Intended for healthcare professionals

Student Education

A bad leg

BMJ 2005; 330 doi: (Published 01 February 2005) Cite this as: BMJ 2005;330:050260
  1. Steven Kennish, senior house officer in general surgery1
  1. 1Pinderfields Hospital, Yorkshire School of Surgery

Your senior house officer visited a 74 year old man in the emergency department. He shows you a photograph of his right lower leg taken after he had examined it (figure).

The man's lower right leg


  • Name the clinical sign?

  • List three common causes of this problem?

  • The patient's abdomen was also grossly swollen and tense; what is this most likely to be due to?


  • Pitting oedema

  • Any three of heart failure, deep vein thrombosis, cellulitis, renal disease, proteinuria, cirrhosis, carcinomatosis, thrombophlebitis, malnutrition, lymphoedema, and immobility

  • Abdominal ascites


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