Quantitative measurement of pitting edema with a novel edema ruler

Lower extremity edema is a symptom of chronic venous disease and venous insufficiency. However, clinical evaluations rely on the qualitative evaluation of the pitting depth, which is neither well-defined nor quantitative. We created a novel three-dimensionally printed edema ruler as a quantitative method to measure pitting depth. Twenty-five patients (50 legs) with chronic venous disease were evaluated for ankle edema using the edema ruler. The results demonstrate excellent intraclass correlation for both single (0.944, P < .001) and average (0.971, P < .001) measurements. The edema ruler is a noninvasive, useful, and objective tool for the clinical measurement of lower extremity edema.