Has anyone had leg edema that cannot be diagnosed?

Question

One year and one month ago my feet swelled up, and ankles hurt. It was gout. Then, 2 weeks later, my lower legs started to swell. Had to take 2 diuretics and use a compression cuff daily. I've had 6 sonograms, 3 MRI's and 2 Doppler imaging tests. All normal. So is heart, arteries and veins. One doc said lymphedema. No, said another. I think it's kidneys. 2 medications I took had kidney problems as side effects. I stopped them nearly 2 weeks ago.Swelling still Present. HELP!

Answer 1

The best way to diagnose lymphedema is to have a lymphscintigraphy study. In this study, a radioactive-labeled protein is injected into the subcutaneous tissues of the foot. A scan is then performed at several intervals to determine if the lymphatic system is functioning. This is because the lymphatic system is responsible returning PROTEINS back to normal circulation by the thorasic duct. This is in contrast to the venous system which mobilizes blood and fluid. This is why diuretics would not help someone with lymphedema...it helps to reduce the fluid, but not the proteins.

It's hard to find someone who does lymphscintigraphy. Most of our referrals are done on subjective history and observation. The key indicators of lymphedema is that it includes the foot as well as the lower leg and there is "fibrosis" present (a "tough" feeling to the tissue) and a positive "stemmer sign." Inability to "pinch" the skin on the top of the foot.

If it is lymphedema, see a physical therapist who is trained in lymphedema management.

Best wishes.

Answer 2

Do you have a job or hobby that requires long hours of sitting? The veins and arteries of the legs can become partially occluded from sitting too long especially if one is overweight with a large abdomen. Also,low albumen in the blood can cause edema in the lower extremities. Is you diet lacking in adequate vitamins and minerals? And the frequent use of NSAIDS ( non-steroidal anti-inflammatoy drugs ) can also cause swelling especially if combined with sitting. I don't have a definitive answer but these are some issues you could bring up with your MD

Answer 3

Extracorporeal Shock Wave Therapy (ESWT) devices generate pulses of high-pressure sound that travel through the skin. For reasons that are not fully understood, soft tissue and bone that are subjected to these pulses of high-pressure energy heal back stronger. The FDA has approved the use of some ESWT machines for heel pain and tennis elbow. ESWT devices evolved from lithotripters (a.k.a. kidney stone shock wave machines). The discovery of the beneficial effects of ESWT came as German researchers were trying to determine what type of high-pressure pulses could be sent through the body to disintegrate kidney stones without causing harm to surrounding tissue. In laboratory animals and humans, it was discovered (with some surprise) that surrounding tissue would often heal back stronger. Physical therapists use ultrasound machines that warm internal tissue by high frequency sound waves, but the ESWT machines send higher-energy pulses 2 or 3 times per second rather than continuous lower-energy waves. Electricity is not sent into the body. It may take as long as 12 weeks to see the full benefit of an ESWT treatment. The beneficial effect of the high-pressure waves may be from the growth of new blood vessels ("neovascularization") in small cavities that are created by the pulses. New blood vessels to an area of tissue would promote healing.

Answer 4

My husband had gout and was rushed to the er and had surgery to re leave the pressure in his foot now he takes allopurinol and he has to take it for the rest of his life to prevent another gout attack.

Answer 5

visit http://www.nlm.nih.gov/medlineplus/ency/article/003104.htm
Is your doctor not helpful?