Unilateral leg swelling - Revision history

Danbot: Add verified PubMed references (PMIDs 38601427, 24264570)

2026-03-22T10:44:23Z

Add verified PubMed references (PMIDs 38601427, 24264570)

← Revisión anterior		Revisión del 10:44 22 mar 2026
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	==Background==		==Background==
	*Unilateral leg swelling is a common ED complaint		*Unilateral leg swelling is a common ED complaint<ref>Markarian B, et al. Assessment Modalities for Lower Extremity Edema, Lymphedema, and Lipedema: A Scoping Review. Cureus. 2024 Mar;16(3):e55906. PMID 38601427</ref>
	*The critical EM concern is ruling out [[deep vein thrombosis]] (DVT), which can lead to [[pulmonary embolism]]		*The critical EM concern is ruling out [[deep vein thrombosis]] (DVT), which can lead to [[pulmonary embolism]]<ref>Schellong SM, et al. [Leg swelling]. Internist (Berl). 2013 Nov;54(11):1294-303. PMID 24264570</ref>
	*Other important causes include [[cellulitis]], [[compartment syndrome]], ruptured [[Baker's cyst]], and [[necrotizing fasciitis]]		*Other important causes include [[cellulitis]], [[compartment syndrome]], ruptured [[Baker's cyst]], and [[necrotizing fasciitis]]
	*Further classified as pitting (compressible) and non-pitting (lymphedema, myxedema)		*Further classified as pitting (compressible) and non-pitting (lymphedema, myxedema)

Danbot: Strip excess bold text

2026-03-22T09:24:37Z

Strip excess bold text

← Revisión anterior		Revisión del 09:24 22 mar 2026
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	==Background==		==Background==
	*Unilateral leg swelling is a common ED complaint		*Unilateral leg swelling is a common ED complaint
	*The critical EM concern is ruling out ~~'''~~[[deep vein thrombosis]] (DVT)~~'''~~, which can lead to [[pulmonary embolism]]		*The critical EM concern is ruling out [[deep vein thrombosis]] (DVT), which can lead to [[pulmonary embolism]]
	*Other important causes include [[cellulitis]], [[compartment syndrome]], ruptured [[Baker's cyst]], and [[necrotizing fasciitis]]		*Other important causes include [[cellulitis]], [[compartment syndrome]], ruptured [[Baker's cyst]], and [[necrotizing fasciitis]]
	*Further classified as pitting (compressible) and non-pitting (lymphedema, myxedema)		*Further classified as pitting (compressible) and non-pitting (lymphedema, myxedema)
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	===Red Flags===		===Red Flags===
	*~~'''~~[[Compartment syndrome]]~~'''~~: pain out of proportion, tense swelling, pain with passive stretch, paresthesias		*[[Compartment syndrome]]: pain out of proportion, tense swelling, pain with passive stretch, paresthesias
	*~~'''~~[[Necrotizing fasciitis]]~~'''~~: pain out of proportion, crepitus, rapidly spreading erythema, systemic toxicity		*[[Necrotizing fasciitis]]: pain out of proportion, crepitus, rapidly spreading erythema, systemic toxicity
	*~~'''~~Phlegmasia cerulea dolens~~'''~~: massive DVT with cyanotic, severely swollen limb, risk of limb loss		*Phlegmasia cerulea dolens: massive DVT with cyanotic, severely swollen limb, risk of limb loss

	==Differential Diagnosis==		==Differential Diagnosis==
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	==Evaluation==		==Evaluation==
	===DVT Assessment===		===DVT Assessment===
	*Apply ~~'''~~Wells criteria~~'''~~ for DVT pretest probability		*Apply Wells criteria for DVT pretest probability
	**Low probability: obtain [[D-dimer]]; if negative, DVT effectively excluded		**Low probability: obtain [[D-dimer]]; if negative, DVT effectively excluded
	**Moderate/high probability: proceed directly to [[DVT ultrasound\|compression ultrasound]]		**Moderate/high probability: proceed directly to [[DVT ultrasound\|compression ultrasound]]
	*~~'''~~[[DVT ultrasound]]~~'''~~ (compression ultrasound) is the diagnostic study of choice		*[[DVT ultrasound]] (compression ultrasound) is the diagnostic study of choice
	**Sensitivity >95% for proximal DVT		**Sensitivity >95% for proximal DVT
	**If negative but clinical suspicion remains high, consider repeat in 5-7 days or whole-leg ultrasound		**If negative but clinical suspicion remains high, consider repeat in 5-7 days or whole-leg ultrasound
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	===Compartment Syndrome===		===Compartment Syndrome===
	*~~'''~~Emergent surgical consultation for fasciotomy~~'''~~		*Emergent surgical consultation for fasciotomy
	*Remove all constrictive dressings/casts		*Remove all constrictive dressings/casts
	*Do not elevate above heart level		*Do not elevate above heart level

Danbot: Expanded with EM-focused content: Wells criteria, DVT evaluation, red flags, compartment syndrome, management, disposition

2026-03-20T23:27:42Z

Expanded with EM-focused content: Wells criteria, DVT evaluation, red flags, compartment syndrome, management, disposition

@@ Línea 1: / Línea 1: @@
 ==Background==
-*Definition: existence of the excess fluid in the lower extremity resulting in swelling of the feet and extending upward
+*Unilateral leg swelling is a common ED complaint
-**Further classified as pitting (depress-able) and non-pitting
+*The critical EM concern is ruling out '''[[deep vein thrombosis]] (DVT)''', which can lead to [[pulmonary embolism]]
+*Other important causes include [[cellulitis]], [[compartment syndrome]], ruptured [[Baker's cyst]], and [[necrotizing fasciitis]]
 {{Causes Pedal Edema}}
 ==Clinical Features==
 [[File:PedalEdema.jpg|thumb|Pitting pedal edema]]
-*Unilateral leg swelling
+*Measure and compare calf circumferences (>3cm difference is significant)
 ==Differential Diagnosis==
@@ Línea 13: / Línea 34: @@
 ==Evaluation==
-*[[DVT ultrasound|Ultrasound to rule-out DVT]]
+===DVT Assessment===
-*Consider x-rays
+*Apply '''Wells criteria''' for DVT pretest probability
 ==Management==
-*Treatment is based on addressing underlying disease process
+===DVT===
-*Idiopathic edema is a diagnosis of exclusion.  Other disease process, including heart failure, cirrhosis, acute renal failure, nephrotic syndrome, chronic venous insufficiency, and medication induced edema must first be considered.<ref>Kay A, Davis CL. Idiopathic Edema. American Journal of Kidney Disease. 1999; 34(3): 405-408.</ref>
+*Anticoagulation: see [[Deep vein thrombosis]] for detailed management
-**Idiopathic pedal edema need not to be treated with diuretics
+*Elevation, analgesia
 ==Disposition==
-*If no respiratory symptoms, most patients may be safely discharged home
+===Admit===
-**Patients should be followed up in medical clinic for further investigation and care
+*Proximal DVT with hemodynamic compromise or phlegmasia
 ==See Also==
-*[[Bilateral pedal edema]]
+*[[Deep vein thrombosis]]
 ==External Links==

Rossdonaldson1: /* Differential Diagnosis */

2017-08-24T02:06:34Z

Differential Diagnosis

@@ Línea 10: / Línea 10: @@
 ==Differential Diagnosis==
-===[[Unilateral leg swelling]]===
+{{Unilateral leg swelling DDX}}
 ==Evaluation==

Rossdonaldson1: /* Differential Diagnosis */

2017-08-24T02:06:13Z

Differential Diagnosis

← Revisión anterior		Revisión del 02:06 24 ago 2017
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	==Differential Diagnosis==		==Differential Diagnosis==
	===[[~~Pedal edema~~]]===		===[[Unilateral leg swelling]]===
	[[File:Differential Diagnosis of Lower Extremity Edema.png\|thumb\|Differential Diagnosis of Pedal Edema]]		[[File:Differential Diagnosis of Lower Extremity Edema.png\|thumb\|Differential Diagnosis of Pedal Edema]]
	*Gravitational		*Gravitational

Rossdonaldson1: /* Evaluation */

2017-08-24T02:02:08Z

Evaluation

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	==Evaluation==		==Evaluation==
	*Ultrasound rule-out DVT		*[[DVT ultrasound\|Ultrasound to rule-out DVT]]
	*Consider x-rays		*Consider x-rays

Rossdonaldson1: /* Evaluation */

2017-08-24T02:01:20Z

Evaluation

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	==Evaluation==		==Evaluation==
	*~~CBC~~		*Ultrasound rule-out DVT
	*Chem 7		*Consider x-rays
	*PT vs albumin (liver)
	*[[ECG]]
	*[[CXR]]
	*[[UA]] (nephrotic)
	*Consider ~~[[BNP]]~~

	==Management==		==Management==

Rossdonaldson1: /* Clinical Features */

2017-08-24T01:59:42Z

Clinical Features

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	==Clinical Features==		==Clinical Features==
	[[File:PedalEdema.jpg\|thumb\|Pitting pedal edema]]		[[File:PedalEdema.jpg\|thumb\|Pitting pedal edema]]
	*~~Pedal edema~~		*Unilateral leg swelling

	==Differential Diagnosis==		==Differential Diagnosis==

Rossdonaldson1 at 01:58, 24 August 2017

2017-08-24T01:58:51Z

← Revisión anterior		Revisión del 01:58 24 ago 2017
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	==Background==		==Background==
	~~[[File:Mechanisms of Lower Extremity Edema.png\|thumb\|Mechanisms of Pedal Edema]]~~
	*Definition: existence of the excess fluid in the lower extremity resulting in swelling of the feet and extending upward		*Definition: existence of the excess fluid in the lower extremity resulting in swelling of the feet and extending upward
	**Further classified as pitting (depress-able) and non-pitting		**Further classified as pitting (depress-able) and non-pitting

	{{Causes Pedal Edema}}		{{Causes Pedal Edema}}
	~~===Causes Pedal Edema===~~
	*Increased hydrostatic pressure
	*Decreased oncotic pressure
	*Increased capillary permeability
	*Lymphatic obstruction

	==Clinical Features==		==Clinical Features==

Rossdonaldson1 at 01:43, 24 August 2017

2017-08-24T01:43:54Z

← Revisión anterior		Revisión del 01:43 24 ago 2017
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	**Further classified as pitting (depress-able) and non-pitting		**Further classified as pitting (depress-able) and non-pitting

	===Causes===		{{Causes Pedal Edema}}
			===Causes Pedal Edema===
	*Increased hydrostatic pressure		*Increased hydrostatic pressure
	*Decreased oncotic pressure		*Decreased oncotic pressure