Pitting edema can be demonstrated by applying pressure to the swollen area by depressing the skin with a finger. In non-pitting edema, which usually affects the legs or arms, pressure that is applied to the skin does not result in a persistent indentation. The focus of the rest of this article is on pitting edema, as it is by far the most common form of edema.
Edema is caused by either systemic diseases, that is, diseases that affect the various organ systems of the body, or by local conditions involving just the affected extremities.
The most common local conditions that cause edema are varicose veins and thrombophlebitis (inflammation of the veins) of the deep veins of the legs. In some cases, however, edema may be a sign of a more serious underlying medical condition.
This disease causes scarring of your liver, which interferes with liver function, causing changes in the hormones and chemicals that regulate fluids in your body, as well as increasing pressure within the large blood vessel (portal vein) that carries blood from your intestine, spleen and pancreas into your liver. When you have kidney disease, your kidneys may not be able to eliminate enough fluid and sodium from your blood. Damage to the tiny blood vessels in your kidneys (glomeruli) that filter waste and excess water from your blood can result in nephrotic syndrome.
Edema most commonly occurs in the feet and legs, where it is referred to as peripheral edema. An accumulation of fluid in the interstitial air spaces (alveoli) in the lungs occurs in a disorder called pulmonary edema. If the pressing causes an indentation that persists for some time after the release of the pressure, the edema is referred to as pitting edema.


Non-pitting edema can occur in certain disorders of the lymphatic system such as lymphedema, which is a disturbance of the lymphatic circulation that may occur after a mastectomy, lymph node surgery, or congenitally.
The most common systemic diseases associated with edema involve the heart, liver, and kidneys. These conditions can cause inadequate pumping of the blood by the veins (venous insufficiency).
This swelling (edema) is the result of excessive fluid in your tissues — often caused by congestive heart failure or blockage in a leg vein. These problems can result in fluid accumulating in your legs and your abdominal cavity (ascites).
One result of nephrotic syndrome is low levels of protein (albumin) in your blood, which can lead to fluid accumulation and edema. Chronic venous insufficiency (CVI) is a condition in which the veins in your legs are weakened or damaged and can't pump enough blood back to your heart.
The swelling is the result of the accumulation of excess fluid under the skin in the spaces within the tissues. Any form of pressure, such as from the elastic in socks, can induce pitting with this type of edema.
Another cause of non-pitting edema of the legs is called pretibial myxedema, which is a swelling over the shin that occurs in some patients with hyperthyroidism. In these diseases, edema occurs primarily because of the body's retention of too much salt (sodium chloride). The resulting increased back-pressure in the veins forces fluid stay in the extremities (especially the ankles and feet).


All tissues of the body are made up of cells and connective tissues that hold the cells together. Anasarca refers to the severe, widespread accumulation of fluid in the all of the tissues and cavities of the body at the same time. Interstitial space is the extravascular compartment of the extracellular fluid and surrounds the cells of a given tissue.
Diuretic medications are generally not effective, although elevation of the legs periodically during the day and compressive devices may reduce the swelling.
Further reading about basics of fluid compartment and fluid therapy: Basics of fluid therapy.
In various diseases, excess fluid can accumulate in either one or both of these compartments. In myxedema, there is infiltrative edema with deposition of mucinous materials under the skin. Learning is not memorizing but conceptualizing.Epomedicine also provides quick access to case discussion on interesting medical cases, videos for developing correct clinical skills and a blog to go beyond notes and research articles to explore the inner-self of medical students and healthcare professionals.



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