LOWER-EXTREMITY EDEMA - EVALUATION AND DIAGNOSIS

Lower-extremity edema is often encountered in clinical practice and re presents a manifestation of a variety of possible disease processes. E dema results from fluid accumulation in the interstitial compartment o f the extravascular space. Clinical assessment relies on several diagn ostic modalities including history, physical examination, noninvasive vascular duplex ultrasound, computerized tomography, and magnetic reso nance imaging. Without intervention, the swollen extremity can progres s, leading to further tissue damage and permanent impairment. Determin ation of the underlying cause is necessary to maximize and specificall y guide the treatment. Peripheral edema should be classified as a unil ateral or bilateral process. Causes of unilateral lower-extremity swel ling include venous and arterial abnormalities, lymphedema, infection, trauma, and neoplasms. The possible sources of bilateral edema includ e congestive heart failure, systemic and metabolic abnormalities, endo crine dysfunction, lipedema, and pregnancy. This article reviews the c linical evaluation modalities and diagnostic standards for assessing l ower-extremity edema, as well as potential causes and differential dia gnoses.