Lower limb edema | definition, causes, clinical picture | OSCE guide | عربي

OSCE COMMENT EXAMPLE:
LL edema comment in nephrology osce

Mild, bilateral, symmetrical, soft, pitting edema, extending to the level of the knees
Not associated with tender calf muscle.
No pigmentations, No dilated veins, No signs of inflammation.
We should examine for sacral, scrotal " if male " or abdominal wall ascites.
We should examine the pulsations of the LL in order to assess if the edema is intact with the LL pulsations or not.

📍 Causes of generalized ( bilateral symmetrical ) edema?
Congestive heart failure, liver cirrhosis, nephrotic syndrome, generalized allergy

📍 Causes of bilateral asymmetrical edema?
Unilateral cause on top of general edema like DVT on top of nephrotic syndrome.

📍 Causes of unilateral edema?
DVT, cellulitis

📍 Causes of non pitting edema?
DVT, Myxedema

📍 Causes of soft pitting edema?
Hypoalbuminemia like that in nephrotic syndrome that is associated with eye puffiness ( periorbital edema )

📍 Causes of firm pitting edema?
Congestive heart failure

📍 Causes of hard pitting edema?
Myxedema

📍 Main mechanism of edema with renal cause?
Increased hydrostatic pressure in oliguric patient.
Decreased oncotic pressure in non oliguric patient.

📍 Main mechanism of edema with cardiac cause?
Increased hydrostatic pressure.

📍 Main mechanism of edema with infectious cause?
Disturbance of the capillary permeability.

📍 Main mechanism of edema in malnourished patient?
Decreased oncotic pressure.

📍 Ascites precox?  
Ascites that early formed before the generalized edema.
Causes:
Hepatic disease
Right side heart failure
Pericardial effusion
Constrictive pericarditis
By: Omnia darwish

Edema
general examination باطنة
Clinical examination

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