lower extremity edema

Etiology

• unilateral edema
  • popliteal cyst (Baker's cyst)
  • tears of the medial head of the gastrocnemius
  • deep vein thrombosis (DVT)
  • chronic venous insufficiency
  • degenerative joint disease
    • Charcot foot
  • medial meniscus medial horn tear
  • trauma, surgery
  • lymphatic obstruction
• bilateral edema
  • generally of systemic origin (also see edema)
    • heart failure
    • pulmonary hypertension
      • obesity hypoventilation syndrome
    • cirrhosis
    • nephrotic syndrome
  • pharmaceuticals
    • Ca+2 channel blockers
      • especially amlodipine, felodipine, nifedipine
    • gabapentin, pregabalin
    • NSAIDs
    • hydralazine
    • clonidine
    • minoxidil
    • carbenicillin, amantadine
    • androgens (testosterone), estrogens, progestins
    • glucocorticoids
    • aromatase inhibitors, tamoxifen
    • alpha-blockers, beta blockers, hydralazine, diazoxide
    • phenothiazines, thioridazine, lithium
    • reserpine, guanethidine, MAO inhibitors
    • thiazolidinediones (pioglitazone)
    • insulin
    • dopamine agonists
      • bromocriptine, pramipexole, ropinirole

Clinical manifestations

• bilateral edema
  • pedal edema, pitting edema
  • painless
  • periorbital edema suggests thyroid disease
  • orthopnea or paroxysmal nocturnal dyspnea suggests heart failure

Laboratory

• urinalysis
• serum creatinine
• serum albumin
• serum transaminases
• serum sodium, serum potassium
• thyroid function testing

Management

• bilateral pedal edema & bilateral lower extremity edema in general
  • conservative measures:
    • sodium restriction
    • leg elevation
    • weight reduction
    • compression stockings
• specific measures for specifc etiologies
  • see venous stasis & venous stasis dermatitis

More general terms

• peripheral edema

Additional terms

• deep vein thrombosis (DVT)
• gastrocnemius muscle tear
• Morrant Baker (popliteal) cyst or pseudothrombophlebitis syndrome
• osteoarthritis (OA)
• venous stasis; venous hypertension