Massive Edema of the Lower Limbs in Patients after Spinal Cord Injury—One Picture, Different Diagnoses

This paper discusses the challenges in diagnosing the cause of leg swelling in patients with spinal cord injuries (SCI). Because SCI patients often have a loss of pain sensation, diagnosing the cause of edema can be difficult. The paper presents four cases of patients with SCI who experienced massive leg swelling due to different underlying conditions, including deep vein thrombosis (DVT), intramuscular hematomas (IHs), heterotopic ossification (HO), and bone fractures. Each of these conditions can be difficult to differentiate in SCI patients. The study emphasizes the importance of careful and continuous observation of edema in SCI patients, as the cause of edema may change over time. Additionally, diagnostic tools, such as ultrasound, can aid in identifying the underlying causes of edema, especially when pain sensation is impaired.

• 1
  Lower-limb edema in SCI patients can be caused by various pathologies, including DVT, intramuscular hematomas, heterotopic ossification, and fractures.
• 2
  Elevated D-dimer levels are common in SCI patients, making it difficult to use this test as the sole indicator of DVT.
• 3
  Careful observation of edema evolution is crucial, as the onset of new symptoms may indicate a different cause of edema from what was previously established.