Lower Extremity Edema

Edema refers to a condition that is often associated with accumulation of fluids in the tissues. It is predominantly caused because of an inflamed or infected tissue. The nature and type of edema caused can depend on various reasons such as trauma, infections or hereditary diseases. Edema is prominently noticed in few areas of the body especially in the legs. In most cases edema is also associated with an existing cardiac or renal condition. The edema associated with vital organs is because of fluid retention. Edema of the lower extremities is often associated with disorders of the vital organs or sometimes because of any prolonged activity such as standing or even sitting.

Fluid electrolyte balance is an important factor in understanding various edematous conditions, especially pertaining to lower extremities. In many cases, it is because of an inflammatory response to the trauma caused to a tissue or an internal organ. Other factors such as urinary infections and cystitis, which are common renal diseases, cause edema in the legs. It is essential to classify the type of edema in order to arrive at an appropriate diagnosis and treatment. Physicians upon general examination and history of the patient can evaluate the edema in to two - pitting and non-pitting.

Pitting edema of the lower extremities is often associated with indentation to the edematous region for a specific amount of time upon applying pressure. Non-pitting edema does not show indentation. Characteristic pitting edema is generally bilateral in nature. Infections caused by Streptococcus especially rheumatoid arthritis cases present prominent edematous appearances. Sometimes, Gout's disease and cellulitis cause edema of the legs. The physiology associated with all these medical conditions have common diagnostic affirmations related to fluid electrolyte balance. Another important factor associated with edema is the protein intake. Higher protein intake can lead to increased uric acid levels causing edema. Decreased protein intake in conditions such as nephrotic syndrome and starvation can lead to edema.

The production of endothelin protein is prominent in edematous conditions. The relevance to this protein production is an important factor for the onset of hydrostatic condition leading to increase systolic pressure causing arterial vasoconstriction. A cascade of metabolic changes occur because of this condition leading to disturbances in renin Angiotensin mechanism and also increased capillary permeability.

The common treatment options for treating edema are the administration of diuretics and vasodilators. In case of infections of bacterial and fungal origin, antibiotics are given to facilitate prophylaxis. Coumadin and Flavonoids are used as therapeutics in addition to vasodilators. Surgical interventions such as liposuction also benefit the patient to a larger extent.

Electrolyte Imbalance

The human body is composed of up to 60 % water. Adequate fluid and electrolyte levels are essential for healthy functioning of all organs and body systems. Electrolytes are found in the blood, urine, tissues and body fluids. Sodium, calcium, potassium, chlorine, phosphate and magnesium play an important role conducting electric charge within the body. These minerals must be maintained in the appropriate ratio for proper functioning of the muscles, nerves, brain and heart. If there is any imbalance in their ratio, which usually occurs due to change in water levels in the body, electrolyte imbalance will occur. The kidneys work as major regulators of the electrolyte balance. Kidney malfunction results in excessive electrolyte retention or excretion resulting in an imbalance.

Symptoms of electrolyte imbalance vary with the electrolyte. Typical symptoms of electrolyte imbalance include fatigue, dizziness, excessive sweating, cold extremities and trembling. Swelling in the feet, ankles, legs, and hands might also be due to a fluid and electrolyte imbalance. There might be nausea, reduced urine output, dark urine, dry skin, aching joints and dry mouth. In cases of severe electrolyte imbalance, there might be convulsions and seizures.

Urine test and blood tests are done to evaluate the electrolyte imbalance. Often kidney ultrasound or EKG might be ordered. Based on the electrolyte that is out of balance, treatment includes dietary changes, fluid intake restrictions and medications to correct the imbalance. Often medication like corticosteroids, laxatives, cough medicines, diuretics and oral contraceptives can cause changes in the electrolyte balance.

Hyponatremia: Imbalance in sodium concentration in the plasma.

Hypokalemiaa: Deficiency of potassium in the bloodstream.

Hypercalcemia: Elevated calcium level in the blood.

CMP blood test

A CMP (Comprehensive Metabolic Panel) blood test is a set of specific tests that aid in providing a physician with vital information on the status of a patient's liver, kidneys, blood sugar, blood proteins and electrolyte balance. Often a CMP blood test is part of a yearly examination. The CMP blood test encompasses:

• BUN blood test
  
• Creatinine test
  
• ALP blood test
  
• ALT blood test
  
• AST blood test
  
• Bilirubin test
  
• Glucose test
  
• Calcium test
  
• Albumin test
  
• Total Protein test
  
• Sodium test
  
• Potassium test
  
• CO2 test
  
• Chloride test