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Patients present with an acute onset of swelling, pain, erythema, prominent tenderness, warmness and limited range of motion in both ankles. [1] [2] Lower legs and heels may also be involved, however the distal parts of feet and toes are usually spared. Patients may also experience high-graded fever, pitting edema and hypotension.
Leg edema Peripheral edema is edema (accumulation of fluid causing swelling) in tissues perfused by the peripheral vascular system , usually in the lower limbs . In the most dependent parts of the body (those hanging distally ), it may be called dependent edema.
The lymphatic system slowly removes excess fluid and proteins from the veins in the lower legs towards the upper body; however, as it is not as efficient as an unimpaired circulatory system, swelling (edema) is visible, particularly in the ankles and lower leg.
As a part of the initial work-up before diagnosing lymphedema, it may be necessary to exclude other potential causes of lower extremity swelling such as kidney failure, hypoalbuminemia, congestive heart-failure, protein-losing kidney disease, pulmonary hypertension, obesity, pregnancy and drug-induced edema. [citation needed]
Swelling from fluid (edema) can result in "pitting" after pressure is applied. If this occurs only on one side, it raises the likelihood of DVT. Symptoms classically affect a leg and typically develop over hours or days, [ 20 ] though they can develop suddenly or over a matter of weeks. [ 21 ]
Podoconiosis causes bilateral yet asymmetrical leg swelling with overlying firm nodules. Early on, symptoms may include itching, tingling, widening of the forefoot, and swelling which then progress to soft edema, skin fibrosis, papillomatosis, and nodule formation resembling moss, giving rise to the disease's alternate name of "mossy foot" in some regions of the world. [3]
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