Overview
Oedema or swelling of the lower limb occurs due to fluid accumulation, and may be either pitting or non-pitting.
Pitting Oedema
Pitting oedema occurs due to the collection of fluid within the subcutaneous space.
How to Elicit
- Apply pressure to the anterior aspect of the tibia for fifteen seconds and then release.
- Look for persistence of the depressed area after pressure is removed.
Causes of Pitting Oedema
- Fluid overload - excessive IV fluids, renal failure, heart failure
- Right ventricular failure
- Venous pathology - thrombosis / insufficiency
- Dependency (the effect of gravity)
- Hypoalbuminaemia - malnutrition, malabsorption, nephrotic syndrome, liver (synthetic) failure
Non-Pitting Oedema
Oedema of the lower limbs that does not pit is classically suggestive of lymphoedema.
Causes of Non-Pitting Oedema
- Lymphoedema
- Pretibial myxoedema (hypothyroidism)
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