Definition : Edema signifies increased fluid in the intercellular tissue spaces and body cavities.

We have described in article :

Common Causes of Edema

Common Causes of leg swelling / Edema

How will you clinically asses and investigate unilateral leg swelling.


Common causes of generalized edema:

1). Heart failure.

2) Renal cause :

  • Nephrotic syndrome.
  • Acute nephritic syndrome.

3) CLD (Chronic liver disease): Cirrhosis of liver.

4) PEM (Protein energy malnutrition): Kwashiorkor.

5) Hypothyroidism.

Common causes of localized/unilateral edema:

  1. Venous obstruction: Deep vein thrombosis (DVT).
  2. Lymphatic obstruction: Filariasis.
  3. Acute inflammatory edema: Cellulitis.
  4. Type-I hypersensitivity edema.

Causes (differential diagnoses) of leg swelling/leg edema:

Bilateral leg swelling:

1) Heart failure:  Right or combined left & right heart failure, pericardial constriction, cardiomyopathy.

2) Chronic venous insufficiency.

3) Hypoproteinaemia: (edema is often widespread, can affect arms & face)

  • Nephrotic syndrome.
  • Chronic liver disease.
  • Protein losing enteropathy.

4) Drugs:

a) Na+ retention: NSAIDs, fludrocortisone.

b) Increased capillary permeability: Nifedipine, amlodipine.

5) Idiopathic:  Women > men.

6) Chronic lymphatic obstruction:  Filariasis, pelvic tumour.

Unilateral leg swelling:

  1. Deep vein thrombosis (DVT).
  2. Lymphatic obstruction (eg. in filariasis).
  3. Soft tissue infection (cellulitis).
  4. Ruptured Baker’s cyst.
  5. Calf muscle haematoma.

Common causes of generalized edema with oliguria:

  • Nephrotic syndrome.
  • Acute nephritic syndrome.
  • Heart failure.

How will you clinically asses and investigate unilateral leg swelling? 

Unilateral leg swelling:

Clinical assessment:


  • Prolonged immobility.
  • Recent major surgery.
  • Oral contraceptive pill (female).
  • Pregnancy (female).
  • Trauma.
  • Filaria endemic zone.
  • Varicose vein.



  • Swelling, extent of swelling.
  • Veins: Engorged, varicosities.
  • Scratch mark.
  • Pigmentation.
  • Purpura.
  • Hair change.
  • Trophic ulcer.
  • Associated joint swelling, clubbing,
  • Swelling of the back of the leg


  • Temperature: Warm or cold.
  • Pulse: Popliteal, posterior tibial, arteria dorsalis pedis.
  • Edema – pitting or non-pitting.
  • Calf tenderness, localized swelling (DVT, ruptured Baker’s cyst).
  • Popliteal and inguinal lymph nodes.


  1. CBC with ESR: Eosinophilia in filariasis, raised ESR & neutrophilia in cellulitis.
  2. For DVT: Doppler USG of lower limb veins for DVT, venography.
  3. For filariasis: Blood film, provocation test (by diethylcarbamazine), CFT, lymphoscintigraphy.
  4. USG or CT scan of whole abdomen.
  5. Factor VIII and IX level in suspected haemophilia.

8 Responses

  1. I consider something genuinely special in this web site.

  2. Diann Boera says:

    An impressive share, I just given this onto a colleague who was doing a little analysis on this. And he in fact bought me breakfast because I found it for him.. smile. So let me reword that: Thnx for the treat! But yeah Thnkx for spending the time to discuss this, I feel strongly about it and love reading more on this topic. If possible, as you become expertise, would you mind updating your blog with more details? It is highly helpful for me. Big thumb up for this blog post!

  3. tlovertonet says:

    After study a couple of of the weblog posts in your website now, and I actually like your way of blogging. I bookmarked it to my bookmark website record and will probably be checking again soon. Pls check out my web site as effectively and let me know what you think.

  4. kkslot777 says:

    Nice blog! Is your theme custom made or did you download it from somewhere? A theme like yours with a few simple tweeks would really make my blog stand out. Please let me know where you got your design. Thanks a lot

  5. Bom88 says:

    Hi there very cool site!! Man .. Beautiful .. Superb .. I’ll bookmark your blog and take the feeds also…I’m satisfied to search out numerous useful information right here within the publish, we want work out extra strategies on this regard, thanks for sharing.

  1. January 25, 2023

    […] Divancation of the recti and scrotal oedema […]

  2. January 26, 2023

    […] Oedema present in the lower segment, sometimes face. […]

  3. January 27, 2023

    […] Oedema […]

Leave a Reply

Your email address will not be published. Required fields are marked *