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Patients present with an acute onset of swelling, pain, erythema, prominent tenderness, warmness and limited range of motion in both ankles. [1] [2] Lower legs and heels may also be involved, however the distal parts of feet and toes are usually spared. Patients may also experience high-graded fever, pitting edema and hypotension.
Podoconiosis causes bilateral yet asymmetrical leg swelling with overlying firm nodules. Early on, symptoms may include itching, tingling, widening of the forefoot, and swelling which then progress to soft edema, skin fibrosis, papillomatosis, and nodule formation resembling moss, giving rise to the disease's alternate name of "mossy foot" in some regions of the world. [3]
Peripheral edema is edema (accumulation of fluid causing swelling) in tissues perfused by the peripheral vascular system, usually in the lower limbs. In the most dependent parts of the body (those hanging distally ), it may be called dependent edema.
Grade 1 (mild edema): Involves the distal parts such as a forearm and hand or a lower leg and foot. The difference in circumference is less than 4 cm (1.6 in) and no other tissue changes are present. Grade 2 (moderate edema): Involves an entire limb or corresponding quadrant of the trunk. Difference in circumference is 4–6 cm (1.6–2.4 in).
Fat deposits/swelling in legs and arms not in hands or feet; hands and feet may be affected as the disease progresses. Fat deposits / swelling widespread in legs/arms/torso: Fat deposits/swelling in one limb including hands and feet: Fat deposits widespread Swelling near ankles; brownish discoloration of lower legs (hemosiderin deposits).
Edema may be described as pitting edema or non-pitting edema. [32] Pitting edema is when, after pressure is applied to a small area, the indentation persists after the release of the pressure. Peripheral pitting edema, as shown in the illustration, is the more common type, resulting from water retention.
The skin surrounding a venous ulcer may be edematous (swollen) and there may be evidence of varicose veins; the skin surrounding an arterial ulcer may be pale, cold, shiny and hairless. Both venous and arterial ulcers may be painful, however arterial ulcers tend to be more painful, especially with elevation of the leg, for example when in bed.
Chronic venous insufficiency (CVI) is a medical condition characterized by blood pooling in the veins, leading to increased pressure and strain on the vein walls. [1] The most common cause of CVI is superficial venous reflux, which often results in the formation of varicose veins, a treatable condition. [2]