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SWELLING OF LEGS
Leg swelling generally occurs because of an abnormal accumulation of fluid in the tissues of the lower extremity. The medical term for leg swelling from excessive fluid in the tissues is peripheral edema. Persisting indentation of a swollen leg after pressure from a finger is known as pitting edema. Common causes of leg swelling include salt retention, cellulitis, congestive heart failure, venous insufficiency, pregnancy, and medication side effects. Less common causes of leg swelling include blood clots in the leg (deep vein thrombosis), parasite infection, lymphedema, liver disease and cirrhosis, kidney disease and nephrotic syndrome, broken ankle, broken leg, and diseases that cause thickness of the layers of skin, such as scleroderma and eosinophilic fasciitis. In these diseases, the leg swelling is typically characterized by nonpitting edema. When leg swelling occurs for unknown reasons, it is referred to as idiopathic edema.Symptoms that can be associated with leg swelling include leg pain, numbness, redness, itching, rash, shortness of breath, and ulceration of the skin.
HOW IS SWELLING OF LEGS DIAGNOSED?
The diagnosis may often be clear without the need for further tests, however, potential investigations include:
Urinalysis: proteinuria suggests renal cause.
FBC: high white cell count in infection, anaemia.
Biochemistry: renal function and electrolytes (raised creatinine in renal disease), LFTs (impaired liver function and associated low albumin), glucose (infection associated with diabetes), TFTs (hypothyroidism).
Clotting screen: abnormal clotting associated with spontaneous haematoma.
CXR: pulmonary oedema.
D-dimer blood test: D-dimers are products of fibrin degradation and are raised in patients with venous thromboembolism. Sensitivity of the test is high but specificity is poor.
ECG, echocardiogram: heart failure.
Ultrasound, CT scan: haematoma, tumour, abdominal or pelvic mass.
Duplex Doppler, venography: deep vein thrombosis, arteriovenous fistula.
Lymphangiography: demonstrates cause of lymphoedema and whether due to hypoplasia or obstruction.
Lymph node biopsy: infection, tumour.
HOW IS SWELLING OF LEGS TREATED?
The treatment will focus on the cause of the swelling. The health care provider may prescribe diuretics to reduce the swelling, but these can have side effects. Home treatment for leg swelling that is not related to a serious medical condition should be tried before drug therapy.
DID YOU KNOW?
Regular exercising can prevent Swelling of Legs as it helps in maintaining a good circulation of blood.