Ankle edema detection by ultrasound
Skin edema will 'pit' only when there is considerable fluid collection.
In early fluid retention, pitting would not be demonstrable by physical examination.
This lady felt that her ankles were uncomfortable.
It was difficult to exclude a joint or tendon disorder. Her BP and heart sounds were normal.
There was no pitting of the skin.
Ultrasound of the lower legs showed normal tendons and joints. However there was edema in the subcutaneous tissue in both legs. USS is much more sensitive than physical examination to confirm fluid collection in the skin
Her edema was related to Norvasc prescribed for hypertension.
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