Severe pitting oedema of the left leg at initial presentation. The arrow indicates a thumbprint. 

Context in source publication

Context 1

... clinical examination revealed a severe, pitting oedema of the left foot and lower leg (up to the level of the knee; Fig. 1) with diffuse tenderness. There was no redness of the skin, but the left lower leg was slightly warmer than the right. The Homans sign was negative. The dorsalis pedis artery pulses were bilaterally palpable; the posterior tibial artery pulse was not definitely palp- able on the left, possibly due to the marked oedema. There were no signs of inguinal lymphadenopathy. Passive movements of the left foot, especially the dorsal extension, were painful. The muscle strength examination in lying position showed no weakness. The sensory functions were intact besides a mild reduction in vibra- tion sense on both lower extremities, which was attributed, together with bilaterally absent ankle jerk reflexes, to a mild per- ipheral neuropathy, probably ...