DIAGNOSIS CHECKLIST
for Leg swelling
Questions Your Doctor May Ask - and Why!
During a consultation, your doctor will use various techniques in his assesment of the symptom: Leg swelling. These may include a physical examination or other medical tests. Your doctor may ask several questions when assessing your condition. It is important to remember that your consultation is a two-way process and any extra information you can share with your doctor may help them with their diagnosis.
Some of the questions your doctor may ask are listed below:
1. How long have you had the leg swelling?
Why: to determine if acute or chronic.
2. Where exactly is the swelling on the leg?
Why: e.g. ankle, calf, thigh.
3. Is it unilateral or bilateral?
4. Are there other areas of the body that are swollen?
Why: e.g. abdomen, face, sacral area.
5. Did the swelling follow trauma or activity?
Why: may suggest leg muscle injury e.g. ruptured gastrocnemius muscle, leg injury, compartment syndrome.
6. Are you pregnant?
Why: Lower leg swelling in the absence of high blood pressure is a normal physiological adaptation to the pregnant state. It is more common towards the evening, in hot humid climates and in obese women.
7. Past medical history?
Why: e.g. diabetes, peripheral vascular disease and alcoholism can predispose to cellulitis; congestive heart failure and malignancy increases the risk of deep venous thrombosis; Congestive cardiac failure, liver cirrhosis, renal disease and hypothyroidism may cause of ankle and lower leg edema (swelling).
8. Risk factors for deep venous thrombosis
Why: e.g. varicose veins, prolonged bed rest, congestive heart failure, major surgery, childbirth, malignancy, oral contraceptive pill.
9. Medications?
Why: e.g. oral contraceptive pill increases risk of deep venous thrombosis; some medications may cause lower limb swelling including corticosteroids, progesterone, estrogen, anti-inflammatory medications, methyldopa, clonidine, calcium channel blockers, beta-adrenergic blockers, antidepressants.
10. Alcohol history?
Why: may indicate risk of cirrhosis of the liver or cellulitis.
11. Recent overseas travel or period of immobility?
Why: may increase risk of deep venous thrombosis.
Questions your doctor may ask about related symptoms:
Sometimes, other symptoms may be present and may help your doctor analyse your condition. These may include:
1. Symptoms of deep venous thrombosis?
Why: e.g. diffuse leg swelling, leg warmth, ankle pitting edema.
2. Symptoms of acute lower limb ischemia or compartment syndrome?
Why: e.g. sudden severe calf pain, absent pallor of skin, paresthesia or numbness of lower leg, paralysis or weakness of leg, swelling of the foot and ankle.
3. Symptoms of Hypothyroidism?
Why: e.g. intolerance to cold , weight gain , constipation, non-pitting lower limb swelling.
4. Varicose veins?
Why: may suggest venous incompetence and possible cause of ankle and lower leg swelling.
5. Symptoms of cardiac failure
Why: e.g. shortness of breath on exertion, bilateral ankle swelling that is usually symmetrical and worse in the evenings, with improvement during the night. As the heart failure progresses, swelling ascends to involve the legs, thighs, genitalia and abdomen.
6. Symptoms of cellulitis?
Why: e.g. brawny-red or reddish brown area of swollen skin which advances rapidly from its starting point. The advancing edge may be vague or sharply defined. Usually associated with a fever.
posted by jsw1952
about 1 month ago
