Peripheral Edema - Differential Diagnosis Framework for Lower Extremity Edema Edema occurs when any of the following conditions exist: (1) Increased capillary hydrostatic pressure (2) Increased plasma volume (3) Decreased plasma oncotic pressure (hypoalbuminemia) (4) Increased capillary permeability (5) Lymphatic obstruction Unilateral Lower Extremity Edema: • DVT • CHF • Cellulitis • Venous insufficiency • Varicose veins • May-Thurner Syndrome • Complex regional pain syndrome type 1 (reflex sympathetic dystrophy) • Compartment syndrome • Lymphedema (Non-pitting) • Neoplasm Bilateral Lower Extremity Edema: • CHF • Cirrhosis • Nephrotic Syndrome • SVC syndrome • DVT: Bilateral • Protein-losing enteropathy • Venous insufficiency • Medications • Preeclampsia • Lipema • Capillary leak syndrome • Lymphedema (Non-pitting) • Pre-tibial Myxedema; (Non-pitting) • Allergic reaction, urticaria, and angioedema Note: • Left leg often swells first, stays slightly more swollen and the edema resolves after the right leg with diuresis • This is due to the compression of the left iliac vein which crosses under the right common iliac artery anteriorly causing compression/stasis. by Dr. Ravi Singh @rav7ks and Dr. Zaven Sargsyan @sargsyanz #Peripheral #Edema #differential #diagnosis #unilateral #Bilateral #Lower #Extremity #PhysicalExam #Pathophysiology
