. Physical diagnosis . Fig. 236.—Angioneurotic oedema of legs. 5. Sarcoma not infrequently attacks the upper end of the tibia orfibula, producing lesions similar to those described in the femur. 6. (Edema of the legs1 is oftenest due to: (a) Uncompensated heart lesions, primary or secondary fromlung disease. (6) Nephritis. (c) Cirrhotic Liver. (d) Anaemia. 1 It is notable that oedema is usually greatest in the front of the leg and in the back ofthe thigh. 432 PHYSICAL DIAGNOSIS (e) Neuritis (alcoholic, beri-beri, etc.). (/) Varicose veins. (g) Obesity, flat-foot, and other causes of deficient
. Physical diagnosis . Fig. 236.—Angioneurotic oedema of legs. 5. Sarcoma not infrequently attacks the upper end of the tibia orfibula, producing lesions similar to those described in the femur. 6. (Edema of the legs1 is oftenest due to: (a) Uncompensated heart lesions, primary or secondary fromlung disease. (6) Nephritis. (c) Cirrhotic Liver. (d) Anaemia. 1 It is notable that oedema is usually greatest in the front of the leg and in the back ofthe thigh. 432 PHYSICAL DIAGNOSIS (e) Neuritis (alcoholic, beri-beri, etc.). (/) Varicose veins. (g) Obesity, flat-foot, and other causes of deficient local circu-lation. In some cases no cause can be found (angioneurotic oedema,essential and hereditary oedema). Diagnosis of the cause of. Fig. 237.—Sporadic elephantiasis. (Non-filarial. oedema depends on the history and the examination of the rest ofthe body. In one leg oedema may be due to thrombosis of a vein (see page427), to pressure of tumors in the pelvis (pregnancy, etc.), to hemi-plegia, elephantiasis (see Figs. 237 and 238) or to inflammation. 7. Tenderness in the lower legs frequently accompanies oedema THE LEGS AND FEET 433 from any cause. It may also be due to neuritis or trichiniasis, and,of course, to any local inflammation. The Feet. i. The varieties of club-foot are: (a) Equinus, the heel drawnup. (b) Varus, the ankle bent outward, (c) Valgus, the anklebent inward and the foot outward, (d) Calcaneus, the foot turnedoutward and upward.
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