[The swollen leg and clarification of bilateral leg swelling : Practical procedure in general practice].Internist (Berl). 2020 Jan; 61(1):36-43.I
Swelling of soft parts of the lower extremities, whether uni- or bilateral, is a common reason for consulting a general practitioner (GP). Complex interactions mean that GPs are faced with a wide range of differential diagnoses during clarification of such findings. Of enormous importance is the prevention of a dangerous course, e.g., by initiating weight-adapted calculated antibiotic treatment, antithrombotic therapy, or even initial inpatient treatment and acute diagnostic workup in case of impending compartment syndrome or extensive venous thrombosis of the leg with or without suspicion of pulmonary embolism. Sometimes an acute venous thrombosis of the leg unmasks malignant disease. A swollen leg/swollen legs are frequently a leading symptom of decompensating heart or renal failure. Another possible cause are drug side effects, which may be exacerbated in a warm environment. An endocrine cause must also be considered in some cases. The GP is the appropriate physician for patients to contact and to initiate and coordinate diagnostics and treatment. In addition to coordination of specialist examinations, it is not infrequent that nurses and physiotherapists have to be involved in treatment, to ensure successful outpatient care.