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I Hope That Someone Is A Vascular Specialist. I'm Male,
Question: I hope that someone is a vascular specialist. I'm male, age 61 yr, 6'2", 207 lb, no history of cardiac or vascular issues. Right foot has been visibly swollen from ankle level downward since early November. No pain, loss of motion/function/range/strength, change of temperature to the touch, or known injury. Color in this condition is paler than normal (not red, except perhaps on ankle itself -- hard to see). Saw a GP; x-ray shows no osseous abnormalities; no particular pain on palpation. GP ruled out cardiac issues but gave no other guidance. Daylong wearing of compression sock typically restores foot to or almost to normal size but for residual swelling around ankle, extending toward Achilles' tendon. Zero discomfort at all times; am unaware of it except when looking at it. NSAIDs (aspirin, Tylenol, 800 mg ibuprofen) and elevation have no effect. Physical therapist suggests Doppler investigation of vein in calf. What are the differential diagnoses and your level of concern? Thanks.
I hope that someone is a vascular specialist. I'm male, age 61 yr, 6'2", 207 lb, no history of cardiac or vascular issues. Right foot has been visibly swollen from ankle level downward since early November. No pain, loss of motion/function/range/strength, change of temperature to the touch, or known injury. Color in this condition is paler than normal (not red, except perhaps on ankle itself -- hard to see). Saw a GP; x-ray shows no osseous abnormalities; no particular pain on palpation. GP ruled out cardiac issues but gave no other guidance. Daylong wearing of compression sock typically restores foot to or almost to normal size but for residual swelling around ankle, extending toward Achilles' tendon. Zero discomfort at all times; am unaware of it except when looking at it. NSAIDs (aspirin, Tylenol, 800 mg ibuprofen) and elevation have no effect. Physical therapist suggests Doppler investigation of vein in calf. What are the differential diagnoses and your level of concern? Thanks.
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Welcome to Ask a Doctor service!
I passed carefully through your question and would explain that your symptoms are suggestive of chronic venous insufficiency in this leg.
For this reason, I agree with your therapist on the recommendation for a Doppler ultrasound of the leg vessels in order to rule in/out this possibility.
Other possible causes , which should be considered for the differential diagnosis are:
- kidney and liver dysfunction. In such case kidney and liver function tests should be checked.
- diabetes: for this reason fasting glucose and HbA1C should be checked
- chronic lymphedema, although it would be much more swelling
- a local infection (maybe a cellulitis or a mycotic infection). For this reason, consulting with a dermatologist may be needed.
Hope you will find this information helpful!
I remain at your disposal in case of further questions whenever you need!
Kind regards,
Dr. Ilir Sharka, Cardiologist
I would explain as follows:
Detailed Answer:
Hello!
Welcome to Ask a Doctor service!
I passed carefully through your question and would explain that your symptoms are suggestive of chronic venous insufficiency in this leg.
For this reason, I agree with your therapist on the recommendation for a Doppler ultrasound of the leg vessels in order to rule in/out this possibility.
Other possible causes , which should be considered for the differential diagnosis are:
- kidney and liver dysfunction. In such case kidney and liver function tests should be checked.
- diabetes: for this reason fasting glucose and HbA1C should be checked
- chronic lymphedema, although it would be much more swelling
- a local infection (maybe a cellulitis or a mycotic infection). For this reason, consulting with a dermatologist may be needed.
Hope you will find this information helpful!
I remain at your disposal in case of further questions whenever you need!
Kind regards,
Dr. Ilir Sharka, Cardiologist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Welcome to Ask a Doctor service!
I passed carefully through your question and would explain that your symptoms are suggestive of chronic venous insufficiency in this leg.
For this reason, I agree with your therapist on the recommendation for a Doppler ultrasound of the leg vessels in order to rule in/out this possibility.
Other possible causes , which should be considered for the differential diagnosis are:
- kidney and liver dysfunction. In such case kidney and liver function tests should be checked.
- diabetes: for this reason fasting glucose and HbA1C should be checked
- chronic lymphedema, although it would be much more swelling
- a local infection (maybe a cellulitis or a mycotic infection). For this reason, consulting with a dermatologist may be needed.
Hope you will find this information helpful!
I remain at your disposal in case of further questions whenever you need!
Kind regards,
Dr. Ilir Sharka, Cardiologist
I would explain as follows:
Detailed Answer:
Hello!
Welcome to Ask a Doctor service!
I passed carefully through your question and would explain that your symptoms are suggestive of chronic venous insufficiency in this leg.
For this reason, I agree with your therapist on the recommendation for a Doppler ultrasound of the leg vessels in order to rule in/out this possibility.
Other possible causes , which should be considered for the differential diagnosis are:
- kidney and liver dysfunction. In such case kidney and liver function tests should be checked.
- diabetes: for this reason fasting glucose and HbA1C should be checked
- chronic lymphedema, although it would be much more swelling
- a local infection (maybe a cellulitis or a mycotic infection). For this reason, consulting with a dermatologist may be needed.
Hope you will find this information helpful!
I remain at your disposal in case of further questions whenever you need!
Kind regards,
Dr. Ilir Sharka, Cardiologist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you, Dr. Sharka. If chronic venous insufficiency is found, am I correct that the typical first action would be injection of a substance to eliminate thrombosis (if this, what substance?), and that surgical correction would be an extreme solution only if everything else failed?
My liver, kidney, glucose, and HbA1C laboratory readings have been stable and normal for many years. A few months ago, an insect bit me on my right upper thigh, and the bite still itches; however, the area did not swell, and the location of the bite was never larger than a pencil tip, so I am not inclined to view this as the cause (although I will mention it to my health providers).
Thank you again.
My liver, kidney, glucose, and HbA1C laboratory readings have been stable and normal for many years. A few months ago, an insect bit me on my right upper thigh, and the bite still itches; however, the area did not swell, and the location of the bite was never larger than a pencil tip, so I am not inclined to view this as the cause (although I will mention it to my health providers).
Thank you again.
Thank you, Dr. Sharka. If chronic venous insufficiency is found, am I correct that the typical first action would be injection of a substance to eliminate thrombosis (if this, what substance?), and that surgical correction would be an extreme solution only if everything else failed?
My liver, kidney, glucose, and HbA1C laboratory readings have been stable and normal for many years. A few months ago, an insect bit me on my right upper thigh, and the bite still itches; however, the area did not swell, and the location of the bite was never larger than a pencil tip, so I am not inclined to view this as the cause (although I will mention it to my health providers).
Thank you again.
My liver, kidney, glucose, and HbA1C laboratory readings have been stable and normal for many years. A few months ago, an insect bit me on my right upper thigh, and the bite still itches; however, the area did not swell, and the location of the bite was never larger than a pencil tip, so I am not inclined to view this as the cause (although I will mention it to my health providers).
Thank you again.
Brief Answer:
I would recommend as follows:
Detailed Answer:
Hello again!
Thank you for the additional information!
Regarding chronic venous insufficiency, it is not the same thing as deep vein thrombosis. So, there is no need to remove any blood clot.
In my opinion your symptoms are not suggestive of any blood clot. The chronic venous insufficiency can be treated with surgery or laser therapy or sclerotherapy to help remove the problematic veins.
You can take blood thinners to help prevent a possible blood clotting in the future.
Compression socks are another treatment option, but not a cure. They just help relieve the swelling.
Regarding the bite, i don't think that it is related to your symptoms, as in case of an infection, it would cause swelling of the entire leg or other symptoms ( allergy symptoms, changes in your blood lab tests, fever, etc..).
Hope you will find this information helpful!
Wishing all the best,
Dr. Iliri
I would recommend as follows:
Detailed Answer:
Hello again!
Thank you for the additional information!
Regarding chronic venous insufficiency, it is not the same thing as deep vein thrombosis. So, there is no need to remove any blood clot.
In my opinion your symptoms are not suggestive of any blood clot. The chronic venous insufficiency can be treated with surgery or laser therapy or sclerotherapy to help remove the problematic veins.
You can take blood thinners to help prevent a possible blood clotting in the future.
Compression socks are another treatment option, but not a cure. They just help relieve the swelling.
Regarding the bite, i don't think that it is related to your symptoms, as in case of an infection, it would cause swelling of the entire leg or other symptoms ( allergy symptoms, changes in your blood lab tests, fever, etc..).
Hope you will find this information helpful!
Wishing all the best,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
I would recommend as follows:
Detailed Answer:
Hello again!
Thank you for the additional information!
Regarding chronic venous insufficiency, it is not the same thing as deep vein thrombosis. So, there is no need to remove any blood clot.
In my opinion your symptoms are not suggestive of any blood clot. The chronic venous insufficiency can be treated with surgery or laser therapy or sclerotherapy to help remove the problematic veins.
You can take blood thinners to help prevent a possible blood clotting in the future.
Compression socks are another treatment option, but not a cure. They just help relieve the swelling.
Regarding the bite, i don't think that it is related to your symptoms, as in case of an infection, it would cause swelling of the entire leg or other symptoms ( allergy symptoms, changes in your blood lab tests, fever, etc..).
Hope you will find this information helpful!
Wishing all the best,
Dr. Iliri
I would recommend as follows:
Detailed Answer:
Hello again!
Thank you for the additional information!
Regarding chronic venous insufficiency, it is not the same thing as deep vein thrombosis. So, there is no need to remove any blood clot.
In my opinion your symptoms are not suggestive of any blood clot. The chronic venous insufficiency can be treated with surgery or laser therapy or sclerotherapy to help remove the problematic veins.
You can take blood thinners to help prevent a possible blood clotting in the future.
Compression socks are another treatment option, but not a cure. They just help relieve the swelling.
Regarding the bite, i don't think that it is related to your symptoms, as in case of an infection, it would cause swelling of the entire leg or other symptoms ( allergy symptoms, changes in your blood lab tests, fever, etc..).
Hope you will find this information helpful!
Wishing all the best,
Dr. Iliri
Note: click here to Consult a cardiac surgeon online. to know the best treatment option for your heart-related issues
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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