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The therapist often has to advisepatients with asymmetric swelling of the lower extremities. Suffer usually young women who for many years unsuccessfully trying to get rid of edema, using all sorts of combinations of cardiac funds. In most cases, these swelling is lymphatic.
There are two types of lymphatic edema: primary (congenital). arising from a congenital defect in the development of the lymphatic vessels of the legs, and secondary (acquired), developing with their inflammation. Lymphatic edema in patients with filariasis and other parasitic diseases of lymphatic vessels in Russia is not found due to the complete elimination of sources of infection. Lymphatic edema arising from the obstruction of lymphatic vessels with a tumor, go beyond the competence of the therapist.
Primary non-inflammatory lymphatic edemalower extremities is called congenital when it first appears in childhood, early - when it occurs in the second decade of life and later - when it appears for the first time after 30 years. The latter variant of the disease is more common than others. First, only one leg is affected and usually moderately. Later, edema of both legs is noted, and one, as a rule, swells considerably more than the other.
Inspection and palpation can be detected usuallya pronounced boundary between the edematous and the non-flowing part of the limb. At the beginning of the disease, edema spreads only to the ankle joint, in later stages - to the knee joints and in the far-reaching ones - to the puarth ligament. In the early stages of the disease, edema can sometimes disappear for several years.
At first, swelling is mild, butafter repeated lymphangites and cellulites become more dense. Disfiguration of the limbs is observed only after many years of illness. Occasionally, not only the lower limbs but also the upper limbs are affected.
In practical work, the therapist sometimes hasto face with lymphatic edema of the upper limb in women who underwent radical surgery for a breast cancer. The diagnosis of this type of lymphatic edema usually does not cause difficulties.