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Lower leg edema
Lower leg edema

Peripheral edema
Definition:
Peripheral edema is an abnormal build-up of fluids in ankle and leg tissues. See also swelling, overall.

Alternative Names:
Swelling of the ankles - feet - legs; Ankle swelling; Foot swelling; Leg swelling; Edema - peripheral

Considerations:
Painless swelling of the feet and ankles is a common problem, particularly in older people. It may affect both legs and may include the calves or even the thighs. Because of the effect of gravity, swelling is particularly noticeable in the lower legs.

When squeezed, the fluid will move out of the affected area and may leave a deep impression for a few moments.

Swelling of the legs is many times related to systemic causes (for example, heart failure, renal failure, or liver failure).
Common Causes:
  • Long airplane flights or automobile rides
  • Menstrual periods (for some women)
  • Sunburn
  • Generalized allergy
  • Prolonged standing
  • Injury or trauma to the ankle or foot
  • Venous insufficiency (varicose veins)
  • Pregnancy (mild to severe swelling)
  • Environmental
  • Medical treatments
    • Body fluid overload
    • Infiltration of an IV site
    • Extremity surgery
  • Medications
    • Estrogens and progestin oral contraceptives
    • Blood pressure-lowering drugs
    • Certain antidepressants (such as Nardil)
    • Estrogen - oral
    • Long-term corticosteroid therapy
    • Nifedipine
    • Testosterone
  • Diagnostic tests
  • Congestive heart failure
  • Glomerulonephritis or other kinds of kidney disorders
Home Care:
Elevate the legs above the heart while lying down. Avoid sitting or standing without moving for prolonged periods of time. Avoid putting anything directly under the knees when lying down, and don't wear constricting clothing or garters on the upper legs.

Exercising the legs causes the fluid to work back into the veins and lymphatic channels so that the swelling goes down. The pressure applied by elastic bandages or support stockings can help reduce ankle swelling.

A low-salt diet may help reduce fluid retention and decrease the ankle swelling.
Call your health care provider if:
Call your health care provider if ankle swelling persists or worsens after the above measures have been taken.
What to expect at your health care provider's office:
The medical history will be obtained and a physical examination performed.

Medical history questions documenting ankle, feet, and leg swelling in detail include:
  • Location
    • What specific body part(s) swell?
    • Is there ankle swelling?
    • Is the whole foot swollen?
    • Is there swelling over the small bones of the feet?
    • Is there swelling of the toes?
    • Is the knee swollen?
    • Is the whole leg swollen?
  • Time pattern
    • Is the swelling always present?
    • Is it worse in the morning or the evening?
  • Aggravating and relieving factors
    • What makes it better?
    • Does the swelling go down when the legs are elevated?
    • What makes it worse?
  • Other
    • What other symptoms are also present?
The physical examination may include emphasis on the heart, lungs, kidneys, and legs.

Diagnostic tests that may be performed include:Intervention:
The specific treatment will be directed at whatever underlying cause is found. Diuretics (fluid pills) may be prescribed. These are effective in reducing the swelling but have some side effects. Home treatment for benign causes of leg swelling should be tried before drug therapy under medical supervision.

After seeing your health care provider:
You may want to add a diagnosis related to ankle, feet, and leg swelling to your personal medical record.
Review Date: 10/27/2001
Reviewed By: Jeffrey Heit, M.D., Department of Medicine, University of Pennsylvania Health System, Philadelphia, PA. Review provided by VeriMed Healthcare Network.
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