A patient presents with non-pitting edema on physical examination. Which diagnosis is most likely?

• A. Hypothyroid
• B. Hyperparathyroidism
• C. Addison's disease
• D. Pheochromocytoma

Answer: (A)

Non-pitting edema points to myxedema from hypothyroidism. In hypothyroidism, dermal accumulation of glycosaminoglycans causes a doughy, non-indentable swelling that doesn’t pit with pressure. This pattern differentiates it from true fluid edema and fits the exam finding of generalized, non-pitting swelling often seen with low thyroid hormone levels. The other conditions aren’t typically associated with this type of edema: Addison’s disease usually involves volume depletion and hypotension; hyperparathyroidism centers on calcium-related symptoms; pheochromocytoma presents with episodic hypertension and catecholamine-driven symptoms rather than fixed non-pitting edema.