Peripheral edema is the presence of excess interstitial fluid in the tissue of the extremities, which causes palpable swelling.
Edema develops when microvascular filtration, and therefore interstitial fluid production, exceeds lymph drainage for a sustained period. This could be because the microvascular filtration rate is high, lymph flow is low, or both.
The body has a number of homeostatic mechanisms that serve to maintain interstitial fluid balance, and these must be overwhelmed before fluid buildup becomes evident as peripheral edema. Clues generated by the history, physical examination, and targeted evaluation help to identify the factors affecting lymphatic drainage and microvascular filtration. In many patients, multiple factors contribute to the development of peripheral edema.
Peripheral edema is called lymphedema when it is predominantly caused by inadequate lymphatic drainage.
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