Pitting Edema

What Is Pitting Edema?

Pitting edema is when a swollen part of your body has a dimple (or pit) after you press it for a few seconds. It can be a sign of a serious health issue.

Pitting vs. Non-Pitting Edema

Edema (swelling) usually happens in your feet, ankles, or legs. But you also might notice it in your face, hands, arms, or other areas.

If you press your finger to a swollen area, it will usually bounce right back. If it leaves a dimple, you have what's called a pitting edema.

Symptoms of Pitting Edema

Many of the symptoms of pitting edema are similar to other types of edema. The symptoms will depend on what part of your body is swollen and may include:

  • A full or heavy feeling
  • Joints that may be hard to move
  • Stretched, shiny, or reddened skin
  • Warm or hot skin
  • Dough-like skin
  • Tenderness
  • Trouble walking
  • Fatigue

These symptoms may be a sign of a more serious health problem:

Pitting Edema Causes and Risk Factors

Edema is caused by extra fluid in your tissues. This can happen for many reasons, including:

For some people, pitting edema can be a sign of a more serious health issue, such as:

  • Blood clot: One of these in a deep vein can cause edema in the region of the clot. This is called "deep vein thrombosis," or DVT. If a DVT is present in one leg, edema may be present in just one leg.
  • Congestive heart failure: If your heart is too weak to pump blood around your body the way it should, fluid will build up in your tissues. Many people with heart problems get swelling in their legs.
  • Kidney disease: It's your kidneys' job to get rid of extra salt and water from your body. If they aren't working right, you can get high blood pressure and pitting edema.
  • Liver disease: If blood isn't flowing normally through your liver, edema can form in your lower legs.
  • Lung disease: If the pressure in your heart or lungs gets too high because of a disease like emphysema, pitting edema can show up in your legs or feet.
  • Vein problems: If your veins have trouble bringing blood back up from your feet to your heart, blood can pool in your feet and ankles. Extra fluid leaks out of your blood vessels and into nearby tissue.

Pitting edema can happen to anyone. But it’s more likely if you:

  • Are pregnant
  • Have other chronic illnesses like heart, kidney, or liver disease
  • Have a traumatic injury
  • Eat too much salt or processed food
  • Take certain medications
  • Are inactive, especially when it’s hot

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Pitting Edema Diagnosis

If you notice signs of pitting edema, see your doctor as soon as you can. They'll look at it and ask about other symptoms. They may test your blood or urine to check your liver or kidney function. You might have an electrocardiogram (ECG or EKG) and other tests to check your heart.

Grading pitting edema

The doctor may give your pitting edema a grade or measure it. These grades, from 1 to 4, tell you how serious it is. The system is based on how deep the pits are and how long they last after you press the swollen area.

  • 1+: You can barely see the pit.
  • 2+: You see a slight pit. It goes away within 15 seconds.
  • 3+: You see a deeper pit. It takes up to 30 seconds to go away.
  • 4+: The pit is deep and takes more than 30 seconds to go away.

Pitting Edema Treatment

Treatment for your edema will depend on the cause. Your doctor may recommend that you:

  • Get treatment for a related chronic illness.
  • Eat less salt.
  • Take a drug called a diuretic that helps your body get rid of extra fluid.
  • Wear compression stockings, sleeves, or gloves to keep pressure on the swollen area and stop fluid from building up.
  • Raise the part of your body with the pitted edema above your heart a few times during the day or while you sleep.
  • Do exercises that help lower swelling.

When to get emergency help

Get help for pitting edema right away if you have chest pain that lasts more than a few minutes, trouble breathing, dizziness, confusion, or fainting spells. These are signs that you might have a serious heart problem or a blood clot in your lungs.

Pitting Edema Prevention

If you’re getting treatment for the cause, the pitting edema should get better. You can help prevent it from happening again by lowering salt in your diet, staying active, and wearing compression stockings, sleeves, or gloves.

WebMD Medical Reference Reviewed by Brunilda Nazario, MD on July 27, 2020

Sources

SOURCES:

American Family Physician: "Edema: Diagnosis and Management."

The American Journal of Medicine: “Peripheral edema.”

Journal of the American Board of Family Medicine: “Approach to leg edema of unclear etiology.”

Mayo Clinic: "Leg Swelling," "Edema."

Physician Education Program: "Edema."

U.S. National Library of Medicine: "Causes and Signs of Edema."

UpToDate: "Patient Information: Edema (Swelling) (Beyond the Basics)."

Cleveland Clinic: “Edema.”

University of Missouri: “Geriatric Examination Tool Kit.”

Frontiers in Medicine: “Fluid Redistribution in Sleep Apnea: Therapeutic Implications in Edematous States.”

Rush University Medical Center: “Edema.”

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