Chronic Lower Extremity Edema

Lower limb edema .

The lower-limb edema may be unilateral or bilateral and takes on different meanings . The review will also look at whether it is of acute onset or is chronic . In all cases, we will consider whether the edema is venous or lymphatic .

Venous edema is often a soft swelling , Pitting, with increased local heat and increasing standing .

The lymphatic edema is rather firm , does not the bucket . The blue test is abnormal in that the injection of patent blue subcutaneously is not accompanied by a reduction along the lymphatic channels but spreadsheet under the skin .

LACE OF VARIOUS TESTS IMAGING

In suspected cases of phlebitis, The Doppler confirms the diagnosis and clarifies if possible the seat of the clot. If it is proximal (iliofemoral) , the risk of embolism leads to practice phlebocavographie which can be supplemented if necessary by placing a filter endoluminal .

If the edema is unilateral but chronic. The venography look for arguments in favor of a chronic phlebitis . If venography is normal , the etiology lymphatic will be demonstrated by a test and a blue lymphatic blockage by lymphography.

Edema can finally have a cause the joint compression process, especially in the scarpa ; it can be caused by arteritis or an arteriovenous malformation as Klippel-Trenaunay .

If the edema is bilateral , after eliminating the general causes , will seek a bilateral phlebitis or compression by a cave phlebocavographie. The absence of a venous anomalies will find a lymphedema and its causes . Note that the compression or invasion by a retroperitoneal process, edema is often mixed : venous and lymphatic

EVALUATION QUESTIONS

QCM 13.1: before a vein substitute suprapubic , what is the diagnosis to evoke ?

A - iliac vein thrombosis ,

B - arteritis associated ,

C - valvular insufficiency ,

D - SVC thrombosis ,

E - sural thrombosis .

QCM 13.2: Radiological signs which can be seen in the aftermath of DVT when venography performed in the lower ?

A - irregular contours venous ,

B - gaps in the image cup, surrounded by the contrast,

C - laminated aspect of the venous system ,

D - pack vascular

E - arteriovenous fistula .

QCM 13.3: A patient has bilateral edema of the lower . Phlebography revealed extrinsic compression of the inferior vena cava . The examinations for first-line guiding the etiologic diagnosis are:

A - abdominal and pelvic ultrasound ,

B - aortography ,

C - abdominopelvic CT ,

D - cavography by jugular

E - MRI pelvis .

QCM 13.4: What is the review to be carried out before a unilateral chronic swelling of the lower limb. When the Doppler is normal?

A - pelvic CT ,

B - cavography,

C - after lymphography blue test ,

D - arteriography ,

E - Monitoring .

Chronic Lower Extremity Edema

Chronic Lower Extremity Edema