PERIPHERAL EDEMA

Distribution of accumulated fluid is the important element in the diff erentiation of peripheral edema resulting from different etiologies. I solated upper extremity edema is rare and is usually caused by obstruc tion of the superior vena cava by a malignancy. The cause of unilatera l edema of a lower limb can usually be determined by the history (hear t, liver or kidney disease, trauma, malignancy, radiation or surgery), a physical examination (distribution of edema, stigmata of infection, trauma, malignancy or organ failure) and appropriate laboratory and o ther tests. Determining the etiology of bilateral lower extremity edem a requires a similar approach; this condition may be the result of sys temic conditions, drug use, lipidema or idiopathic edema, in addition to obstructive causes and chronic venous states. Algorithms, based on the patient's history, physical examination and diagnostic tests, can help guide physicians to the correct diagnosis.