TOC |
D-Dx
Diffenrential Diagnosis
Outlines
in Clinical Medicine on Physicians' Online 2001
Differential Diagnosis of Edema - Leg
Swelling
Bilateral lower limb edema is a very concerning finding
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Serious disease must be ruled out
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Cardiac Insufficiency is usually bilateral [1]
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a.Left ventricular systolic dysfunction is most common cardiac cause
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b.Diastolic Dysfunction is not uncommon
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c.Atrial fibrillation is third most common
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Pulmonary dysfunction including pulmonary hypertension is often bilateral
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Portal Hypertension may show Right > Left lower extremity edema
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Dihydropyridine calcium channel blockers often cause bilateral ankle edema
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Hypoalbuminemia from Nephrotic Syndrome, Hepatic Failure, Malnutrition, Protein
Malabsorption
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1.Hypoalbuminemia
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2.Albuminuria
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3.Frequently present with true anasarca
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Soft Tissue Swelling , Cellulitis, Fasciitis - infectious, eosinophilic
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Lymphatic Insufficiency
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a.Lymphedema
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b.Described as woody or brawny
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Scleroderma
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a.Mainly begins on hands, feet
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b.Spreads proximally
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Myxedema (hypothyroidism)
Unilateral is usually due to obstruction of venous or lymphatic return
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Venous Obstruction
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Lymphatic Obstruction
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Venous Insuffiency - usually deep vein
thrombosis or after harvest of vein graft
03162001