II. Exam: Pitting Edema
- Technique
- Examiner impresses thumb into skin over bony surface
- Tibia
- Fibula
- Sacrum
- Withdraw thumb
- Measure depth of pit and record in millimeters (1-4 plus Pitting Edema)
- Examiner impresses thumb into skin over bony surface
- Interpretation
- Pitting Edema
- Non-Pitting Edema (Brawny Edema)
- Chronic inflammation
- Pretibial Myxedema (Hypothyroidism)
- Chronic, longstanding Lymphedema
- Chronic, longstanding Venous Stasis (Venous Insufficiency)
III. Exam: Edema Distribution and Characteristics
- Dependent Edema (fluid shift in response to gravity)
- Standing patient accumulates fluid in feet and ankles
- Bed-bound patient collects fluid posteriorly (Sacrum)
- Chronic Leg Edema (Brawny Edema)
- Tissue becomes fibrotic and fails to pit
-
Stemmer's Sign
- Attempt to pinch and lift skinfold at the base of the second toe (or middle finger)
- Negative (able to pinch skin)
- Does not completely exclude Lymphedema (especially if recent onset), but is more suggestive of other edema cause
- No swelling at base of digit is more consistent with Chronic Venous Insufficiency
- Pitting swelling of the base of digit is more suggestive of CHF, Nephrotic Syndrome, Cirrhosis or other similar edema
- Positive (unable to pinch skin)
- Pathognomonic for Lymphedema
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Related Studies
| Concepts | Finding (T033) |
| SnomedCT | 206894005, 248499004, 58692005 |
| English | EDEMA DEPENDENT, OEDEMA DEPENDENT, [D]Dependent edema, [D]Dependent oedema, Edema dependant, Oedema dependant, Edema dependent, Oedema dependent, Gravitational edema, Orthostatic edema, Postural edema, Gravitational oedema, Orthostatic oedema, Postural oedema, orthostatic edema, Oedema;dependent, dependant edema, dependent edema, gravitational edema, postural edema, Dependent edema, Dependent oedema, Dependent edema (finding), Dependent edema (morphologic abnormality), Edema;dependent, dependent oedema |
| Italian | Edema gravitazionale, Edema declive, Edema ortostatico, Edema posturale |
| Dutch | oedeem secundair, orthostatisch oedeem, neerhangend oedeem, zwaartekrachtsoedeem, secundair oedeem, houdingsafhankelijk oedeem, gravitatie-oedeem |
| French | Oedème gravitationnel, Oedème dépendant, Oedème postural, Oedème orthostatique, Oedème déclive, OEDEME IDIOPATHIQUE, Oedème de gravitation |
| German | Oedem der Gravitation folgend, orthostatisches Oedem, posturales Oedem, OEDEM ABHAENGIGE KOERPERPARTIEEN, Gravitationsoedem |
| Portuguese | Edema de estase, Edema ortostático, Edema de posição, EDEMA IDIOPATICO, Edema gravitacional |
| Spanish | Edema por declive, Edema postural, Edema ortostático, Edema dependiente, EDEMA GRAVITACIONAL, edema por declive, edema dependiente (hallazgo), edema postural (hallazgo), edema dependiente, edema postural (anomalía morfológica), edema postural, Edema gravitacional |
| Japanese | 重力性浮腫, 起立性浮腫, 動性浮腫, 体位性浮腫, ﾄﾞｳｾｲﾌｼｭ, ﾀｲｲｾｲﾌｼｭ, ｼﾞｭｳﾘｮｸｾｲﾌｼｭ, ｷﾘﾂｾｲﾌｼｭ |
| Czech | Edém závislý na poloze těla, Ortostatický edém, Edém závislý na gravitaci, Posturální edém |
| Hungarian | Orthostaticus oedema, Orthostatikus ödéma, Posturalis ödéma, Gravitációs ödéma, Orthostatikus oedema, Posturalis oedema, Oedema orthostatica, Gravitációs oedema, Dependens oedema, Orthostatikus vizenyő |
Ontology: Pitting edema (C0333243)
| Definition (NCI) | Swelling due to excessive accumulation of fluid under the skin defined by a persistent indentation when pressure is applied to the swollen area. Causes include systemic conditions (e.g., heart failure, liver failure, or kidney failure) and local conditions affecting the extremities. |
| Concepts | Sign or Symptom (T184) |
| SnomedCT | 139248000, 161986005, 284521000, 5008001 |
| English | pitting edema, pitting edema (physical finding), Pitting Edema, oedema pitting, edema pitted, edema pitting, edema pits, pit edema, pitting oedema, Pitting oedema (finding), Pitting edema, Pitting oedema, Pitting edema (finding), Pitting edema (morphologic abnormality), edema; pitting, pitting; edema |
| Spanish | Edema depresible, edema con fóvea (anomalía morfológica), edema con fóvea (hallazgo), edema con fóvea |
| Portuguese | Edema com godet, Edema depressível |
| French | Oedème prenant le godet, Oedème qui prend le godet |
| Italian | Edema plastico |
| German | eindrueckbares Oedem, Eindrueckbares Oedem |
| Dutch | putjesoedeem, oedeem; putjes, putjes; oedeem |
| Czech | Hydrostatický intersticiální edém |
| Japanese | 圧痕浮腫, ｱｯｺﾝﾌｼｭ |
| Hungarian | Ujjbenyomatot tartó ödéma, Ujjbenyomatot tartó oedema |
Ontology: Brown edema (C0333248)
| Concepts | Sign or Symptom (T184) |
| SnomedCT | 248500008, 18174004 |
| English | edema brown, brawny edema, browning edema, edema brawny, Brawny edema, Brawny oedema, Brown edema, Brown oedema, Brawny edema (finding), Brown edema (morphologic abnormality) |
| Spanish | edema indurado con coloración parda (hallazgo), edema indurado con coloración parda, edema pardo (anomalía morfológica), edema pardo |
Ontology: Non-pitting edema (C1265804)
| Concepts | Finding (T033) |
| SnomedCT | 420435001, 125308006 |
| English | Non-pitting edema (finding), Edema, nonpitting, nonpitting edema, non-pitting edema, non-pitting edema (physical finding), edema non pitting, Nonpitting edema, Non-pitting edema (morphologic abnormality), Non-pitting edema, Non-pitting oedema |
| Spanish | edema sin fóvea (hallazgo), edema sin fóvea (anomalía morfológica), edema sin fóvea |
