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Ankle/Leg Swelling Differentials (Cardiovascular (Venous thromboembolism…
Ankle/Leg Swelling Differentials
Worst case scenario/immediate referral to hospital
DVT/ Venous Thromboembolism
Unilateral, particularly calf
Acute onset
? Associated PE - Tachycardia/ SOB
?Post surgery
?Recent long haul flight
Malignant tumour (causing compression of a large vein)
Red flag symtpoms
Cardiovascular
Venous thromboembolism (any)
Heart failure (right sided/congestive)
Valve incompetence
Hypertension
Chronic venous insufficiency
Dermatology/Trauma
Cellulitis
Burns
Animal/ insect bites
Allergic response (angiodema, non-pitting oedema)
Renal
Nephrotic syndrome
Proteinuria
Facial swelling
Chronic kidney disease
Endocrinology/Environmental
Leg ulcer/foot secondary to diabetes
Immobility
Pregnancy
Hypothyroidism
High altitude sickeness
Iatrogenic/ Idiopathic
Non-compliance with heart failure medication
Calcium channel blockers and NSAIDs
Idiopathic peripheral oedema
Post surgery/surgical damage of lymphatic drainage
Idiopathic lymphoedema
Gastrointestinal
Liver failure
Ascites
Hypoalbunaemia
Liver Disease
Ascities
Hypoalbunaemia
Congenital
Milroy's disease (VERY RARE)
Autosomal dominant inheritance (i.e. FHx)
Hydroceles
Prominent veins
Up-slanting toenails
Papillomatosis (warty like growths)
Respiratory
Obstructive sleep apnoea