What is the Difference Between Pitting and Non-Pitting Edema

Pitting and non-pitting edema are two common forms of edema. Edema refers to swelling caused by the body’s holding onto fluid. It usually occurs in the ankles, feet, and legs. It was once also called dropsy.

The key difference between pitting and non-pitting edema is their response to pressure. Pitting edema responds to pressure, while non-pitting edema does not respond to pressure.

CONTENTS

1. Overview and Key Difference
2. What is Pitting Edema
3. What is Non-Pitting Edema
4. Similarities – Pitting and Non-Pitting Edema
5. Pitting vs Non-pitting Edema in Tabular Form
6. Summary – Pitting vs Non-Pitting Edema
7. FAQ – Pitting and Non-Pitting Edema

What is Pitting Edema?

Pitting edema is a type of edema that responds to pressure and causes indentation when pressing the skin of the affected area of the body. Pitting edema is associated with problems in the liver, kidneys, heart, or lymphatic system. Pitting edema can be caused by lung diseases, obesity, pregnancy, medications, low levels of protein, and heart failure. The symptoms of this condition are similar to other types of edema. These may include full or heavy feeling, joints that may be hard to move, stretched, shiny or reddened skin, warm or hot skin, dough-like skin, tenderness, trouble walking, and fatigue.

Figure 01: Pitting Edema

Pitting edema can be diagnosed through physical examination, blood tests, kidney and liver suction tests, and electrocardiogram (ECG or EKG). Furthermore, treatment options for pitting edema include managing chronic illnesses, eating less salt, taking diuretics, wearing compression stockings, sleeves, or gloves, raising the part of the body with the pitted edema, and exercising.

What is Non-pitting Edema?

Non-pitting edema is a type of edema that occurs when excess fluid builds up in the body and causes swelling that does not cause indentation when pressure is applied. Conditions affecting the thyroid and lymphatic system can cause non–pitting edema such as lymphedema, myxedema, angioedema, and lipedema. The signs and symptoms of pitting edema may include tenderness, tense skin, limited movement, a sensation of heaviness that can interfere with walking, and, in severe cases, ulcers or infections of the skin.

Figure 02: Pitting vs Non-pitting Edema

Non-pitting edema can be diagnosed through medical history, physical examination, thyroid function tests, and a specific type of imaging called lymphoscintigraphy. Treatment for non-pitting edema may include managing the underlying condition, performing exercises, engaging in decongestive physiotherapy, and using medications such as synthetic hormones (e.g., levothyroxine for myxedema), antihistamines, corticosteroids, or epinephrine (for angioedema). In some cases, liposuction or surgical removal of excess fat may be considered.

Similarities Between Pitting and Non-pitting Edema

1. Pitting and non-pitting edema are two common forms of edema.
2. Both forms can be caused by underlying medical conditions.
3. They may result in swelling in the body parts.
4. Both forms can be diagnosed by physical examination and blood tests.
5. They can be treated through medications and therapies.

Difference Between Pitting and Non-pitting Edema

Definition

1. Pitting edema occurs when excess fluid builds up in the body, causing swelling that indents when pressure is applied.
2. Non-pitting edema occurs when excess fluid builds up in the body and causes swelling that does not indent when pressure is applied.

Causes

1. Pitting edema can be caused by problems in the liver, kidney, lymphatic system, lung diseases, obesity, pregnancy, medications, low levels of protein, and heart failure.
2. Non-pitting edema can be caused by lymphedema, myxedema, angioedema, and lipedema.

Signs and Symptoms

1. The signs and symptoms of pitting edema are indentations on the skin when pressure is applied, full or heavy feeling, joints that may be hard to move, stretched, shiny or reddened skim, warm or hot skin, dough-like skin, tenderness, trouble walking, fatigue, trouble breathing, shortness of breath, coughing and chest pain.
2. The signs and symptoms for non-pitting edema include no indentation on the skin when pressure is applied, tenderness, tense skin, limited movement, and heaviness that can interfere with walking and lead to ulcers and infections on the skin in severe cases.

Diagnosis

1. Pitting edema can be diagnosed through physical examination, blood tests, kidney and liver suction tests, and electrocardiogram (ECG or EKG).
2. Non-pitting edema can be diagnosed through medical history, physical examination, thyroid function tests, or a specific type of radioactive imaging called lymphoscintigraphy.

Treatment

1. The treatment options for pitting edema are elevating the swollen limbs above the level of the heart, undergoing vascular surgery, wearing compression stockings for better circulation, increasing blood protein levels, and taking diuretics to flush out excess fluid.
2. The treatment options for non-pitting edema are using gentle massage to stimulate fluid movement and open up lymphatic capillaries, following a skincare routine to maintain moisture, wrapping the area with bandages, exercising, wearing compression garments, lipectomy, and taking synthetic T4 hormone called levothyroxine to balance thyroid hormones.

The following table summarizes the difference between pitting and non-pitting edema.

Summary – Pitting vs Non-pitting Edema

Edema is the swelling caused by fluid trapped in the body’s tissues. Pitting and non-pitting edema are two common forms of edema. Pitting edema refers to swelling that is impacted by pressure, while non-pitting edema refers to swelling that isn’t impacted by pressure. This is the basic difference between pitting and non-pitting edema.

FAQ: Pitting and Non-Pitting Edema

1. What is the main cause of pitting edema?

• Pitting edema is a type of edema characterized by indentations or pits in the affected areas when pressure is applied. It is often caused by conditions that affect the liver, kidneys, heart, or lymphatic system

2. What deficiency causes pitting edema?

• Pitting edema can be caused by a deficiency in blood proteins, particularly albumin. When albumin levels are too low, fluid can accumulate in tissues, leading to edema. This type of swelling often occurs in the feet, ankles, and lower legs and can also be seen in the abdomen

3. How does it fix pitting edema?

• Pitting edema can be treated by managing the related chronic illness, eating less salt, taking a drug called a diuretic that helps the body get rid of extra fluid, wearing compression stockings, sleeves, or gloves that keep pressure on the swollen area, and stopping the fluid from building up.

4. What causes non-pitting edema?

• Non-pitting edema is typically associated with conditions affecting the thyroid or lymphatic system. It can be caused by conditions like lymphedema, myxedema, angioedema, and lipedema.

5. How does one control non-pitting edema?

• Non-pitting edema is usually a sign of an underlying condition. Therefore, it is best to have the doctor take a look at the affected area and manage the underlying conditions. Depending on the cause, it can be treated through massage therapy, medication, compression garments, and surgery called lipectomy, or a combination of all the above-mentioned things.

Reference:

1. “Pitting Edema: Causes, Treatment, and More.” Medical News Today, MediLexicon International.
2.  Gotter, Ana. “Non-Pitting Edema: Pitting vs. Non-Pitting, Causes, and Diagnosis.” Healthline, Healthline Media.

Image Courtesy:

1. ” Pitting Edema2008” By James Heilman, MD – Own work (CC BY-SA 3.0) via Commons Wikimedia
2. “Depiction of different types of Edema” By Myupchar.com (CC BY-SA 4.0) via Commons Wikimedia

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