Difference between revisions of "Bilateral pedal edema"

(Differential Diagnosis)
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==Differential Diagnosis==
 
==Differential Diagnosis==
 
{{Bilateral pedal edema DDX}}
 
{{Bilateral pedal edema DDX}}
 +
*Idiopathic edema is a diagnosis of exclusion, must first rule out CHF, cirrhosis, renal failure, nephrotic syndrome, chronic venous insufficiency, and medication-induced edema<ref>Kay A, Davis CL. Idiopathic Edema. American Journal of Kidney Disease. 1999; 34(3): 405-408.</ref>
  
 
==Evaluation==
 
==Evaluation==
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==Management==
 
==Management==
 
*Treatment is based on addressing underlying disease process
 
*Treatment is based on addressing underlying disease process
*Idiopathic edema is a diagnosis of exclusion.  Other disease process, including heart failure, cirrhosis, acute renal failure, nephrotic syndrome, chronic venous insufficiency, and medication induced edema must first be considered.<ref>Kay A, Davis CL. Idiopathic Edema. American Journal of Kidney Disease. 1999; 34(3): 405-408.</ref>
 
 
**Idiopathic pedal edema need not to be treated with diuretics
 
**Idiopathic pedal edema need not to be treated with diuretics
  

Revision as of 21:16, 31 August 2017

Background

  • Definition: existence of the excess fluid in the lower extremity resulting in swelling of the feet and extending upward
    • Further classified as pitting (depress-able) and non-pitting

Causes Pedal Edema

Mechanisms of Pedal Edema
  • Increased hydrostatic pressure
  • Decreased oncotic pressure
  • Increased capillary permeability
  • Lymphatic obstruction

Clinical Features

Pitting pedal edema
  • Pedal edema

Differential Diagnosis

Bilateral pedal edema

Differential Diagnosis of Pedal Edema

Evaluation

  • CBC
  • Chem 7
  • PT vs albumin (liver)
  • ECG
  • CXR
  • UA (nephrotic)
  • Consider BNP

Management

  • Treatment is based on addressing underlying disease process
    • Idiopathic pedal edema need not to be treated with diuretics

Disposition

  • If no respiratory symptoms, most patients may be safely discharged home
    • Patients should be followed up in medical clinic for further investigation and care

See Also

External Links

References

  1. Kay A, Davis CL. Idiopathic Edema. American Journal of Kidney Disease. 1999; 34(3): 405-408.