Edema Flashcards
Causes of bilateral pedal edema
Medications like ( NSAIDS, birth control, steroids Bilateral deep vein thrombosis Venous insufficiency Congestive Heart failure Liver disease Lymphedema Pregnancy
Acute bilateral pedal edema causes swelling of the feet due to medication or bilateral DVT (Deep vein thrombosis). Bilateral Chronic pedal edema in older people may be due to venous insufficiency. It could also be due to heart failure or in some rare cases, systemic reasons like renal or liver disease.
Causes of Unilateral pedal edema
Define the following below.
Deep vein thrombosis
Trauma
Lymphoedema
Venouse insufficiency
Deep vein thrombosis: A blood clot in a deep vein, usually in the legs.
This condition is serious because blood clots can loosen and lodge in the lungs.
Trauma: physical injury. Injury to the body, or an event that causes long-lasting mental or emotional damage.
Lymphedema:
Swelling in an arm or leg caused by a lymphatic system blockage.
The condition is caused by a blockage in the lymphatic system, part of the immune and circulatory systems. Lymphoedema is most commonly caused by lymph node removal or damage due to cancer treatment.
Venous insufficiency: Improper functioning of the vein valves in the leg, causing swelling and skin changes.
Normally, the vein valves keep blood moving back towards the heart.
Lymphedema Cause Signs and symptoms Investigations Complications Differential diagnosis Management Risk factors
Lymphedema refers to tissue swelling caused by an accumulation of protein-rich fluid that’s usually drained through the body’s lymphatic system. It most commonly affects the arms or legs, but can also occur in the chest wall, abdomen, neck and genitals.
Lymph nodes are an important part of your lymphatic system. Lymphedema can be caused by cancer treatments that remove or damage your lymph nodes. Any type of problem that blocks the drainage of lymph fluid can cause lymphedema.
Cause
The most common causes of lymphedema include:
Cancer. If cancer cells block lymph vessels, lymphedema may result. For instance, a tumor growing near a lymph node or lymph vessel could enlarge enough to block the flow of the lymph fluid.
Radiation treatment for cancer. Radiation can cause scarring and inflammation of lymph nodes or lymph vessels.
Surgery. In cancer surgery, lymph nodes are often removed to see if the disease has spread. However, this doesn’t always result in lymphedema.
Parasites. In developing countries in the tropics, the most common cause of lymphedema is infection with threadlike worms that clog the lymph nodes.
Less commonly, lymphedema results from inherited conditions in which the lymphatic system doesn’t develop properly.
Signs and symptoms
The main symptom is swelling in an arm or leg that may be accompanied by pain or discomfort.
Symptoms Parts of the immune system Parts of the immune system Open pop-up dialog box A person with leg lymphedema Leg lymphedema Open pop-up dialog box Lymphedema signs and symptoms include:
Swelling of part or all of the arm or leg, including fingers or toes
A feeling of heaviness or tightness
Restricted range of motion
Recurring infections
Hardening and thickening of the skin (fibrosis)
Signs and symptoms can range from mild to severe. Lymphedema caused by cancer treatment may not occur until months or years after treatment.
Investigations
Lymphedema can be confirmed by a lymphoscintigram, computed tomography, magnetic resonance imaging, or ultrasound. The lymphatic anatomy is demonstrated with lymphoscintigraphy, which is particularly indicated if surgical intervention is being considered. The treatment of choice for lymphedema is multidisciplinary.
Complications
Lymphedema complications may include:
Skin infections (cellulitis). The trapped fluid provides fertile ground for germs, and the smallest injury to the arm or leg can be an entry point for infection. Affected skin appears swollen and red and is typically painful and warm to the touch. Your doctor may prescribe antibiotics to keep on hand so that you can start taking them immediately.
Sepsis. Untreated cellulitis can spread into the bloodstream and trigger sepsis — a potentially life-threatening condition that occurs when the body’s response to an infection damages its own tissues. Sepsis requires emergency medical treatment.
Leakage through the skin. With severe swelling, the lymph fluid can drain through small breaks in the skin or cause blistering.
Skin changes. In some people with very severe lymphedema, the skin of the affected limb can thicken and harden so it resembles the skin of an elephant.
Cancer. A rare form of soft tissue cancer can result from the most-severe cases of untreated lymphedema.
Differential diagnosis
The differential diagnosis of lymphedema includes: capillary malformation, CLOVES syndrome, hemihypertrophy, infantile hemangioma, kaposiform hemangioendothelioma, Klippel–Trénaunay syndrome, lipedema, lipofibromatosis, microcystic/macrocystic lymphatic malformation, obesity, Parkes Weber syndrome, systemic diseases (e.g., cardiac, renal, hepatic, rheumatological), trauma, venous malformation, and venous insufficiency.
Management
Treatment of lymphedema includes treating swelling and prevention of infections. Exercise, compression garments and pumps, manual lymph drainage, meticulous skin care, therapy and a healthy lifestyle can all help control your swelling.
Risk factors Factors that may increase the risk of developing lymphedema include: Older age Excess weight or obesity Rheumatoid or psoriatic arthriti
