Lower extremity edema is the noticeable swelling of one or both legs. This condition occurs when there is fluid buildup in the leg, typically in the subcutaneous tissues (the layer of tissue just beneath the skin surface) or in the soft tissues.
There are a wide range of causes for fluid retention in the lower legs. If you notice swelling in your legs, our experienced vascular specialists can provide an accurate diagnosis of lower extremity edema.
Edema Symptoms and Signs
The main symptom of edema is swelling and puffiness that occurs on one or both sides of the body. With lower extremity edema, swelling occurs in one or both legs. Unilateral edema occurs on one side of the body, whereas bilateral lower extremity edema occurs on both sides.
Bilateral equal swelling means that the swelling is occurring in the same area on both lower extremities: for example, the ankles of the right and left legs. Bilateral asymmetrical swelling indicates that edema is present in both lower extremities but in different locations. For example, the right side may have a swollen ankle while the left presents with a swollen calf.
The swelling may present without additional symptoms, but sufferers may also experience:
- Limb fatigue
- A heavy feeling in the legs
- Discoloration of the skin
- Shiny, tight skin
- Changes in skin texture
- A change in skin temperature
- Skin that does not bounce back after being pressed on (pitting)
Why Does Lower Extremity Edema Occur?
There are many reasons for fluid retention in the legs. Some reasons require attention but may be resolved easily, including: sitting or standing for long, uninterrupted periods of time, pregnancy, eating too much sodium, or inflammation, especially in relation to an injury.
Fluid buildup in the lower extremities can also be a side effect of medicines used to treat high blood pressure, nonsteroidal anti-inflammatory drugs (NSAIDs), steroids, estrogens, and some types of diabetes medications.
Serious causes of fluid buildup in the legs may include:
- Chronic kidney failure
- Chronic venous insufficiency
- Deep vein thrombosis (DVT)
- Heart failure
- Peripheral artery disease (PAD)
- Peripheral edema
- Pulmonary hypertension
In some cases, multiple factors may be at play. Regardless of what you may think is causing fluid retention in your lower legs, it’s important to speak with a medical professional to help determine the root cause of the issue.
Diagnosing the Cause of Fluid Retention and Buildup in Legs
We encourage you to seek a diagnosis as soon as you first experience fluid in the legs. See a doctor right away if one or both of your legs swells suddenly for no apparent reason, or if your legs are swollen and you feel:
- Chest pain
- Difficulty breathing
- Shortness of breath, even at rest
- Coughing up blood
- Dizziness or fainting
- Persistent cramping in one or both legs
These may be indicators of conditions that could be serious if left untreated. Even if you aren’t suffering from lower extremity edema and one of the above listed conditions, you’ll want to consult with your primary doctor as soon as possible. You may also need to see a vascular specialist who is specifically trained to diagnose and treat vascular conditions like edema, deep vein thrombosis (DVT), peripheral artery disease (PAD), and other conditions. A vascular specialist can help figure out what is causing the lower extremity edema.
The specialist will take a personal history, wherein you can relate when the edema began, whether or not the swelling changes depending on the position of your leg, and whether the edema is unilateral or bilateral. A vascular specialist will also take a medical history to find out if any medication you are taking could be part of the problem.
As part of a physical exam, the specialist may examine the swollen extremity (or extremities) and assess it for pitting, change of skin texture, color, or temperature, and tenderness, which could be a sign of deep vein thrombosis (DVT). DVT is a life-threatening condition wherein a blood clot forms in the deep veins of the legs. If you suspect a blood clot, go to the emergency room right away.
Your specialist may also use techniques such as water displacement, girth measurements, and pitting the edema with a finger or other instrument to help diagnose your lower extremity edema.
In addition, your specialist may order lab tests, including a complete blood count, a metabolic panel, urinalysis, a thyroid panel, an atrial natriuretic peptide test, a hepatic panel, and a measurement of the albumin level in your blood.
To help determine the cause of the fluid retention in your legs, your specialist may perform a duplex ultrasound (DUS), which uses high-frequency sound waves to study the structure of the vascular system in your legs. It also measures the speed of blood flow through the vascular system. DUS can help diagnose serious or life-threatening conditions like DVT.
Treatment & Management Options for Lower Extremity Edema
Once you’ve been evaluated to determine the cause of fluid buildup in your legs, your vascular specialist may prescribe one or more of several treatment options. If the case is mild and not caused by a serious condition, your vascular specialist may recommend you take diuretics, lower your sodium intake, and keep the lower extremities elevated for a certain amount of time each day.
For more serious cases, such as cardiomyopathy, chronic venous insufficiency, DVT, PAD, or heart failure, your vascular specialist can treat the underlying condition, which may help ease the symptoms of lower extremity edema.
Schedule a Consultation with USA Vascular Centers
If your doctor has determined that your lower extremity edema may be a symptom of PAD, or you are concerned that the fluid retention in your legs is caused by PAD, a vascular specialist at USA Vascular Centers can help provide an accurate diagnosis.
Our vascular doctors perform minimally invasive treatments for PAD, such as:
- Angioplasty, a treatment that uses a thin wire catheter to widen narrowed arteries.
- Stent placement, wherein a mesh stent is placed in the artery to keep it open.
- Atherectomy, a procedure that removes the plaque from the artery.