Unilateral leg swelling pdf

Unilateral leg swelling in a diabetic should suggest a muscle infarct. Unilateral leg edema is generally due to a local cause such as deep vein thrombosis, venous insufficiency, or lymphedema. Unilateral leg swelling and hydronephrosis article pdf available in qjm. A case that demonstrates this condition is described. No fevers and reports she gets chills at times but doesnt feel well right now. Lymphedema praecox is usually unilateral and is limited to the foot and calf in most patients. In this case, the edema is mostly limited to the feet or ankles and usually affects only one side the left or right. Doppler ultrasonography ruled out deep vein thrombosis. Jul 14, 2016 unilateral leg swelling secondary to venous insufficiency margaret clarke tracci and julie armatas presentation a 33yearold woman with no past medical history presents with pain, swelling, and heaviness of her left leg. Diagnosis and management american family physician.

Leg swelling causes mayo clinic mayo clinic mayo clinic. Edema visible and palpable swelling caused by an increase of fluid content of the intertitium this is a symptom of an underlying. Follicular lymphoma recurrence presenting as unilateral. Unilateral leg swelling in an adolescent girl rheumatology. Magnetic resonance venography of the lower extremity and pelvis should be obtained in patients with unilateral left leg swelling and negative results on duplex ultrasonography if there is high. There was no history of fever, trauma, local foot infection, pain in the limb or difficulty in walking. It didnt help and the entire right leg up till my knee soon went numb. However, bilateral swelling from systemic causes may be much more obvious on one side than the other and therefore can appear to be unilateral swelling.

Case report a 23yearold woman presented at the clinic with worsening swelling and tenderness and easy bruising in her left leg and ankle ongoing for 6 months. Edema is defined as a palpable swelling produced by expansion of the interstitial fluid volume. The diagnosis can be narrowed by categorizing the edema according to its duration, distribution unilateral or bilateral and accompanying. If yes, refer to the emergency department rather than the slc. She reported discomfort and pain in the calf and upper thigh. Ankle swelling may be the result of local, regional or systemic disease. Department of hospital medicine, cleveland clinic foundation, 9500 euclid avenue, mail code a, cleveland, oh 44195, usa. Discuss causes of both unilateral and bilateral leg swelling. Atypical lymphoedema was suspected and a lymphangiogram was performed. Jan, 2014 unilateral leg lymphoedema may occur secondary to radiation, surgery, compression by a tumour or early filariasis infection.

It can be caused by a problem with the circulatory system, the lymphatic system or the kidneys. Pdf unilateral leg swelling and hydronephrosis mohamad. As a rare cause of unilateral leg swelling, extrinsic vein compression caused by intraperitoneal, retroperitoneal, or inguinal lesions has been noted. Her left leg had been larger than the right since birth. A 73yearold man with a history of follicular lymphoma ten years ago with complete remission presented to the emergency room with a large unilateral leftleg swelling as the only symptom. It tends to be unilateral and the extent, site and number of previous episodes will determine the degree of swelling. Unilateral leg swelling and redness digital nomad physician. Many factors varying greatly in seriousness can cause leg swelling. Brawny, nonpitting skin with edema characterizes lymphedema, which can present in one or both lower extremities. Unilateral leg lymphoedema may occur secondary to radiation, surgery, compression by a tumour or early filariasis infection. In general, chronic swelling of one leg is more likely to be local whereas bilateral swelling usually has a systemic cause such as cardiac failure, but may be due to a local or lymphatic problem.

Table 1 lists the most common causes of leg oedema that present to gps today. Common causes of unilateral leg swelling and pain legit. Disease childhood the swollen leg and primary lymphoedema. Approach to leg edema of unclear etiology american board of. It is important to be aware of other causes of the unilateral swollen leg to avoid unnecessary anticoagulation and potential missed diagnosis. Hypoproteinaemia malnutrition, nephrotic syndrome, liver failure, etc. The presentation of unilateral leg swelling is commonly encountered clinical practice, with deep vein thrombosis dvt often raised as the main diagnosis. Bilateral swelling is more commonly due to systemic conditions whereas unilat eral swelling more often. Deep venous thrombosis dvt is a prominent cause of lower limb swelling. A 9yearold girl presented with a 10day history of swelling of the left leg that occurred spontaneously and gradually increased in size by 33%. Common and important causes of unilateral leg swelling for doctors and medical students this page is currently being written and will be available soon. She first noticed these symptoms 4 years ago after giving birth to her second child.

Approach to leg edema of unclear etiology journal of the. There is little guidance for the utility of bnp levels in identifying hf in patients that present primarily with leg edema and without dyspnea. She had unilateral, right, lower limb oedema extending upto the knee and pitting in nature. Unilateral leg swelling in an infant adc education. Discoloration of bruising was found above the ankle figure 1.

Jul 26, 2012 unilateral leg swelling and hydronephrosis article pdf available in qjm. The incidence of deep venous thrombosis in children is low and lymphoedema may be a more appropriate diagnosis. A ct of the abdomen showed a bulky soft tissue mass in the region of. Bilateral edema can be due to a local cause or systemic disease, such as heart failure or kidney disease. Leg swelling caused by the retention of fluid in leg tissues is known as peripheral edema. While it is common to have swollen lower extremities postpartum as fluid shifts occur after delivery, this is usually bilateral. A variety of conditions cause unilateral leg swelling and thus mimic deep venous thrombosis dvt. A variety of clinical conditions are associated with the development of edema, including heart failure, cirrhosis, and the nephrotic syndrome, as well as local conditions. Lymphoedema was suspected and lymphatic obstruction confirmed by lymphoscintigraphy, no obvious lymphatic vessels being identified. To be updated when it is complete please like us on facebook, follow us on twitter or subscribe on youtube using the follow us buttons.

Jan 12, 2019 4 possible unilateral upper leg swelling causes the list below shows results from the use of our quiz by buoy users who experienced unilateral upper leg swelling. Bedside pointofcare ultrasound pocus revealed left moderate hydronephrosis. In three of these patients, the diagnosis of lymphoma was overlooked during the initial presentation, and appropriate therapy not given at that time. Unilateral leg edema is a frequent clinical problem, usually reflecting underlying vascular disease. Obstructive sleep apnea may cause bilateral leg edema even in the absence of pulmonary hypertension. Lowerextremity edema during late pregnancy gynecology.

Unilateral edema of the lower extremity symptom checker. Not infrequently, and at times unexpectedly, a different pathology can be encountered. Physiologic edema results from hormoneinduced sodium retention. Differential diagnosis for unilateral leg swelling. Leg swelling isnt always a sign of a heart or circulation problem.

If the swelling is unilateral andor accompanied by pain, would recommend seeking evaluation to confirm not a deep vein. Unilateral lower extremity lymphoedema has been reported as a rare initial presentation for lymphoma, mostly in women, usually without bsymptoms, and often with inguinal lymphadenopathies or abdominal masses. Peripheral edema refers to swelling in your lower legs or hands, and it can have a variety of causes ranging from mild to serious. Hypertrophy of soft tissue or bone klippeltrenaunay syndrome overgrowth of body part proteus syndrome postthrombotic syndrome. The arm swelling resolved spontaneously, but, a few months later, moderately painful leg swelling occurred. Swelling in one leg during pregnancy doctor answers. They usually cause bilateral leg swelling, but, as we have said before, sometimes it is hard to tell bilateral swelling from unilateral. Differential diagnosis of acute calf pain and swelling with.

Right leg pain and swelling and redness and warmth 46 yo female with sudden onset right lower leg pains and chills. Differential diagnosis of the swollen leg mainly unilateral dvt pts cvi. Approach to leg edema of unclear etiology american board. Unilateral leg swelling is a very rare clinical feature in patients with ureteral cancer, caused by direct invasion or metastatic lymphadenopathy can result in. Pain or tenderness in the leg which may be felt only when standing or walking. Deep vein thrombosis remains one of the more common and clinically significant causes, particularly in view of the associated risk of pulmonary embolization. It typically involves the lower extremities but occasionally appears as swelling or puffiness in the face or hands.

Unilateral swelling of the leg andor foot or along a vein in the leg. There was no circulatory compromise of the left leg, and he. See detailed information below for a list of 7 causes of swelling in one leg, symptom checker, including diseases and drug side effect causes. However, studies have demonstrated that congestion may precede symptoms of hf by 7 to 10 days and that rising bnp levels in patients with chf are at higher risks for decompensation. Bilateral edema can be due to a local cause or systemic disease, such as heart failure. Bilateral swelling is more commonly due to systemic conditions whereas unilateral swelling more often represents local pathology.

A 25yearold female having asymptomatic edema of unilateral leg was provisionally diagnosed as a case of psoas abscess. This article describes an uncommon cause of this presentation, malignant lymphoma, in ten cases. Treatment is based on addressing underlying disease process. If bilateral, do not refer to slc has it been greater than 4 weeks since the onset of swelling. My doctor thought it was a torn nerve and gave naproxen.

A 73yearold man presented to the emergency room with a massive unilateral left leg swelling that had started two months ago. Unilateral pitting edema of the leg as a manifestation of. The familial form of lymphedema praecox is an autosomal dominant disorder known as. An often missed etiology for unilateral painful swollen leg. Imaging of the unilateral swollen painful lower leg. On presentation, his vital signs were stable and physical exam was remarkable for left leg pitting edema and tenderness to palpation of left calf with purple discoloration. Differential diagnosis for unilateral leg swelling oxford. He had been treated for follicular lymphoma ten years ago with a complete course of chemotherapy, which had led to complete remission, his medical history also included laparoscopic cholecystectomy, chronic kidney disease, and parkinsonism for which he was on medication. Pdf edema is defined as a palpable swelling caused by an increase in interstitial fluid volume. If yes, do not refer to slc does the patient have symptoms of pulmonary embolism.

Swelling in one leg refers to puffiness or enlargement of one leg. Obesity is associated with sleep apnea and venous insufficiency. Although this disorder has been reported only three times before. Physical examination revealed a swollen left calf with a circumference 4 cm larger than the unaffected side. The diagnosis is confirmed by mri which shows the mass with high signal intensity in t2weighted images and gadolinium enhancement. Doctors give trusted, helpful answers on causes, diagnosis, symptoms, treatment, and more. Unilateral leg swelling secondary to venous insufficiency margaret clarke tracci and julie armatas presentation a 33yearold woman with no past medical history presents with pain, swelling, and heaviness of her left leg. Leg edema is a common problem with a wide range of. Etiology onset and location examination findings evaluation methods treatment. Lymphoedema of the lower extremities is usually bilateral.

Unilateral leg swelling secondary to venous insufficiency. The rest of the history and examination were unremarkable. Unilateral leg swelling caused by common femoral vein. Children who present with unilateral or bilateral swelling of the legs are often suspected of having a deep venous thrombosis. Often, its due to factors you can change or a situation that. Remarkably, she had developed pitting edema of her left leg four months. This presentation is contrary to usual age and mode of presentation of nonhodgkins lymphoma. Jul 15, 20 unilateral swelling from compression or compromise of venous or lymphatic drainage can result from dvt, venous insufficiency, venous obstruction by tumor e. The most common causes of unilateral leg swelling are deep vein thrombosis dvt, bakers cyst, and cellulitis. Graves hyperthyroidism has a number of wellrecognized but relatively rare extrathyroid manifestations such as thyroid acropachy, pretibial myxedema, and congestive heart failure. Leg swelling can occur with varicose veins simply as a consequence of venous stasis and venous hyperten sion that develops as a consequence of valve. Diagnosis and management of common causes of localized edema. Mar 25, 2020 many factors varying greatly in seriousness can cause leg swelling.

Feb 22, 2016 unilateral leg swelling is more often due to local causes eg, deep vein thrombosis or cellulitis. An obscure cause of leg edema, nonhodgkins lymphoma. The skin of the left lower leg was pink and hot, and pitting oedema was noted. Later, she turned out to be a case of nonhodgkins lymphoma. There was pain on weight bearing and he walked with a limping gait. An international journal of medicine 1067 july 2012 with 297 reads how we measure reads. Differential diagnosis of the swollen leg mainly unilateral dvt pts cvi angiodysplasias cellulitis, arthritis aca baker cyst lymphedema mainly bilateral lipedema cyclic idiopathic cardiac, renal, hepatic, dysproteinemic drugs. Check the full list of possible causes and conditions now. An 8monthold boy presented with a weeks history of left lower limb swelling. We therefore suggest that diffuse soft tissue edema, with in. He was apyrexic, well and developmentally age appropriate. Deep vein obstruction and leg swelling caused by femoral.

Jul 19, 2015 right leg pain and swelling and redness and warmth 46 yo female with sudden onset right lower leg pains and chills. Oedema can be classified as venous oedema and lymphoedema. Edema can also develop as a result of a blood clot in the deep veins of the lower leg called deep vein thrombosis dvt. Practical approach to lower extremity edema anmed health. Bilateral lower extremity us in the patient with unilateral symptoms of deep venous thrombosis.

Differential diagnosis of acute calf pain and swelling. We present two cases of a unilateral leg swelling of unusual aetiology as a reminder to the. This list does not constitute medical advice and may not accurately represent what you have. Most unilateral lower limb swelling is the result of deep vein thrombosis or lymphatic disorders. Unilateral numbness, stiffness, and swelling whyme0506. Evaluation of the swollen leg american society of podiatric. The symptoms worsened as the day progressed and improved at night.

A heretoforeunderappreciated condition that may lead to unilateral iliac vein compression, simulating dvt, is massive enlargement of the bladder caused by urinary retention. Clinical differential diagnosis of the swollen leg h. The patient had noticed this swelling since 3 days. The causes of unilateral leg swelling are numerous, and many previous articles have addressed this topic. Unilateral numbness, stiffness, and swelling neurology. A 38yearold caucasian woman presented to the outpatient clinic with symptoms of hyperthyroidism lasting for approximately five months. Unilateral swelling of the leg andor foot or along a vein ppt. Pdf an often missed etiology for unilateral painful. Follicular lymphoma recurrence presenting as unilateral leg. Unilateral iliac vein occlusion, caused by bladder.