history (ankle swelling)

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Points in the history:

  • age of patient - 'stasis' or 'gravitational' oedema is common in the elderly; also degenerative diseases are more common in the elderly e.g. cancer, anaemia, heart failure
  • duration of symptom - swelling due to venous insufficiency is generally a longstanding problem, and is unlikely to present suddenly without some precipitating factor
  • mobility of patient - 'stasis' oedema is more common in the immobile patient; however so are other causes of a swollen lower limb such as a deep vein thrombosis
  • the effect of elevation and dependency - patients with pain and swelling due to venous insufficiency cannot be parted from their compression stockings when they discover what relief they bring, so long as they exert the correct degree of compression
  • associated symptoms e.g. breathlessness - may be due to cardiac failure, anaemia or carcinoma
  • past medical history - a history of ischaemic heart disease or chronic lung disease increases the likelihood of cardiac failure or cor pulomale. A previous deep vein thrombosis could lead to venous insufficiency.
  • smoking history - smoking is a risk factor for many cancers and vascular disease

Last reviewed 01/2018

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