Differential diagnosis and treatment edema. Tactics gp

Edema with joint problems
With joint problems edema has a very specific pattern. In contrast to all other options limb edema "joint" is local. He appears in the area of ​​the affected joint, not extending to the distal or prokcimalnom direction. Manifestation of edema is clearly associated with other symptoms - pain in the joint, however, increases with its flexion and extension, limit the amount of active and passive movements. Many patients say the so-called starting problems - joint stiffness in the morning after a night's rest, going after 10-20 minutes of movement. Regression of edema occurs as the elimination of inflammatory phenomena in the very next episode of acute edema reappears.
Some patients with gonarthrosis possible swelling or leg and pastoznost nadlodyzhechnoy area. The mechanism of the appearance of this symptom is associated with compression of the lymphatic vessels of the medial manifold in patients with severe subcutaneous edema in the area of ​​the knee.
Edema occur when osteoartikulyarnyh diseases:
- He almost always is local and occurs in the affected joint in the acute period of the disease, combined with the severe pain and limitation of motion in the affected joint.
After a course of treatment of edema disappears, though in the long course and frequent exacerbations of deformation of the surrounding tissues ("psevdootek") becomes constant.
Swelling pregnantIn
Normal pregnancy swelling of the ankles in the later stages are quite common. The development of edema associated with pregnancy disorders of water-salt metabolism and blood circulation in the capillaries and the system as a result of the changed prekapillyarov neuroendocrine regulation. Edema usually found pregnant after 30 weeks of pregnancy, is rare - before. Attention is called to a greater increase in body weight (1.2 kg per week, while in normal pregnancy, it is 300-400 g per week). Swelling initially appear on the feet and legs, then climb higher. Even with large edema and ascites hydrothorax observed. General condition is satisfactory. In contrast nephropathy pregnant is no change in the urine (in particular, no proteinuria), and hypertension. Prognosis is usually favorable. In rare cases, a transition to nephropathy pregnant.
Cyclic edema
Cyclic swelling in the so-called premenstrual syndrome are due, apparently, hormonal imbalance (excess of estrogen and progesterone deficiency), which affects the vascular permeability and promotes sodium and water retention. Often reveals insufficiency of the corpus luteum and anovulatory cycles. In the second half of the cycle usually appear small swelling legs and feet. Perhaps swollen gums. Sometimes dizziness, which is associated with swelling of the inner ear structures. In addition, the weakness, irritability, headaches, sleep problems (insomnia or hypersomnia), sometimes - depression. After the cessation of menstruation, these effects quickly diminish and disappear.