Internal Medicine, University of Manitoba; Site Director, Respiratory Medicine, St Boniface General Hospital, Sat Sharma, MD, FRCPC is a member of the following medical societies: American Academy of Sleep Medicine, American College of Chest Physicians, American College of Physicians-American Society of Internal Medicine, American Thoracic Society, Canadian Medical Association, Royal College of Physicians and Surgeons of Canada, Royal Society of Medicine, Society of Critical Care Medicine, and World Medical Association, Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference. Chronic lymphoedema and angiosarcoma. Immediate, unlimited access to all AFP content. 2010 Mar. Obesity with a large abdomen also may contribute to bilateral lower limb edema. Clin Dermatol. [Medline]. The swelling from lymphedema might dull pain from an injury or burn, so don’t use heating pads on the affected limb. 142(6):704-8. Primary lymphedema may be associated with hypoparathyroidism, microcephaly, distichiasis (i.e., double row of eyelashes on an eyelid), yellow nails, vertebral anomalies, cerebrovascular malformations, and intestinal lymphangiectasia.2. 2016 2017 2018 2019 2020 2021 Billable/Specific Code. Diuretics are not indicated in the treatment of lymphedema; however, some studies report benefits with flavonoids (or benzopyrones, not available in the United States).4 Surgical procedures are palliative and focus on debulking or drainage bypass. [Medline]. Komorowski AL, Wysocki WM, Mitus J. Angiosarcoma in a chronically lymphedematous leg: an unusual presentation of Stewart-Treves syndrome. Found inside – Page 56Peripheral oedema may be acute or chronic, and unilateral or bilateral. Mild bilateral ankle oedema may frequently be due to chronic venous disease or ... Search Results: Lower leg, Rash or multiple lesions. Causes. [Full Text]. Localized lymphedema (elephantiasis): a case series and review of the literature. Limb massage and rest do not decrease the size of the limb appreciably. Found inside – Page 1Examples include unilateral lower extremity edema caused by deep venous thrombosis or ... Differential Diagnosis of Pleural Effusion ; Chapter 5 , Abdominal ... 2000 Jun. Chronic bilateral lower extremity edema likely secondary to chronic venous insufficiency perhaps related to OSA given ultrasound findings of pulsatile flow in EIV’s. Lymphoedema associated with Kaposi sarcoma. [Medline]. Dividing edema into symmetric or asymmetric patterns helps narrow the differential diagnosis: symmetric edema is typical of ... Dermatomyositis in a 50-year-old man with bilateral lower extremity weakness. 1. Primary cutaneous B-cell lymphoma of the leg in a chronic lymphedematous extremity. Showcasing the expertise of top-tier specialists who contributed to the newly released guidelines for the care of thrombosis in cancer patients, this exciting guide was written and edited by members of the American Society of Clinical ... [24] bilateral leg symptoms in a patient is the most important . Differential Diagnosis This patient's constellation of lower extremity edema and shortness of breath, with evidence of pulmonary congestion on examination and chest X ray, was most indicative of biventricular cardiac failure. Indian J Dermatol. Differential diagnosis, investigation, and current treatment of lower limb lymphedema. The patient was otherwise systemically well with normal heart sounds and a clear chest examination. 2 –4. [Medline]. Differential diagnosis, investigation, and current treatment of lower limb lymphedema. Found inside – Page 1202Lymphoedema is swelling due to the accumulation of lymph within the tissues and ... at or after puberty with distal lower limb swelling, usually bilateral. Effect of manual lymph drainage in addition to guidelines and exercise therapy on arm lymphoedema related to breast cancer: randomised controlled trial. Mossy leg--an unusual therapeutic success. 2021 Jan. 9 (1):234-241. [Medline]. Lymphedema. Lymphat Res Biol. Edema is the medical term for swelling that’s caused by extra fluid. Symptom burden and infection occurrence among individuals with extremity lymphedema. 2003 Aug. 96(8):807-8. Hamilton G. [Medline]. Doxycycline improves filarial lymphedema independent of active filarial infection: a randomized controlled trial. He had noted a recent spontaneous increase in left lower calf and heel pain that was beginning to resolve. Urgent message: The high specificity but broad range of possible causes associated with a primary complaint of lower extremity edema poses a particular challenge to the urgent care clinician. 37(4):213-8. [Medline]. J Lymphoedema. 25(2):153-9. Int J Dermatol. Maltese PE, Michelini S, Ricci M, Maitz S, Fiorentino A, Serrani R, et al. A 55-year-old male presented to a Level I trauma center via ambulance with a complaint of bilateral lower extremity weakness after falling. Berry FB, Tamimi Y, Carle MV, Lehmann OJ, Walter MA. These include tofu, spinach, cashews, almonds, dark chocolate, broccoli and avocados. PLoS One. Age of onset in hereditary lymphedema. [Medline]. The painful limb is inspected for color, edema, and any skin or hair changes, and palpated for pulses, temperature, tenderness, and crepitation (a subtle crackling sensation indicating soft-tissue gas). Finegold DN. 2011 Sep 1. [Medline]. Narushima M, Mihara M, Yamamoto Y, Iida T, Koshima I, Mundinger GS. 2003 Jun. William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative DermatologyDisclosure: Received income in an amount equal to or greater than $250 from: Elsevier; WebMD
Served as a speaker for various universities, dermatology societies, and dermatology departments. Lymphology. [Medline]. Successful treatment of papillomatosis cutis lymphostatica with acitretin. Nikitenko LL, Shimosawa T, Henderson S, Mäkinen T, Shimosawa H, Qureshi U, et al. 2 Various commonly prescribed drugs can also cause LE swelling: gabapentin, … E-mail submissions to [email protected]. [Full Text]. Chavda LK, Vaidya RA, Vaidya AD. Covers pathological aspects of skin diseases in addition to providing superb descriptions and illustrations of their clinical manifestations - the only available reference with this unique combination of features. Salim A, Pike M, Turner R, Mortimer P. Lymphedema: an additional finding in the charge association. J Parasitol Res. Chopra K, Tadisina KK, Brewer M, Holton LH, Banda AK, Singh DP. 1 Most often, bilateral LE edema is caused by heart failure, nephrotic syndrome, or cirrhosis. Found inside – Page 454Differential diagnosis Both infections may present with swelling of the limbs. ... Bilateral pitting oedema of the lower limbs can be caused by cardiac ... Recessive primary congenital lymphoedema caused by a VEGFR3 mutation. 4. 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: Cortisone, Ca antagonists, diuretics etc. Edema is swelling that is caused by fluid trapped in your body’s tissues. What is bilateral leg edema? Epidemiology of elephantiasis with special emphasis on podoconiosis in Ethiopia: A literature review. Local infection, trauma (including burns, which may also cause generalised oede… The first is venous edema, caused by increased capillary filtration and retention of protein-poor fluid from the venous system into the interstitial space. He stated he had slipped and fallen on his buttocks while showering. The intravascular stenting method for treatment of extremity lymphedema with multiconfiguration lymphaticovenous anastomoses. 2000 Jun. Edema limited to the lower limbs. Lebwohl M, ed. The excessive swelling causes weight gain, fatigue, and impairment in daily activities. Acta Derm Venereol. Weight lifting in women with breast-cancer-related lymphedema. The first is venous edema caused by increased capillary permeability, resulting in a fluid shift from the veins to the interstitial space. Unilateral lower extremity swelling as a rare presentation of non-Hodgkin's lymphoma. 2013. Extensive searching for a secondary cause for this condition could result in undue morbidity for the patient. The differential diagnosis for a patient with bilateral lower leg edema accompanied with hyperpigmented patches and plaques includes lymphedema, lipodermatosclerosis, Kaposi … Most often, a rash affecting the lower legs is a type of dermatitis. J Vasc Surg Venous Lymphat Disord. 2014 Mar. History, physical examination, … 4. Lymphedema. CRPS used to be known as reflex sympathetic dystrophy (RSD) and causalgia. hematocoele Painful scotum, non-tender testis Incarcerated hernia Insect bite Rash Torsion of testicular appendix Painless scrotum, testis enlarged Genetic syndrome – e.g. Trop Med Int Health. Found inside – Page 70MCC differential diagnosis with added evidence HYPERTENSION IN GENERAL Definition: ... and/or current renal dialysis; bilateral lower limb swelling; ... Ostomy Wound Manage. [Medline]. Found inside – Page 447The differential diagnosis of limb swelling is very wide . For bilateral pitting oedema of the lower limbs it includes cardiac failure or any of the causes ... 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