Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Oct;35(9):650-655.
doi: 10.1177/0268355520938283. Epub 2020 Jul 6.

Diagnostic approach to lower limb edema

Antonios P Gasparis  1 , Pamela S Kim  2 , Steven M Dean  3 , Neil M Khilnani  4 , Nicos Labropoulos  1
Affiliations

Diagnostic approach to lower limb edema

Antonios P Gasparis et al. Phlebology. 2020 Oct.

Abstract

Patients with lower limb edema are frequently referred to vascular specialists for evaluation. Multiple etiologies must be considered and often more than one cause may be present. Notably, the role of lymphatic system regardless of the underlying pathology has been underestimated. A thorough history and physical examination and a carefully considered laboratory and imaging evaluation are critical in differentiating causes. In this opinion article, we propose a diagnostic algorithm that incorporates a systematic approach to the patient with leg swelling and provides an efficient pathway for the differential diagnosis for this problem.

Keywords: Chronic venous disease; lymphedema; vascular medicine.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Proposed diagnostic algorithm for chronic lower extremity swelling.
See this image and copyright information in PMC

References

    1. Dean SM, Valenti E, Hock K, et al. The clinical characteristics of lower extremity lymphedema in 440 patients. J Vasc Surg Venous Lymphat Disord 2020; 8: 851–859. - PubMed
    1. Ely JW, Osheroff JA, Chambliss ML, et al. Approach to leg edema of unclear etiology. J Am Board Fam Med 2006; 19: 148–160. - PubMed
    1. Evans NS, Ratchford EV. The swollen leg. Vasc Med 2016; 21: 562–564. - PubMed
    1. Trayes KP, Studdiford JS, Pickle S, et al. Edema: diagnosis and management. Am Fam Phys 2013; 88: 102–110. - PubMed
    1. Thaler HW, Pienaar S, Wirnsberger G, et al. Bilateral leg edema in an older woman. Z Gerontol Geriat 2015; 48: 49–51. - PubMed