Classification of Woo et al for Extensive Limb Swelling After Immunization

Woo et al classified extensive swelling of the limb occurring after vaccine administration. The authors are from the US Food and Drug Administration.

Extensive Limb Swelling (ELS) refers to edema/swelling of the proximal limb at least to the elbow or knee.

General features:

(1) affects all ages

(2) usually develops within 24 hours of the immunization

(3) accompanied by other signs of inflammation (erythema, warmth, pain, fever, agitation, systemic flu-like symptoms)

Extent of Limb Swelling	ELS Term
up to the elbow or knee	proximal ELS
involving the hand or foot	whole limb swelling
between elbow/knee and hand/foot	more than proximal (MTP)

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