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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.
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]
Bone lesions can be sclerotic, lytic with sclerotic rims, or a mixture of the two with a soup-bubble look. About half of the patients have a single bone lesion, whereas the other half have several lesions. The most prevalent locations for bone lesions are the pelvis, spine, ribs, and proximal extremities. [5]
Lymphedema can occur in both the upper and lower extremities, and in some cases, the head and neck. Assessment of the extremities first begins with a visual inspection; color, presence of hair, visible veins, size and any sores or ulcerations are noted. Lack of hair may indicate an arterial circulation problem. [34]
A. Pelvic and lower extremity radiograph shows extensive calcification of the femoral arteries. B. Translumbar aortography shows near-total obstruction of the femoral arteries. Mönckeberg's arteriosclerosis, or Mönckeberg's sclerosis, is a non-inflammatory form of arteriosclerosis (artery hardening), which differs from atherosclerosis ...
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.
Analysis of human embryological development has shown that the popliteal artery and the medial head of the gastrocnemius muscle arise at approximately the same time. Because of that, abnormal development of muscle's position in relation to the nearby vessels can result in potential vascular compromise. [ 3 ]
Excess water retention (pitting edema, due to loss of serum albumin) Susceptibility to infection (due to loss of serum antibodies) Common signs are also due to loss of blood proteins by the glomerulus of the kidney, including: [2] [5] [10] Protein in the urine (often in the nephrotic syndrome-range of >3.5 g/day) Low serum albumin (<3.5 g/dl)