Approach to leg edema

  • Fulvio Pomero | fulviopomero@yahoo.it Internal Medicine Department, S. Croce e Carle Hospital, Cuneo, Italy.
  • Roberta Re Internal Medicine Department, Maggiore della Carità Hospital, Novara, Italy.
  • Michele Meschi Internal Medicine Department, Santa Maria Hospital, Parma, Italy.
  • Domenico Montemurro Internal Medicine Department, S. Bortolo Hospital, Vicenza, Italy.
  • Laura Spadafora Specialty training in Internal Medicine, University of Turin, Italy.
  • Valentina Borretta Specialty training in Internal Medicine, University of Turin, Italy.
  • Monica Zampogna Specialty training in Nutrition, University of Padova, Italy.
  • Annalisa Marchetti Accident and Emergency Department, INRCA, Ancona, Italy.
  • Mariangela Di Lillo Accident and Emergency Department, Ospedali Riuniti, Marche Nord, Fano (PU), Italy.
  • Daniela Tirotta Internal Medicine Department, Hospital of Cattolica (RN), Italy.
  • Chiara Bozzano Accidents and Emergency Department, San Donato Hospital, USL 8, Arezzo, Italy.
  • Micaela La Regina Internal Medicine Department, Levante Ligure Hospital, ASL 5, La Spezia, Italy.
  • Paola Gnerre Internal Medicine Department, San Paolo Hospital, Savona, Italy.

Abstract

Edema is defined as a palpable swelling caused by an increase in interstitial fluid volume. Leg edema is a common problem with a wide range of possible causes and is the result of an imbalance in the filtration system between the capillary and interstitial spaces. Major causes of edema include venous obstruction, increased capillary permeability and increased plasma volume secondary to sodium and water retention. In both hospital and general practice, the patient with a swollen leg presents a common dilemma in diagnosis and treatment. The cause may be trivial or life-threatening and it is often difficult to determine the clinical pathway. The diagnosis can be narrowed by categorizing the edema according to its duration, distribution (unilateral or bilateral) and accompanying symptoms. This work provides clinically oriented recommendations for the management of leg edema in adults.

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Published
2017-09-11
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Section
Reviews
Keywords:
Edema, internal medicine, differential diagnosis.
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How to Cite
Pomero, F., Re, R., Meschi, M., Montemurro, D., Spadafora, L., Borretta, V., Zampogna, M., Marchetti, A., Di Lillo, M., Tirotta, D., Bozzano, C., La Regina, M., & Gnerre, P. (2017). Approach to leg edema. Italian Journal of Medicine, 11(3), 267-277. https://doi.org/10.4081/itjm.2017.771