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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.
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 legs and face are the most common sites involved, although cellulitis can occur on any part of the body. [1] The leg is typically affected following a break in the skin. [1] Other risk factors include obesity, leg swelling, and old age. [1] For facial infections, a break in the skin beforehand is not usually the case. [1]
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]
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.
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Chronic venous insufficiency (CVI) is a medical condition characterized by blood pooling in the veins, leading to increased pressure and strain on the vein walls. [1] The most common cause of CVI is superficial venous reflux, which often results in the formation of varicose veins, a treatable condition. [2]
Individuals affected by RS3PE typically have repeated episodes of inflammation of the lining of their synovial joints and swelling of the end portion of the limbs. [8] The arms and hands are more commonly affected than the legs and feet. [8] Both sides are usually involved though RS3PE can affect only one side in certain cases. [8]
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