Circumferential Measurements
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Purpose: Measure the quantity of edema a patient has and compare the amount of limb edema from one side to another.
Procedure: Upper extremity
Figure 8— This detects the presence of hand edema.
Lower extremity—
Ankle/foot (figure 8)—***in acute edema*** from: Esterson, P. Measurement of Ankle Joint swelling Using a Figure of 8. JOSPT, 1979. Measures the swelling around the talar and subtalar joints. 1. The ankle is maintained in a neutral position for eversion and inversion while flexed to 90 degrees (if range of motion permits), 2) the patient is in a long sitting position. Landmarks Mark the following landmarks with a skin pencil: 1) tuberosity of the navicular 2) base of the 5th metatarsal 3) distal tip of the medial malleolus 4) distal tip of the lateral malleolus 5) tibialis anterior tendon. Placement of the tape measure SUBTALAR JOINT 1) The beginning of the tape is placed midway between the tibialis anterior tendon and lateral malleolus; 2) the tape is drawn medially across the instep and placed just distal to the tuberosity of the navicular; 3) pull the tape across the arch and up just proximal to the base of the 5th metatarsal; 4) cross the tibialis anterior tendon. TALAR JOINT 1) Continue the tape around the ankle joint just distal to the distal tip of the medial malleolus; 2) pull the tape across the achilles tendon; 3) place the tape just distal to the distal tip of the lateral malleolus 4) End the measurement at the start of the tape Record the measurement in centimeters. Normal Result: No differences in limb circumference between measured limbs. Abnormal Result: May indicate lymphedema, DVT, or compartment syndrome. An increase in circumference from previous measurements bilaterally, may indicate venous insufficiency or congestive heart failure exacerbation.
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References
Brodovicz, K. G., McNaughton, K., Uemura, N., Meininger, G., Girman, C. J., & Yale, S. H. (2009). Reliability and feasibility of methods to quantitatively assess peripheral edema. Clinical medicine & research, 7(1-2), 21-31.
Esterson, P. Measurement of Ankle Joint swelling Using a Figure of 8. JOSPT, 1979.
McCulloch, J. M., & Kloth, L. C. (2010). Wound healing: Evidence-based management. FA Davis.
Rehabilitation of the Hand and Upper Extremity, 6th Edition, Elsevier publisher.
Stanton, A. W. B., Badger, C., & Sitzia, J. (2000). Non-invasive assessment of the lymphedematous limb. Lymphology, 33(3), 122-135.
Brodovicz, K. G., McNaughton, K., Uemura, N., Meininger, G., Girman, C. J., & Yale, S. H. (2009). Reliability and feasibility of methods to quantitatively assess peripheral edema. Clinical medicine & research, 7(1-2), 21-31.
Esterson, P. Measurement of Ankle Joint swelling Using a Figure of 8. JOSPT, 1979.
McCulloch, J. M., & Kloth, L. C. (2010). Wound healing: Evidence-based management. FA Davis.
Rehabilitation of the Hand and Upper Extremity, 6th Edition, Elsevier publisher.
Stanton, A. W. B., Badger, C., & Sitzia, J. (2000). Non-invasive assessment of the lymphedematous limb. Lymphology, 33(3), 122-135.
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