CT of swollen legs

Area of Science:

• Radiology
• Medical Imaging
• Diagnostic Techniques

Background:

• Swollen legs can have various causes, necessitating accurate differential diagnosis.
• Computed Tomography (CT) offers a non-invasive imaging modality for anatomical assessment.
• Distinguishing between conditions like venous obstruction, lymphoedema, and obesity is clinically important.

Purpose of the Study:

• To evaluate the utility of a single axial CT slice of the mid-calf for diagnosing the cause of leg swelling.
• To correlate CT findings with specific pathologies causing leg edema.

Main Methods:

• Review of CT findings from 64 patients with leg swelling and 10 controls.
• Analysis of a single axial CT slice at the mid-calf level.
• Comparison of imaging characteristics across different pathologies.

Main Results:

• Venous obstruction shows increased muscle compartment cross-sectional area.
• Obesity/lipoedema present with homogeneous subcutaneous fat increase.
• Lymphoedema demonstrates interstitial fluid collection, progressing to a honeycomb pattern in chronic cases due to fibrosis.
• Popliteal cysts cause fluid collections between muscle planes.
• Haematomas appear as intramuscular, high-attenuation collections.

Conclusions:

• A single mid-calf axial CT slice is a simple, quick, and non-invasive tool for the differential diagnosis of swollen legs.
• Specific CT imaging patterns reliably differentiate between venous obstruction, lymphoedema, obesity, cysts, and haematomas.
• This technique aids in efficient and accurate diagnosis of lower limb edema.