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The following summarized guidelines for the evaluation and management of peripheral edema are prepared by our editorial team based on guidelines from the American Academy of Family Physicians (AAFP 2013).
Magnetic resonance venography: obtain MRV of the lower extremity and pelvis in patients with unilateral left leg swelling and negative results on duplex ultrasound, if there is high clinical suspicion for DVT (in the context of suspected May-Thurner syndrome).
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Topical therapies: advise daily hydration with emollients and prescribe short courses of topical corticosteroid creams for severely inflamed skin to treat eczematous (stasis) dermatitis associated with chronic venous insufficiency.
Compression stockings: offer compression stockings for patients following DVT to prevent post-thrombotic syndrome.
Pneumatic compression devices: consider pneumatic compression devices in conjunction with standard therapy in patients with lymphedema.