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What Causes Severe Sudden Onset Of Swelling In The Foot?

Posted on Wed, 16 Aug 2017

Question: Father, 80, stroke 10 years ago...on insulin. He woke up this morning with the right leg very swollen, especially the foot. Currently has it raised on an ottoman in a cool room. Somewhat overweight, goes to the gym three times a week, quit drinking alcohol five years ago but was chronic alcoholic up to that point...

Answered by Dr. Bhagyesh V. Patel (46 minutes later)

Brief Answer:
Possible cellulitis or early sign of deep vein thrombosis .

Detailed Answer:
Hello dear
Thanks for using Healthcaremagic.com
I have evaluated your query thoroughly .

* Sudden onset of such foot swelling may be
- cellulitis - developing deep vein thrombosis - others .

Kindly provide further details so that I can answer your query completely .

1. Swelling - extent , type , overlying skin changes as red , hot ;
is there pit formation when you press your fingers over it
2. Pain - if present , type , intensity , severity , frequency .
3. Can walk or difficult , painful .
4. Any smoking history .
5. Any other medications than Insulin as blood thinners .
6. If possible and no objection , a high resolution photograph of the same would
be of great help as an attachment .

Awaiting for your response .

Regards .

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Bhagyesh V. Patel (1 hour later)

Thank you Dr. XXXXXXX to answer further - the skin is cool, when pressed it leaves a white mark but then quickly returns to reddish color. There is no pain, walking is not painful a little more hobbling than usual (from the stroke), he quit smoking two packs a day 30 years ago, the medications are Glimepiride, Januvia, potassium cl, Metformin, Humalog Kwik 100u/ml 5x3 ml, Lantus solostar 5x3ml. I am going to send photos after this, thank you for your time Dr. XXXXXXX XXXX

Answered by Dr. Bhagyesh V. Patel (3 hours later)

Brief Answer:
Deep vein thrombosis most likely. suggestions provided regarding it.

Detailed Answer:
Hello XXXXXXX
Thanks for very precise pictures from all the angels .

* Seems almost deep vein thrombosis .

* Recommendations

- Immediate appointment with your primary care provider .
- He requires basic work up of laboratory with complete blood counts ,
coagulation profile , current diabetes status along with doppler ultrasound of the
periphery to check for the perfusion defect .
- Till the keep the leg elevated over 3 - 4 pillows support .
Keep moving all toes intermittently when resting also .
- Tylenol if more pain .

Wishing him fine recovery .
Welcome for further doubts .

Regards dear take care .

Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.

Above answer was peer-reviewed by : Dr. Remy Koshy