Ultrasonographic evaluation of soft tissues in patients with lower extremity edema

Objective: This study aimed to investigate the relationship between patellar tendon, plantar fascia, Achilles tendon, peroneus longus tendon and tibialis posterior tendon thickness and edema volume, and their effects on tendinopathy frequency, pain localization, quality of life and functional level in individuals with lower extremity edema. Method: This prospective case-control study conducted between October 2024 and April 2025 included 53 patients diagnosed with lower extremity edema and 55 healthy volunteers with similar characteristics in terms of age and gender. Circumference measurement, ultrasonographic examination of musculoskeletal system and assessment scales (VAS, LYMQOL-Leg, LEFS) were applied to all participants. Results: Plantar fascia, Achilles tendon, peroneus longus tendon and tibialis posterior tendon thicknesses increased significantly in the edema group; a positive correlation was found between edema volume and thickness in the Achilles tendon and plantar fascia (p<0.05). The frequency of plantar fasciitis and Achilles tendinopathy was found to be high in the edema group. These conditions negatively affected the quality of life and functional level (p<0.05). Conclusion: Lower extremity edema is not limited to fluid accumulation but can also cause significant structural changes in tendon structures. Musculoskeletal ultrasonography is thought to be a useful tool in the diagnosis and follow-up of such cases. Keywords: Pain, Lymphedema, Lipedema, Tendinopathy, Ultrasonography