1 Clinical Differential Diagnosis of the Swollen Leg H. Partsch Edema=. visible and palpable swelling caused by an increase of fluid content of the intertitium This is a symptom of an underlying disease and not a Diagnosis F ldi M et al. Urban&Fischer 2003. Causes for oedema Lymphatics are always involved Increase of lymphatic Damage of lymphatic load drainage Increase of fluid Decompensation after extravasation from the overloading blood capillaries into the Structural damage of tissue due to lymphatics Inflammation Trauma Venous-capillary LYMPHOEDEMA. hypertension OEDEMA. Different forms of swelling have different causes Clinical picture Pathogenesis Venous: DVT, PTS, CVI, VMF Reflux, Obstruction Dependency syndrome Immobile sitting Lymphedema Lymphatic damage Lipedema Fat deposition in the legs Inflammation Ischemia, infection, trauma Artificial Tourniquet Cyclical idiopathic Capillary leakage Differential Diagnosis of the Swollen leg Mainly unilateral Mainly bilateral DVT Lipedema PTS.
2 Cyclic idiopathic CVI. Angiodysplasias cardiac, renal, hepatic, Cellulitis, Arthritis dysproteinemic ACA Drugs: Cortisone, Ca Baker cyst antagonists, diuretics Lymphedema etc More important than unilateral/ bilateral: Proximal Always search for a cause! (descending). swelling exclusion of secondary . lymphedema In lymphedema especially of malignant . lymphedema Books Diseases of the Lymphatics N. Browse, K. Burnand, P. Mortimer Arnold, London, 2003. Textbook of Lymphology M. F ldi, E. F ldi, S. Kubik Urban & Fischer, M nchen, Jena, 2003.