Non-pitting Edema: Causes, Diagnosis, and Treatments

non pitting edema assessment

It refers to a build-up of fluids in the tissue often caused by issues with the thyroid or lymphatic systems.

Medical experts define Edema as the accumulation of fluids in the tissues beneath the skin, which ends up forming a noticeable swelling in different parts of the body.

Doctors tend to divide Edema into two clinical types: Pitting Edema is when pressure applied and released in the affected area induces indentation.

However, Non-pitting Edema describes the case of a swelling in which the pressure-induced indentation seen in the affected area does not occur.

When the cause of this Edema is not an underlying condition, medical experts label it as Idiopathic Edema.

Causes of Non-pitting Edema

In many cases, this type of Edema is a sign of a disease or a clinical condition that affects the thyroid or the lymphatic system.

One of those diseases is Lymphedema, which consists of a swelling that occurs due to a build-up of lymph in the soft tissue.

Lymph is a clear colorless fluid that contains white cells. It bathes the tissues and flows through the lymphatic system to end up getting discharged into the bloodstream.

Patients may develop Lymphedema because of a surgical procedure that went wrong, but in other cases, this disease manifests as an inherited condition.

Severe or Advanced Hypothyroidism, can cause Non-pitting Edema as well. This condition features hormonal imbalance due to heavily underactive thyroid glands.

The thyroid glands produce hormones that regulate the speed with which cellular metabolism works as well as the heart rate and how fast the intestines process food.

In cases of Severely Advanced Hypothyroidism, the hormonal imbalance causes a decompensation that results in a wide variety of symptoms along with swelling in the legs, feet, eyelids, lips, or even the tongue.

Another potential cause of Non-pitting Edema is Lipedema, a chronic condition that features the symmetric enlargement of the legs due to an abnormal accumulation of fat around that area.


When dealing with unusual swelling, medical experts seek to determine the cause by physically examining the patient.

Doctors will likely apply some pressure to the affected area and then release it to evaluate the behavior of the swelling.

In some cases, health care providers may also use tests like the Lymphoscintigraphy, also known as Sentinel Lymph Node Mapping.

This imaging technique helps doctors to evaluate the body’s lymphatic system by identifying lymphatic obstruction.

Some medical experts that perform Lymphoscintigraphy use small subcutaneous injections of radioactive particles usually known as “Technetium-99m-sulfur Colloid.”

Doctors refer to such radioactive material as a radiotracer. In such particular cases, they tend to inject it into the first and second interdigital space in both feet of the patient.

The radiotracer travels through the area examined by the health care providers and gives off energy in the form of gamma rays.

More often than not, medical experts advise patients to avoid exercise after they get injected with the radiotracer.

The energy of the radiotracer will later get detected by a camera and a computer that produce images that reflect the molecular activity within the body.

However, when the camera doesn’t detect activity during the first couple of hours, doctors will likely advise the patient to do exercise for 20 minutes.

Usually, that means the patient will have to walk or get a massage in the examined area.

Non-pitting Edema Treatments

More often than not, doctors find Non-pitting Edema harder to treat than Pitting Edema due to its relatively complex causes making it more difficult to drain the fluids from the affected area.

However, there are several treatments available to deal with this condition. The procedures to treat Non-pitting Edema focus on the underlying cause of the swelling.

For example, if the cause of a particular case of Non-pitting Edema is related to Lymphedema, the treatment will likely consist of Complex Decongestive Therapy (CDT).

CDT involves the use of gentle massages to stimulate the movement of fluids and open up lymphatic capillaries. People must follow a skin care routine to keep the affected area moisturized.

This therapy also demands regular exercise as well as the use of bandages or compression garments.

When the cause of the condition is Lipedema, doctors will focus on alleviating the symptoms.

Since Lipedema has no cure, medical experts may recommend CDT. But, patients can also choose other procedures such as Belt Lipectomy.

That treatment consists of a circumferential removal of loose hanging skin and fat from around the waistline.

When dealing with a case of Non-pitting Edema caused by Severely Advanced Hypothyroidism, health care providers will likely prescribe medications such as Levothyroxine.