Causes and Mechanisms of Extremity Swelling

Pathophysiologic Mechanisms

Increased hydrostatic pressure, such as in venous insufficiency and heart failure, can cause extremity swelling, as noted by the American College of Radiology 3
Increased capillary permeability due to infection, inflammation, or allergic reactions can also lead to swelling, according to the American College of Radiology 2

The American Journal of Kidney Diseases recommends assessing for jugular venous distension and cardiac findings suggesting heart failure during physical examination 1
The Journal of the American College of Radiology suggests checking for unilateral versus bilateral distribution to distinguish local from systemic causes 3
Duplex ultrasound is recommended for suspected DVT, with a sensitivity and specificity >80% for upper extremity DVT, as stated by the Journal of the American College of Radiology 2

Erythromelalgia can present with episodic burning pain and swelling in the feet and hands, triggered by heat and exercise, as described by the Mayo Clinic Proceedings 4
Psoriatic arthritis can cause painful, swollen joints in hands and feet with dactylitis, according to the Journal of the American Academy of Dermatology 6
Connective tissue diseases like scleroderma can present with hand swelling, Raynaud's phenomenon, and associated pulmonary hypertension, as noted by the European Respiratory Review 7

Deep vein thrombosis (DVT) can cause upper extremity swelling, accounting for 10% of all DVTs, and presents with ipsilateral arm edema, pain, and paresthesia, as stated by the Journal of the American College of Radiology 2
Superior vena cava syndrome can cause bilateral upper extremity swelling with facial edema, according to the Journal of the American College of Radiology 2