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[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. The clinical presentation usually resembles cellulitis, however bilateral involvement is a differentiating feature.
Bilateral lower extremity inflammatory lymphedema (BLEIL) is a distinct type of lymphedema occurring in a setting of acute and prolonged standing, such as in new recruits during basic training. [28] Possible underlying mechanisms may include venous congestion and inflammatory vasculitis.
Edema may be described as pitting edema, or non-pitting edema. [32] Pitting edema is when, after pressure is applied to a small area, the indentation persists after the release of the pressure. Peripheral pitting edema, as shown in the illustration, is the more common type, resulting from water retention.
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.
edema (swelling) erythema (redness) ulcers – arterial ulcers tend to be on the borders / sides of the foot, neuropathic ulcers on the plantar surface of the foot, venous ulcers tend on be on the medial aspect of the leg superior to the medial malleolus. hair – hair is absent in peripheral vascular disease (PVD) shiny skin – seen in PVD
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]
[44] [45] Bilateral DVT refers to clots in both limbs while unilateral means only a single limb is affected. [46] DVT in a leg above the knee is termed proximal DVT . DVT in a leg below the knee is termed distal DVT , also called calf DVT when affecting the calf, [47] [48] and has limited clinical significance compared to proximal DVT. [49]
[19] [20] Both ovarian and internal iliac vein reflux causes leg varicose veins. This condition affects 14% of women with varicose veins or 20% of women who have had vaginal delivery and have leg varicose veins. [21] In addition, evidence suggests that failing to look for and treat pelvic vein reflux can be a cause of recurrent varicose veins. [22]
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