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Massive Edema of the Lower Limbs in Patients after Spinal Cord Injury—One Picture, Different Diagnoses

Diagnosis of the cause of massive edema of the lower limbs in patients after spinal cord injury (SCI) can be difficult because of loss of pain sensation, commonly occurring in this group of patients. This paper reviews several different pathologies that can lead to lower-limb edema and the associate...

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Autores principales: Mackiewicz-Milewska, Magdalena, Cisowska-Adamiak, Małgorzata, Sakwińska, Katarzyna, Szymkuć-Bukowska, Iwona, Głowacka-Mrotek, Iwona
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8073802/
https://www.ncbi.nlm.nih.gov/pubmed/33923442
http://dx.doi.org/10.3390/ijerph18084219
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author Mackiewicz-Milewska, Magdalena
Cisowska-Adamiak, Małgorzata
Sakwińska, Katarzyna
Szymkuć-Bukowska, Iwona
Głowacka-Mrotek, Iwona
author_facet Mackiewicz-Milewska, Magdalena
Cisowska-Adamiak, Małgorzata
Sakwińska, Katarzyna
Szymkuć-Bukowska, Iwona
Głowacka-Mrotek, Iwona
author_sort Mackiewicz-Milewska, Magdalena
collection PubMed
description Diagnosis of the cause of massive edema of the lower limbs in patients after spinal cord injury (SCI) can be difficult because of loss of pain sensation, commonly occurring in this group of patients. This paper reviews several different pathologies that can lead to lower-limb edema and the associated diagnostic difficulties. We present four cases of patients with massive edemas of lower limbs at different times after SCI undergoing treatment in the Department of Rehabilitation, University Hospital in Bydgoszcz, Poland. All patients had a lack of pain sensation in the lower limbs and significantly elevated levels of D-dimer. In two cases, deep vein thrombosis (DVT) and intramuscular hematomas (IHs) were diagnosed. IHs were probably a consequence of antithrombotic treatments implemented due to the occurrence of DVT. Heterotopic ossification (HO) was diagnosed in a third case, and, in another patient, who was hospitalized for the longest period after injury, we found humeral bone fractures. Heterotopic ossification, intramuscular haematomas, and bone fractures of the lower limb can mimic DVT. Careful observation of the edema evolution is recommended, as the onset of new symptoms may indicate a different cause of edema from that initially established.
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spelling pubmed-80738022021-04-27 Massive Edema of the Lower Limbs in Patients after Spinal Cord Injury—One Picture, Different Diagnoses Mackiewicz-Milewska, Magdalena Cisowska-Adamiak, Małgorzata Sakwińska, Katarzyna Szymkuć-Bukowska, Iwona Głowacka-Mrotek, Iwona Int J Environ Res Public Health Case Report Diagnosis of the cause of massive edema of the lower limbs in patients after spinal cord injury (SCI) can be difficult because of loss of pain sensation, commonly occurring in this group of patients. This paper reviews several different pathologies that can lead to lower-limb edema and the associated diagnostic difficulties. We present four cases of patients with massive edemas of lower limbs at different times after SCI undergoing treatment in the Department of Rehabilitation, University Hospital in Bydgoszcz, Poland. All patients had a lack of pain sensation in the lower limbs and significantly elevated levels of D-dimer. In two cases, deep vein thrombosis (DVT) and intramuscular hematomas (IHs) were diagnosed. IHs were probably a consequence of antithrombotic treatments implemented due to the occurrence of DVT. Heterotopic ossification (HO) was diagnosed in a third case, and, in another patient, who was hospitalized for the longest period after injury, we found humeral bone fractures. Heterotopic ossification, intramuscular haematomas, and bone fractures of the lower limb can mimic DVT. Careful observation of the edema evolution is recommended, as the onset of new symptoms may indicate a different cause of edema from that initially established. MDPI 2021-04-16 /pmc/articles/PMC8073802/ /pubmed/33923442 http://dx.doi.org/10.3390/ijerph18084219 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Mackiewicz-Milewska, Magdalena
Cisowska-Adamiak, Małgorzata
Sakwińska, Katarzyna
Szymkuć-Bukowska, Iwona
Głowacka-Mrotek, Iwona
Massive Edema of the Lower Limbs in Patients after Spinal Cord Injury—One Picture, Different Diagnoses
title Massive Edema of the Lower Limbs in Patients after Spinal Cord Injury—One Picture, Different Diagnoses
title_full Massive Edema of the Lower Limbs in Patients after Spinal Cord Injury—One Picture, Different Diagnoses
title_fullStr Massive Edema of the Lower Limbs in Patients after Spinal Cord Injury—One Picture, Different Diagnoses
title_full_unstemmed Massive Edema of the Lower Limbs in Patients after Spinal Cord Injury—One Picture, Different Diagnoses
title_short Massive Edema of the Lower Limbs in Patients after Spinal Cord Injury—One Picture, Different Diagnoses
title_sort massive edema of the lower limbs in patients after spinal cord injury—one picture, different diagnoses
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8073802/
https://www.ncbi.nlm.nih.gov/pubmed/33923442
http://dx.doi.org/10.3390/ijerph18084219
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