pitting edema


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edema

 [ĕde´mah]
the accumulation of excess fluid in a fluid compartment. Formerly called dropsy and hydrops. adj., adj edem´atous. This accumulation can occur in the cells (cellular edema), in the intercellular spaces within tissues (interstitial edema), or in potential spaces within the body. Edema may also be classified by location, such as pulmonary edema or brain edema; types found in certain locations have specific names, such as ascites (peritoneal cavity), hydrothorax (pleural cavity), or hydropericardium (pericardial sac). Massive generalized edema is called anasarca. Classification by location does not indicate whether the edema is cellular or interstitial or occupies a potential space (for example, brain edema may be either cellular or interstitial). Edema can be caused by a variety of factors, including conditions that affect osmotic pressure, such as hypotonic fluid overload, which allows the movement of water into the intracellular space, or hypoproteinemia, which decreases the concentration of plasma proteins and permits the passage of fluid out of the blood vessels into the tissue spaces. Other factors include poor lymphatic drainage; conditions that cause increased capillary pressure, such as excessive retention of salt and water and heart failure; and conditions that increase capillary permeability, such as inflammation.
Edema formation. With trauma, increased capillary permeability and dilation cause leaking into tissue space. Initially clear, exudate in the tissue space becomes more viscous with an increase in plasma protein. From Copstead and Banasik, 2000.
alveolar edema pulmonary edema in the alveoli, usually with hypoxemia and dyspnea.
brain edema cerebral edema.
cardiac edema a manifestation of congestive heart failure, due to increased venous and capillary pressures and often associated with renal sodium retention.
cellular edema edema caused by the entry of water into the cells, causing them to swell. This may occur because of decreased osmolality of the fluid surrounding the cells, as in hypotonic fluid overload, or increased osmolality of the intracellular fluid, as in conditions that decrease the activity of the sodium pump of the cell membrane, allowing the concentration of sodium ions within the cell to increase.
cerebral edema swelling of the brain caused by the accumulation of fluid in the brain substance. It may result from head injury, stroke, infection, hypoxia, brain tumors, obstructive hydrocephalus, and lead encephalopathy; it may also be caused by disturbances in fluid and electrolyte balance that accompany hemodialysis and diabetic ketoacidosis. The most common type is vasogenic edema, which may result from increased capillary pressure or from increased capillary permeability caused by trauma to the capillary walls. Cellular edema may occur in ischemia or hypoxia of the brain. Because the brain is enclosed in the solid vault of the skull, edema compresses the blood vessels, decreasing the blood flow and causing ischemia and hypoxia, which in turn result in further edema. Unless measures are taken to reverse the edema, destruction of brain tissue and death will result.
dependent edema edema of the lowermost parts of the body relative to the heart; it is affected by gravity and position, so that the lower limbs are affected if the individual is standing, but the buttocks are affected if the individual is supine.
generalized edema edema that is caused by poor venous return; it is not localized by the effects of gravity, in contrast to dependent edema.
interstitial edema
1. edema caused by the accumulation of fluid in the extracellular spaces of a tissue.
2. pulmonary edema in the interstitial tissues; there is dyspnea but no hypoxemia.
edema neonato´rum sclerema neonatorum.
nonpitting edema edema in which pressure does not leave a depression in the tissues, such as in cellular edema. See also pitting edema.
pedal edema swelling of the feet and ankles.
peripheral edema edema affecting the extremities; seen in heart disease, Crohn's disease, and amyloidosis.
pitting edema edema in which external pressure leaves a persistent depression in the tissues (see pitting); it occurs because the pressure pushes the excess fluid out of the intercellular spaces in the tissue. See also nonpitting edema.
pulmonary edema diffuse extravascular accumulation of fluid in the tissues and air spaces of the lung due to changes in hydrostatic forces in the capillaries or to increased capillary permeability. It is most often symptomatic of left ventricular heart failure, but can also be a complication of mitral stenosis, aortic stenosis, altitude sickness, acute hypertension, volume overload during intravenous therapy, or reduced serum oncotic pressure, as in patients who have nephrosis, cirrhosis, or hypoalbuminemia.

During the initial stage of pulmonary edema, patients may complain of restlessness and anxiety and the feeling that they are getting a common cold. Other signs include a persistent cough, slight dyspnea, and intolerance to exercise. On auscultation, rales can be heard over the dependent portion of the lung. As fluid continues to fill the pulmonary interstitial spaces the dyspnea becomes more acute, respirations increase in rate, and there is audible wheezing. The cough becomes productive of frothy sputum tinged with blood, giving it a pinkish hue. Eventually, if the condition persists, the patient becomes less responsive to stimuli as levels of consciousness decrease. Ventricular arrhythmias develop and breath sounds diminish. In some patients these phases are telescoped as the pulmonary edema develops rapidly and the final stages of respiratory insufficiency are evident in a very short period of time.

Treatment is aimed at enhancing gas exchange, reducing fluid overload, and strengthening and slowing the heart beat. To accomplish these goals the patient is often given oxygen by mask or through mechanically assisted ventilation. Drug therapy includes diuretics to remove excess alveolar fluid and morphine to relieve anxiety and reduce the effort of breathing. Administration of other medications depends on the cause of the edema, as well as what other problems the patient may be having.
vasogenic edema that characterized by increased permeability of capillary endothelial cells; the most common form of cerebral edema.

pit·ting e·de·ma

edema that retains for a time the indentation produced by pressure.

pitting edema

Physical exam  A term used to describe the indentation caused when fingertip pressure is applied to the skin, forcing fluids into the underlying tissue; PE occurs when there is an ↑ amount of low protein fluid in the interstitial space, associated with disorders caused by high capillary filtration–DVT, chronic venous insufficiency, or venous obstruction, or hypoalbuminemia; pitting is a subjective assessment using the grading scale of 1+ for mild and up to 4+ for deep pitting. Cf Nonpitting edema.

pit·ting e·de·ma

(pit'ing ĕ-dē'mă)
Area of swelling that retains for a time the indentation produced by pressure.
Enlarge picture
PITTING EDEMA: Demonstration of pitting edema
Enlarge picture
PITTING EDEMA: Demonstration of pitting edema

pitting edema

Evidence of fluid in soft tissues, esp. those of dependent body parts like the lower extremities. When pressed firmly with a finger, tissues that are swollen with extravascular fluid retain the shape of the depression produced by the finger. See: illustration
See also: edema

Pitting edema

A swelling in the tissue under the skin, resulting from fluid accumulation, that is measured by the depth of indentation made by finger pressure over a boney prominence.
Mentioned in: Edema, Lymphedema

pit·ting e·de·ma

(pit'ing ĕ-dē'mă)
Area of swelling that retains for a time the indentation produced by pressure.
References in periodicals archive ?
Pitting edema is seen in DVT and venous insufficiency; increased jugular venous distention, along with crackles and ascites, indicates systemic problems.
Clinicians must recognize RS3PE syndrome when they come across it in connection with cases of asymmetric arthritis with pitting edema. However, we agree with other studies that have suggested that asymmetrical RS3PE may provide an additional challenge for clinicians in these cases.
Paraneoplastic remitting seronegative symmetrical synovitis with pitting edema. Clin Exp Rheumatol 1999, 17: 741-744.
According to the authors, the severity of laminitis in horses exposed to black walnut residue can range from a mild swelling of the legs to severe swelling and edema of all four limbs, pitting edema of the ventral abdomen and colic.
* Signs of undiagnosed pregnancy-induced hypertension (PIH) including rapid weight gain, pitting edema, severe headaches, mid-back pain on right side and visual disturbances.
Musculosketetal: Jordan is noted to have 2+ pitting edema of his lower extremities bilaterally.
He also had right upper quadrant tenderness, Murphy's sign positive, and 3+ pitting edema in the lower extremities.
An 81-year-old man was admitted to our hospital because of bilateral pitting edema of his legs for about one month in October 2015.
The patient also had decreased breath sounds in both lower lung zones and moderate pitting edema up to the knees.
On general examination, he had an elevated jugular venous pressure, pallor, normal blood pressure, macroglossia (Fig.1) and pitting edema of both lower limbs up-to the level of the knees.
For CardioPulmonary conditions, CardioFlex Therapy has occupational therapist that can performs physical therapy for patients suffering from Heart Disease, COPD, Breathing Difficulty, Lung Disease, Lymphedema, Chronic Swelling, Chronic Edema, Pitting Edema, Lymhedema Obstruction, Breast Lymphedema & Chronic Fluid Retention.
The rate of polymyalgia rheumatica (PMR) and remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome in a clinic where primary care physicians are working in Japan.