Swelling of the legs below the knees: causes and treatment

There is a stereotype that swelling of the lower limbs is associated only with excessive fluid intake and a sedentary lifestyle. If you have swollen legs below the knees, the reasons for this can be more alarming. In fact, the presence of this symptom can be a formidable harbinger of cardiovascular pathology, kidney disease, liver, inflammatory bowel disease, iliac vein compression and other serious diseases.

Correctly performed diagnostics allows to reveal the main disease in time and to select effective timely therapy.

Right ventricular failure

Swelling of the legs can be a consequence of right ventricular failure. Wherein:

• There is shortness of breath, reduces the ability to perform the usual physical activity (climbing the stairs, walking). Weakness and rapid fatigue are caused by oxygen starvation of tissues due to inferior blood supply.
• There are swelling of the legs.

Let's consider more in detail, for what reason the legs below the knees swell with right ventricular failure. Due to the deterioration of the contractility of the ventricles, adequate blood supply to organs and tissues is disrupted, activation of the sympathoadrenal system occurs, and the lumen of the venules and arterioles narrows, and the number of cardiac contractions increases. In response to vasoconstriction, blood pressure rises, the renin-angiotensin-aldosterone system is activated, renal blood flow decreases, sodium and water retention occurs, vascular blood flow increases, hydrostatic pressure in the veins increases.

If the legs swell below the knees, the reasons for this may be that the permeability of the vessels has been increased, in reducing the synthesis of protein and excretion of it in the urine due to the affection of the kidneys.

Cardiogenic swelling develops gradually, maximum expressed by the end of the day. Distribute from the bottom up.

The first swelling of the feet, there are complaints of crowdedness, inconvenience of shoes. Then the calf drips. The skin is cold to the touch, pale cyanotic. There are marks from socks, rubber bands, shoes fasteners. When pressing on the skin, the fossa is permanently retained.

Symmetry of edema is characteristic. With prolonged sitting, there may be an edema of the lumbar region.

When decompensation of right ventricular failure, edema becomes widespread. Ascites appear (filling the abdominal cavity with liquid). Perhaps the development of anasarca (extensive swelling of the skin and subcutaneous fat).

Left ventricular failure

For left ventricular failure is more typical manifestations of cardiac asthma:

1. Orthopnea (the patient can not be in a horizontal position, due to increased blood filling of the pulmonary capillaries and the development of severe dyspnoea).
2. Paroxysmal nocturnal breathing (severe dyspnoea, appearing during sleep, accompanied by wheezing, wheezing, pronounced cough, cyanosis of the face).
3. The wheezing in the lungs.
4. Profuse cold sweat.

Diagnosis of left ventricular failure

1. Electrocardiography (estimated violations of rhythm and conductivity, the presence of pathological teeth).
2. Echocardiography (the fraction of cardiac output, the thickness of the walls of the atria and ventricles, the presence of damage to valves or stenoses, structural changes in the pericardium), daily monitoring of the ECG (holter).
3. Chest X-ray.
4. Test under load to determine the functional class of heart failure.
5. Urine test for protein content.
6. A blood test with the definition of markers of myocardial damage.
7. Immunoglobulins M and G to cytomegalovirus and Epstein-Barr virus.
8. Assessment of the level of natriuretic peptides.

Treatment

Therapy consists of the following measures:

• A diet with salt restriction in accordance with the degree of heart failure;
• Dosed physical exercise, daily walking;
• Drug therapy (diuretics, cardiac glycosides, angiotensin-converting enzyme blockers, beta-adrenoblockers, antiaggregants, antiarrhythmics).

With left ventricular failure, the legs swell below the knees? The reasons and recommendations for treatment are examined.

Renal edema

Unlike cardiac edema, the kidneys are most pronounced in the morning, develop from the top down. Initially swollen eyelids, face. Closer to the second half of the day, swelling of the legs (shins and ankles), swelling of the face is less pronounced. The skin is soft, warm, the fossa quickly disappears after pressing with a finger. The presence of cyanosis is not typical.

The ability of edema to "migrate" is an important diagnostic sign in the pathology of the kidneys.

There is a tendency to increased pressure.

If the leg is lowered in the kidneys below the knee, the reasons, treatment, and other useful recommendations, you will find below.

Edema is associated with toxic-immune damage to the glomeruli of the kidneys, a decrease in the rate of their filtration, fluid retention, an increase in blood volume, the release of plasma blood components into tissues due to increased vascular permeability and decreased oncotic blood pressure due to pronounced loss of protein in the urine.

And yet, why swell the legs below the knees? The causes and symptoms of these unpleasant sensations are interrelated.

With the development of edema due to glomerulonephritis, there is a connection with a transmitted infection, for example, angina.

With nephritic syndrome, edema is less pronounced, characterized by a hematuric syndrome (urine acquires a color of meat slops).

Nephrotic syndrome is accompanied by a massive loss of protein in the urine and marked swelling up to the anasarca.

Diagnosis of renal edema

• Protein in urine.
• Urine for sterility.
• Determination of streptococcal and staphylococcal antibodies to serum.
• Ultrasound examination of the kidneys.
• Control of blood pressure.
• Blood test.

General principles of treatment

In therapy, the following are used:

• Diet with restriction of salt, protein and liquid;
• Bed rest;
• Systemic antibiotic therapy;
• The appointment of diuretics;
• Lowering blood pressure;
• Antihistamine therapy;
• Use of non-steroidal anti-inflammatory drugs;
• Anticoagulants and antiaggregants (for the prevention of microthrombogenesis and further damage to the glomeruli);
• Glucocorticosteroids and cytostatics in the treatment of nephrotic syndrome.

Lesion of the liver

Why do swollen legs below the knees? The causes and symptoms of these unpleasant sensations can talk about liver diseases.

Decreased protein synthesis in the liver due to severe damage to its tissue (terminal stage of hepatitis, cirrhosis, fatty degeneration, hepatocellular carcinoma) is accompanied by severe widespread swelling, down to the anasarca. Hepatic edema is accompanied by a pronounced itch of the skin, combs, vascular asterisks, fragility of the capillaries, jaundice of the skin and visible mucous membranes.

Diagnosis of liver damage

1. Urine examination.
2. Study of feces.
3. Blood test, determination of the level of the total protein, liver samples (ALAT, ACAT, GGT, bilirubin, alkaline phosphatase), the thymol test, the level of urea and creatinine are investigated.
4. Ultrasound.
5. Markers of viral hepatitis, immunoglobulins M and G to cytomegalovirus and Epstein-Barr virus.
6. Blood for HIV.

Varicose disease

What else has such a phenomenon as swelling of the legs below the knee, causes? Redness and peeling of the skin is characterized by varicose veins on the legs, which is accompanied by dull aching pain, rapid fatigue, heaviness in the legs.

With severe lesions, trophic skin changes are possible: dermatitis, ulcers, hyperpigmentation. Visually visible contour venous patterns, pronounced edema, enlargement and swelling of the veins, trophic skin changes. Edema is asymmetric, of varying severity, depending on the degree of venous damage.

The presence of edema on the legs is of an isolated nature and is not combined with other clinical symptoms (dyspnea, cough, edema on the face and trunk, fever, etc.).

If you are concerned about varicose edema of the leg below the knee, reasons, photos and other useful information are available in this article. Perhaps this will help you.

Treatment of varicose veins

In severe lesions, surgical treatment (phlebosclerosis) is used.

Medication includes the use of venotonic and antiaggregants.

Phlebothrombosis

What is the reason for swelling of the legs below the knee, in addition to the above diseases? Swelling of the legs may occur including phlebothrombosis. With deep vein thrombosis, the initial stages proceed without signs of inflammation of the vein wall.

Redness of the skin swelling is rare. The skin is glossy, the venous pattern is clearly contoured. Appears only puffiness of the affected leg. Characteristic of the spread of pain on the inner surface of the thigh. Pain sharply increases with walking.

Venous insufficiency

Let's consider more in detail, for what reason the legs below the knees swell with chronic venous insufficiency. The constantly progressive defeat of the venous system is accompanied by symmetrical edema, disappearing by morning and appearing in the evening. There is reddening of the skin of the lower legs (on the background of pronounced puffiness). Very rarely there is a one-sided defeat.

Arthritis and systemic diseases

Pain and swelling in arthritis are associated with an effusion in the joint cavity. The joint is enlarged in size. The redness of the skin is characteristic.

The debut of juvenile arthritis (up to 16 years) is accompanied by a sharp onset, fever, a rash on the skin of the face, trunk, buttocks, over the joints. Affect internal organs. Rheumatoid arthritis is characterized by morning stiffness in movements.

Hemorrhagic vasculitis of Shenlaine - Genocha

If you have a Henoch-Henoch hemorrhagic vasculitis , and you are worried about why the right leg is lowered below the knee, the reasons will be considered below.

Typical connection with the transmitted infection, the use of antibiotics, the presence of severe allergic reactions.

With articular form characterized by: swelling, swelling of the knee joints, muscle pains, hemorrhagic rash on the extremities, hips and buttocks.

Hemophilia

Due to a violation of coagulation, there may be bleeding in the muscles, joints associated with minor trauma. The affected joint is edematous, sharply painful during movement and palpation, the skin is hyperemic, hot to the touch.

Appearance of edema on the legs, not associated with the presence of pathologies

If the legs swell below the knees, the reasons for this are not always associated with pathology. The onset of edema can be a consequence:

• Alcohol abuse;
• Excessive consumption of salty foods that cause fluid retention;
• Protective reaction to overheating of the body;
• Increased stress on the foot and spine associated with wearing uncomfortable shoes, too high heels;
• Stagnant phenomena and increased pressure in the veins due to a sedentary lifestyle;
• Physiological edemas with prolonged physical work;
• Excess weight;
• Edema during pregnancy (only massive, rapidly increasing edema accompanied by nausea, increased blood pressure and headache - the threat of eclampsia);
• Edema in the premenstrual syndrome.

So, you need to worry if your legs often swell below your knees. The causes and types of edema can be different.

In prophylactic purposes, it is recommended: to normalize body weight and balance nutrition, to stop using alcohol, to regularly undergo preventive examinations with the therapist, to include daily and regular exercise in the regime of the day. In the absence of pathology on the part of the kidneys and the cardiovascular system, yoga (inverted asanas), exercise therapy (exercise "birch") are effective for normalizing venous outflow.

What should I do if my legs swell below my knees? The reasons, than to treat, how to get rid of it - all this is of interest to those who have encountered a problem. Our article answers all these questions.