The fluid between the interstitial and intravascular spaces is regulated by the capillary hydrostatic pressure gradient and the oncotic pressure gradient across the capillary. Use of pneumatic compression devices or compression stockings may be helpful in these cases.Įdema is an accumulation of fluid in the intercellular tissue that results from an abnormal expansion in interstitial fluid volume. Possible secondary causes of lymphedema include tumor, trauma, previous pelvic surgery, inguinal lymphadenectomy, and previous radiation therapy.
PITTING EDEM SKIN
Brawny, nonpitting skin with edema characterizes lymphedema, which can present in one or both lower extremities. Obstructive sleep apnea may cause bilateral leg edema even in the absence of pulmonary hypertension. If clinical suspicion for deep venous thrombosis remains high after negative results are noted on duplex ultrasonography, further investigation may include magnetic resonance venography to rule out pelvic or thigh proximal venous thrombosis or compression. Patients who have had deep venous thrombosis should wear compression stockings to prevent postthrombotic syndrome. Eczematous (stasis) dermatitis can be managed with emollients and topical steroid creams. Skin care is crucial in preventing skin breakdown and venous ulcers. The chronic accumulation of edema in one or both lower extremities often indicates venous insufficiency, especially in the presence of dependent edema and hemosiderin deposition.
The rapid development of generalized pitting edema associated with systemic disease requires timely diagnosis and management. Edema is an accumulation of fluid in the interstitial space that occurs as the capillary filtration exceeds the limits of lymphatic drainage, producing noticeable clinical signs and symptoms.
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