A known case of leprosy presented with bilateral distal leg - ankle - foot edema. Color Doppler for deep venous thrombosis was negative for both lower limbs. Patient had multiple skin patches involving both lower limbs from mid-thigh to ankle level. He was taking some kind of treatment in another hospital for last few months for these skin lesions. Previous records showed he was under treatment for leprosy. At that time, he presented with complaints of 'glove and stocking type' sensory loss in both lower limbs.

Ultrasound shows thickening of bilateral lower limbs nerves staring at about mid-leg level extending to forefoot. 

Even though, there was no histopathology report of nerve biopsy stating etiology of leprosy in previous records; findings of peripheral nerve thickening in this clinical background is very much likely to be due to leprosy.