Vignette diagnostique de l'etudiant. Oedeme des membres inferieurs chez un patient diabetique de type 2.

Differential diagnosis of lower limb oedema is a common exercise in clinical practice. Taking the example of a patient presenting with such clinical picture in the presence of type 2 diabetes and arterial hypertension with coronary heart disease and chronic kidney disease as comorbidities, we discuss here the respective contributions of congestive heart failure, renal impairment (and possibly nephrotic syndrome) and liver disease in the development of lower limb oedema. The focus is made on a careful patient history and a meticulous clinical examination, two crucial steps that should allow prescribing well selected simple complementary procedures and rapidly make the final diagnosis.