Pedal edema: Difference between revisions
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* [[Abscess]] | * [[Abscess]] | ||
* [[ACE inhibitor]] | |||
* [[Aceon]] | |||
* [[Acquired C1-esterase inhibitor deficiency]] | * [[Acquired C1-esterase inhibitor deficiency]] | ||
* [[Actos]] | * [[Actos]] | ||
* [[Acute glomerulonephritis]] | * [[Acute glomerulonephritis]] | ||
* [[Addison's Disease]] | * [[Addison's Disease]] | ||
* [[Aldomet]] | |||
* [[Amlodipine]] | * [[Amlodipine]] | ||
* Amniotic band | * Amniotic band | ||
* [[Angioneurotic edema]] | * [[Angioneurotic edema]] | ||
* [[Angiotensin converting enzyme inhibitor]] | |||
* [[Anemia]] | * [[Anemia]] | ||
* [[Anorexia Nervosa]] | * [[Anorexia Nervosa]] | ||
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* [[Bartter's Syndrome]] | * [[Bartter's Syndrome]] | ||
* [[Beriberi]] | * [[Beriberi]] | ||
* [[Beta blockers]] | |||
* [[Boils]] | * [[Boils]] | ||
* [[Bruise]] | * [[Bruise]] | ||
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* [[Cachexia]] | * [[Cachexia]] | ||
* [[Carbuncle]] | * [[Carbuncle]] | ||
* [[Cardura]] | |||
* [[Cellulitis]] | * [[Cellulitis]] | ||
* [[Chemotherapy]] | * [[Chemotherapy]] | ||
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* Mediastinal cancer | * Mediastinal cancer | ||
* [[Milroy's Disease]] | * [[Milroy's Disease]] | ||
* [[Minipress]] | |||
* [[Motrin]] | * [[Motrin]] | ||
* Musculoskeletal [[trauma]] | * Musculoskeletal [[trauma]] | ||
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* [[Trichinosis]] | * [[Trichinosis]] | ||
* [[Tumor]]s | * [[Tumor]]s | ||
* [[Univasc]] | |||
* [[Valproic acid]] | * [[Valproic acid]] | ||
* [[Varicose veins]] | * [[Varicose veins]] | ||
* [[Vesinoid]] | * [[Vesinoid]] | ||
* [[vytorin]] | |||
===Complete Differential Diagnosis of the Causes of ...=== | ===Complete Differential Diagnosis of the Causes of ...=== | ||
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| '''Drug Side Effect''' | | '''Drug Side Effect''' | ||
|bgcolor="Beige"| [[actos]], [[amlodipine]], [[avandia]], [[cisplatin]], [[diltiazem]], [[docetaxel]], [[estrogen]], [[glitazones]], [[ibuprofen]], [[motrin]], [[nifedipine]], [[norvasc]], [[trentinion]], | |bgcolor="Beige"| [[ACE inhibitors]], [[aceon]], [[actos]], [[aldomet]], [[amlodipine]], [[avandia]], [[beta blockers]], [[cardura]], [[cisplatin]], [[coreg]], [[diltiazem]], [[docetaxel]], [[estrogen]], [[glitazones]], [[ibuprofen]], [[labetalol]],[[minipress]], [[motrin]], [[nifedipine]], [[norvasc]], [[pindol]], [[plendil]], [[tenormin]], [[trentinion]], [[univasc]] [[valproic acid]], [[verapamil]], [[vesinoid]], [[vytorin]] | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
Revision as of 21:34, 9 December 2010
| Peripheral edema | |
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| Massive peripheral edema (Image courtesy of Charlie Goldberg, M.D., UCSD School of Medicine and VA Medical Center, San Diego, CA) | |
| ICD-10 | R60.0 |
| ICD-9 | 782.3 |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Associate Editor-In-Chief: M.Umer Tariq [2]
Please Take Over This Page and Apply to be Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [3] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.
Overview
Competent venous valves, intermittent leg muscle contraction and respiration is required to support normal venous blood return. When these fail, venous insufficiency and edema occur. Edema can occur in 2 forms: pitting and non-pitting. Pitting occurs when there is fluid movement when pressure is applied. Non-pitting is swelling of the tissue itself, not an excess of fluid surrounding the tissue. Edema is caused by an accumulation of an excessive amount of watery fluid in the serous cavities, tissues or cells causing painless, non-reddened swelling
Epidemiology and Demographics
25% of the general population suffers from chronic venous insufficiency.
Complete Differential Diagnosis
In alphabetical order: [1] [2]
- Abscess
- ACE inhibitor
- Aceon
- Acquired C1-esterase inhibitor deficiency
- Actos
- Acute glomerulonephritis
- Addison's Disease
- Aldomet
- Amlodipine
- Amniotic band
- Angioneurotic edema
- Angiotensin converting enzyme inhibitor
- Anemia
- Anorexia Nervosa
- AV fistula
- Avandia
- Bartter's Syndrome
- Beriberi
- Beta blockers
- Boils
- Bruise
- Bulimia Nervosa
- Burn
- Cachexia
- Carbuncle
- Cardura
- Cellulitis
- Chemotherapy
- Cisplatin
- Cold (physical stimuli)
- Constrictive pericarditis
- Contact dermatitis
- Contusion
- Cushing's Syndrome
- Diltiazem
- Drugs
- Docetax
- Erysipelas
- Exudative enteropathy
- Filariasis
- Fracture
- Frostbite
- Gas gangrene
- Glitazones
- Gout
- Hyperthyroidism
- Hypoalbuminemia
- Hypoplasia
- Hypothyroidism
- Ibuprophen
- Idiopathic edema
- Insect bite
- Irritant
- Left heart failure
- Ligamentous sprain
- Liver failure
- Lymph node mass
- Malabsorption
- Malnutrition
- Mediastinal cancer
- Milroy's Disease
- Minipress
- Motrin
- Musculoskeletal trauma
- Myocardial Infarction
- Neoplasm
- Nephrotic Syndrome
- Nifedipine
- Norvasc
- Osteomyelitis
- Peripheral nerve lesion
- Premenstrual edema
- Right heart failure
- Scleroderma
- Sepsis syndrome
- Snakebites
- Starvation edema
- Sunburn
- Surgical excision
- Tendonous strain
- Thoracic aneurysm
- Thrombophlebitis
- Thrombosis
- Tight clothing
- [[Trentinion
- Trichinosis
- Tumors
- Univasc
- Valproic acid
- Varicose veins
- Vesinoid
- vytorin
Complete Differential Diagnosis of the Causes of ...
(By organ system)
Diagnosis
History and Symptoms
- History should include:
- DVT risk factors
- time lapse
- other associated symptoms
- unilateral vs. bilateral
- pitting and/or non-pitting
(Images courtesy of Charlie Goldberg, M.D., UCSD School of Medicine and VA Medical Center, San Diego, CA)
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Moderate edema
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Massive edema
Laboratory Findings
- Labs include:
Chest X Ray
- Chest X-Ray may indicate pulmonary edema and/or cardiomegaly
Echocardiography or Ultrasound
- Duplex ultrasound for DVT
- Echocardiography for EF in patients with CHF
Other Diagnostic Studies
Treatment
Acute Pharmacotherapies
Chronic Pharmacotherapies
- DVT: Anticoagulation with unfractionated heparin, low molecular weight heparin / warfarin for 3-6 months
Indications for Surgery
- Nephrotic syndrome: transplant in adult patients may be necessary
- Cirrhosis: liver transplant may be necessary
Additional therapies
- Venous insufficiency: Leg elevation, compression stockings, minimize time standing
- Cellulitis: extremity elevation
- CHF: Salt restrictions
- Cirrhosis: Diuretics & low salt diet
Prognosis
Successful treatment depends on control of the underlying cause. Severe swelling can cause permanent damage to nerves, resulting in peripheral neuropathy. Many cases from temporary or minor causes resolve on their own, with no lasting damage.
Acknowledgements
The content on this page was first contributed by: C. Michael Gibson, M.S., M.D.
References
Additional Resources
- Cho S, Atwood J (2002). "Peripheral edema". Am J Med. 113 (7): 580–6. doi:10.1016/S0002-9343(02)01322-0. PMID 12459405.