Sonography of leg venous edema

Ultrasonography is currently used only to designate the pattern and location of venous lesions. Recent experiences showed that the structure of the cutaneous and subcutaneous layers is clearly demonstrated by ultrasonography. In legs with edema due to venous insufficiency, two patterns of subcutaneous thickening can be observed: 1) diffuse soaking with light increase of tissue echogenicity; 2) anechogenic lacunae of variable size and extension. Edema of the dermis may coexist. In order to possibly evaluate the effects of mechanical treatments, Duplex findings from the cutaneous and subcutaneous layers are evaluated also after a squeezing maneuver. Skin ultrasonography should improve our knowledge about pathophysiology of edema and contribute to a better grading of venous disease severity. Further investigations are needed to possibly explain the pathophysiology of the different patterns of subcutaneous layers thickening, as well as the occurrence of dermal edema.