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Renal Exam

Peripheral Oedema

November 28th, 2019


  • Look For

  • Swelling of the lower limb due to fluid accumulation.

Pitting Oedema

  • 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

  • Look For

  • Oedema to the lower limbs that does not pit.
  • Causes of Non-Pitting Oedema

  • Impaired lymphatic drainage
  • Pretibial myxoedema (hypothyroidism)
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