The Experts on Lower Extremity Edema? Primary Care

Clinical Assistant Professor, Department of Medicine, Perelman School of Medicine at University of Pennsylvania ; Internist, Department of Medicine, Hospital Medicine Section, Pennsylvania Hospital, Philadelphia, Pennsylvania Associate Professor of Clinical Medicine, Department of General Internal Medicine, Lewis Katz School of Medicine; Staff Physician, Department of General Internal Medicine, Temple Internal Medicine Associates, Philadelphia, Pennsylvania Primary care physicians are essentially...

Those are the big three causes of acute unilateral lower extremity edema. I would start with DVT, then cellulitis, and then the other possible causes. Representative Lauren Boebert of Coloradorecently when she had what sounded like a unilateral DVT, apparently attributed to May-Thurner syndrome, when the right iliac artery compresses the left iliac vein, leading to venous stasis, which predisposes to thrombosis and DVT.

For an acute process, it's easier; you just need an ultrasound. For chronic longstanding edema, I'll check electrolytes and an albumin level. If they have symptoms that go along with the three big organ systems that you talked about — cardiac, hepatic, or renal — you let that guide your workup. If a patient has longstanding diabetes and you are worried about nephrotic syndrome, then you chase that down by trying to quantify urine protein. Liver disease is a different workup.

Diet Exercise Physical Activity Edema Deep Venous Thrombosis DVT Deep Vein Thrombosis DVT - Deep Venous Thrombosis Hypertension Cardiovascular Imaging Cardiac Imaging CV Imaging Heart Failure Multidisciplinary Team Pennsylvania Chronic Venous Insufficiency Skin And Soft Tissue Infection Sleep Apnea Sleep Apnoea Sleep Disturbance Abnormal Sleep Pattern Sleep Disorder

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