National Physical Therapy Examination (NPTE) Practice Exam

A physical therapist assistant notes pitting edema in the left lower extremity of their patient. However, upon an attempt to elevate the limb, the edema does not change. What stage of lymphedema would be suspected?

1. Stage I

2. Stage 0

3. Stage III

4. Stage II

The correct answer is: Stage II

The correct stage of lymphedema suspected in this scenario is indeed Stage II. In Stage II lymphedema, the edema becomes more persistent and cannot be completely resolved through elevation or other conservative measures. This stage is characterized by the presence of pitting edema that does not diminish when the limb is elevated and often includes thickening of the skin or fibrosis in the affected area. In contrast, Stage I lymphedema typically presents with reversible swelling that diminishes with elevation, while Stage 0 represents a latent stage where no clinical edema is present despite the lymphatic system being impaired. Stage III lymphedema, also known as lymphostatic elephantiasis, involves significant swelling, skin changes, and is often marked by large, non-pitting edema, and is generally more advanced than what would be indicated in this scenario. Therefore, based on the observed characteristics of persistent pitting edema that does not change with elevation, Stage II is the most appropriate classification.