leg swelling
| Headline | |
|---|---|
| History | ➥ duration → acute or chronic? ➥ painful/pain free ➥ oedema – pitting? Other skin changes? ➥ "?Cellulitis": source of infection? ➥ impact on function ➥ PMH: HF, lymphoedema (2o to malignancy/surgery?) ➥ Surgical history? Polypharmacy/multimorbidity? |
| Examination | mobility, obs, cardiovascular status. ➥ Legs: signs of infection? Skin break? signs of venous insufficiency? ➥ Groin lymphadenopathy |
| Diagnostic investigations | |
| Differentials | ➥ Cellulitis, infected ulcers, Septic arthritis ➥ DVT ➥ lymphoedema ➥ decompensated HF - see acute heart failure ➥ trauma, burns ➥ acute gout ➥ thrombophlebitis (Varicose veins?); vascular insufficiency ➥ erysipelas |
| Immediate management | |
| Ongoing management | ➥ skin care ➥ compression stockings - requires dexterity ➥ movement/mobility - to maximise lymph drainage ➥ simple lymphatic drainage if primary lymphatic problem |