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Clinical assessment of signs and symptoms still guides cellulitis diagnosis
Clinical Question
What diagnostic approach is best for diagnosing cellulitis?
Bottom line
Despite the availability of some high techery (a thermal camera attached to a smartphone), clinical impression is still the best way to identify cellulitis in a patient with a red leg. A suggestive history and unilateral signs and symptoms point to cellulitis, but there is still no foolproof way to differentiate cellulitis from other causes of a red leg. This visual summary illustrates a reasonable approach. 5
Reference
Study design: Practice guideline
Funding: Government
Setting: Various (guideline)
Synopsis
These authors searched several databases for research that investigated noninvasive strategies for diagnosing cellulitis. They identified 8 studies, 7 of which were performed in emergency departments and enrolled patients with suspected cellulitis. A history that increases the likelihood of cellulitis includes previous cellulitis, chronic leg edema, excoriating skin disease or tinea pedis, and obesity. Unilateral erythema, pain, heat, swelling, and tenderness also point to cellulitis. But even the use of these markers will overdiagnose cellulitis.
Reviewer
Allen F. Shaughnessy, PharmD, MMedEd
Professor of Family Medicine
Tufts University
Boston, MA
Comments
Cellulite
l histoire clinique les atcd médicaux (diabète dermite des jambes insuffisances veineuses) les signes cliniques le côté unilatérale avec des points d appel tel que lésion de grattage les pieds d athlète la nature topographique non démarquée des lésion (comme dans les érysipèles) en plus de la rougeur la chaleur ss nécessairement la douleur (dermo hypodermite) permettent avec plus de certitude le diagnostic de cellulite