Symptoms of diseases of extremities

Lymphatic vessels

Vessels of extremities
The sensations of coldness, tiredness, and pain are the first symptoms of chronic insufficient blood supply of the limbs, especially of the lower limbs. The pain can be intermittent or permanent and is a sign of a chronic diseases or an acute episode.
A) Chronic diseases
Intermittent claudication (claudicatio intermittens - occasional painful limping) represents a sharp and convulsive pain caused by leg ischaemia while walking. At rest, the pain diminishes. The distance between re-occurrence of  walking-associated pain is called a claudication interval. The localisation of the pain, depends on the localisation of vascular changes, and can develop in the buttocks, thighs, and most often in the calf.
The rest-pain is a more significant signal of ischaemia that already affects the peripheral nerves. It is permanent, and manifests when lying down, especially at night (dropping of the limb brings relief).
Trophic disorders develop in further worsening of blood supply of the limbs, usually in acral parts (toes, heels). They sometimes develop into gangrene. Contusions or small skin traumata are usually contributing factors.
 Symptoms are caused by the arteriosclerosis of the limb and pelvic arteries.
B) Urgent conditions
Acute pain
   Sharp, even shocking pain, associated with a sensation of coldness in the limb and colour changes, with developing mobility disorders, even the emergence of plegia, can be found in embolisation or acute thrombosis of the peripheral vessels of the upper or lower limbs.
   Associated with a sudden paleness of the fingers or toes (digiti mortui), appearing especially in girls when staying in coldness, it corresponds to Raynaud's disease (vessel spasms).
   Similar changes can develop when working with vibratory machines in some collagenoses (Raynaud's phenomenon).
Their affection is usually manifested by pain and oedema of the affected part.
   In the sole or in the calf, manifested when treading on a sole, is related to phlebothrombosis.
   Very intensive pain, of the whole extremity, associated with redness, massive oedema, and alteration of the general condition and later with the development of blisters occurs in the case of phlegmasia coerulea dolens.
   Dull pain, in the extremity or its part, is usually present in case of phlebothrombosis of the upper extremity.
   Localised pain in a knot-like, red formation in the epidermis, is present in case of thrombophlebitis.
   One-sided, affecting a part or the whole upper or lower limb, is present in case of phlebothrombosis.
Lymphatic vessels
Damage of lymphatic vessels (obstruction, interruption) usually manifests by unilateral or bilateral oedema (lymphoedema) of the upper limb (exenteration or irradiation of the axilla in the case of breast carcinoma) or the lower limb.
Pain is the most significant symptom of degenerative and inflammatory joint disease.
Degenerative diseases
Rather intensive pain is present in the joint struck by arthritis at the beginning of the movement (start pain), later it gradually diminishes. The pain is especially intensive in knees when walking down the stairs.
Inflammatory diseases
are accompanied by the rest-pain (the pain is present also when the joint is relaxed). Repeated movement of the joint usually leads to reduction of the pain (rheumatoid arthritis of interphalangeal joints of the hand).
Sharp, even unbearable pain in metacarpophalangeal joint of the toe, manifesting in early morning hours (the patient cannot even bear the touch of the blanket) corresponds to the acute gout attack.


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