DIFFERENTAL DIAGNOSIS OF LIMB CHRONIC EDEMA

Zolotarevsky V.Ya., Savchenko T.V., Dan V.N., Moroz V.Yu., Grigoryan R.M., Maksimova T.V.
Department of Vascular Surgery, A.V. Vishnevsky Institute of Surgery,
Russian Academy of Medical Science,
Moscow, Russia

The present study evaluates differential diagnosis of the most severe and common diseases compromising venous and lymph drainage in lower extremities, that are lymphedema (elephantiasis), edematous and varicose-edematous forms of postphlebitic syndrome, congenital leg angiodysplasia and pelvic neoplasms. So called nonedematous hypertrophy – leg gigantism, obesity and erythrocyanosis are also reviewed. Tabled clinical signs of vascular disorders causing lower limb chronic edemas proved in our study to enable positive differential diagnosis in 90-95% of cases. Additional instrumentation data given in the table can rise the rate of true diagnosis up to 100%. Instrumentation diagnostic devices: radionuclide lymphography, ultrasound, computer tomography of lower extremities are options for assessment of leg edema and rational surgical strategy as well as implementation of new effective therapeutic procedures. Angioradiography is also in value. An attempt is made to summarise up-to-date findings about chronic edema clinical features of different etiology. The authors do not pretend to comprehensiveness but hope that this complicated and interesting problem is worth further investigating.

P. 26-33

« Back