Pitting Edema,
What Do You See? No. 18

The highly mobile skin on the dorsum of the hand allows excess fluid (edema) to accumulate in the dorsal “pocket.” When pressure is applied in one area (by the thumb of the examiner) and the indentation persists after releasing the pressure, the edema is referred to as pitting edema.

Although any constriction around an extremity can cause pitting edema, it is most commonly seen in the hand following significant dorsal trauma which damages the dorsal lymphatic system. The internal pressure created by this magnitude of edema offers resistance to motion. Attempts to mobilize a stiff, edematous hand must include edema reduction.

Pitting edema on a hand

 

ADDITIONAL SUGGESTED READING

Clinical Pearl No. 34 – Edema Control Instructions for Patients

Book Chapter – Spring-Wire Extension Splinting of the Proximal Interphalangeal Joint, Rehabilitation of the Hand – 1995

Clinical Pearl No. 9 – To Glove or Not to Glove; That is the Question

Clinical Pearl No. 19 – Interosseous Muscle Tightness Testing

Clinical Pearl No. 20 – Quantifying Interosseous Muscle Tightness

Clinical Pearl No. 21 – Nuances of Interosseous Muscle Tightness Testing

Clinical Pearl No. 14 – How Long Should I Serial Cast a Finger?

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Disclaimer: HandLab’s What Do You See? is intended to be an informal sharing of practical clinical ideas; not formal evidence-based conclusions of fact.