Ely et al listed the differential diagnosis of leg edema. The authors are from the University of Iowa, Moses Cone Hospital and Michigan State University.
Causes of unilateral leg edema of acute onset:
(1) deep vein thrombosis
(2) ruptured Baker's cyst
(3) ruptured medial head of the gastrocnemius
(4) compartment syndrome
Causes of unilateral leg edema chronic duration:
(1) venous insufficiency
(2) primary or secondary lymphedema
(3) pelvic or inguinal tumor compressing veins
(4) reflex sympathetic dystrophy
(5) congenital venous malformations
(6) May-Thurner syndrome (iliac-vein compression syndrome)
Causes of bilateral leg edema of acute onset:
(1) bilateral deep vein thrombosis
(2) acute decompensation of heart failure, renal failure or other systemic cause
Causes of bilateral leg edema of chronic duration:
(1) venous insufficiency
(2) pulmonary hypertension with or without sleep apnea
(3) heart failure
(4) idiopathic edema (in adolescent or premenopausal female)
(5) lymphedema
(6) drugs including diuretics
(7) premenstrual edema
(8) pregnancy
(9) obesity
(10) chronic kidney disease
(11) chronic liver disease
(12) pelvic or inguinal tumor compressing veins
(13) dependent edema
(14) pre-eclampsia
(15) lipidema
(16) anemia
(17) protein malnutrition (protein-losing enteropathy, malnutrition, malabsorption)
(18) restrictive pericarditis
(19) restrictive cardiomyopathy
(20) beri beri
(21) myxedema
