Leg swelling DDx

Leg swelling – Differential Diagnosis

Common causes

• Chronic venous insufficiency
• Gravitational oedema
  • Idiopathic oedema
• Venous Eczema
• Cellulitis
• Lymphoedema
• Cardiac failure

Must Not Miss

• Vascular
  • Cardiac failure
  • DVT
  • IVC obstruction
• Pelvic Tumour/mass
• Renal failure
• Myxoedema

Easily missed

• Medication
• Baker’s cyst rupture
• Hypoalbuminaemia
  • Cirrhosis
  • Coeliac disease
  • Crohn’s dis/ Ulcerative colitis
  • Malnutrition
  • Nephrotic syndrome

Red flags

• Unilateral calf pain and tenderness
• Risk factors for DVT
• Swelling of the entire leg
• Dyspnoea
• Haemoptysis
• Abdominal swelling

Investigations to consider

• FBC, CRP/ESR, D-dimers
• U&Es, LFTs, TFTs, Serum glucose
• Serum proteins, Coeliac screen
• BNP
• Urinalysis
• CXR
• ECG/ Echocardiography
• USS (Duplex Doppler)
• CT abdo/ pelvis
• Venography
• Arteriography