Lower extremity swelling, also known as edema, occurs when fluid accumulates in the legs. A surprisingly wide variety of medical conditions including disorders of the following:

  • Heart
  • Kidneys
  • Liver
  • Intestinal tract
  • Muscles
  • Joints
  • Immune system
  • Lymphatic system
  • Blood vessels

These types of disorders can result in lower extremity swelling (edema).

Vein problems are a common cause of leg swelling. In many patients, leg swelling may be the only symptom of venous disease.
a woman with swollen ankles

Symptoms

Although lower extremity swelling (edema) can be asymptomatic, many patients report symptoms of:

  • heaviness
  • tiredness
  • aching discomfort
  • pain

Symptoms are typically worse towards the end of the day and tend to be exacerbated by long periods of sitting or standing.

Diagnostic Workup

The overwhelming majority of patients with lower extremity limb swelling will benefit from an evaluation with duplex ultrasound. The purpose of this test is to confirm or exclude the presence of vein problems.

Occasionally vein problems in the abdomen and pelvis can cause leg swelling. In this situation, CAT-scan imaging of the abdomen may be necessary.

On a case-by-case basis additional diagnostic testing evaluating other organ systems (such as heart function, or kidney function need to be coordinated). Cross-referral to other medical specialists is utilized when appropriate.

Lower Extremity Edema Treatment

Successful treatment of lower extremity swelling (“edema”) requires an accurate diagnosis of the underlying disease process.

If “non-vascular” causes of limb pain are diagnosed then management is directed towards that condition.

It is not uncommon to encounter patients who have been dealing with swelling for months (or even years) before seeking medical attention.  If underlying vein problems are identified the condition may be readily treatable/reversible.

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