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Cardio Exam

Pedal Oedema

July 1st, 2020


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.
  • Pitting Oedema
  • 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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