Feature Article

A guide to peripheral oedema

Gayathri Kumarasinghe, Gerard Carroll



Peripheral oedema is a nonspecific symptom with a wide range of potential causes. A systematic time-efficient review of the patient will aid in differentiating the benign from the more serious causes, guide initial investigations and determine who can be managed in the community and who requires specialist referral or hospitalisation.

Key Points

  • The differential diagnosis of peripheral oedema is wide, requiring a systematic approach for diagnosis and management.
  • Initial assessment of whether the oedema is generalised or localised is essential to tailor the differential diagnosis.
  • Patients whose condition is stable with localised disease processes can be investigated and managed in the community.
  • Patients with signs of advanced heart failure or of hepatic or renal disease require early specialist involvement or hospital admission.
  • Constrictive pericarditis is a medical emergency that can present with peripheral oedema. A high index of suspicion is required and patients with suggestive signs should be referred for urgent cardiologist review.

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