How do you diagnose lymphedema. Lymphedema Diagnosis: Comprehensive Guide to Detection and Assessment Methods
How is lymphedema diagnosed. What are the key symptoms of lymphedema. Which tests are used to confirm lymphedema. Who can diagnose lymphedema. What is the difference between primary and secondary lymphedema. How do healthcare professionals assess lymphedema severity. What role does medical history play in lymphedema diagnosis.
Understanding Lymphedema: Types and Causes
Lymphedema is a chronic condition characterized by the accumulation of lymph fluid in tissues, typically affecting the limbs. To effectively diagnose and manage this condition, it’s crucial to understand its types and underlying causes.
Primary vs. Secondary Lymphedema
Lymphedema is classified into two main categories:
- Primary Lymphedema: A rare, genetic condition resulting from an underdeveloped or dysfunctional lymphatic system present from birth.
- Secondary Lymphedema: More common, caused by damage to the lymphatic system due to injury, surgery, radiation therapy, or infection.
Understanding the distinction between these types is essential for accurate diagnosis and appropriate treatment planning.
Initial Steps in Lymphedema Diagnosis
The journey to diagnosing lymphedema often begins with recognizing symptoms and seeking medical attention. Early diagnosis is crucial for effective management and prevention of complications.
Recognizing Lymphedema Symptoms
Common signs and symptoms of lymphedema include:
- Swelling in the affected limb or body part
- Feeling of heaviness or tightness
- Restricted range of motion
- Recurring infections
- Hardening and thickening of the skin (fibrosis)
If you experience these symptoms, it’s important to consult a healthcare professional promptly.
The Role of General Practitioners
General practitioners (GPs) play a crucial role in the initial assessment of lymphedema. They perform a general check-up, which includes:
- Examining the body, focusing on skin and soft tissues
- Assessing lymph nodes
- Checking arterial and venous function
- Evaluating swollen areas
- Ordering blood tests to assess heart, kidney, and thyroid function
Based on these findings, GPs may refer patients to lymphedema specialists for further evaluation and treatment planning.
Comprehensive Physical Examination for Lymphedema
A thorough physical examination is fundamental in diagnosing lymphedema. Healthcare professionals employ various techniques to assess the condition’s severity and characteristics.
Key Components of the Physical Exam
The physical examination for lymphedema typically includes:
- Skin inspection: Checking for signs of infection, injuries, or changes in texture
- Tissue palpation: Assessing the consistency of affected areas (soft or hard)
- Lymph node examination: Evaluating size and tenderness
- Limb measurements: Recording circumferences to track changes over time
- Vascular assessment: Checking blood flow in veins and arteries
These assessments provide valuable information about the extent and nature of the lymphedema, guiding treatment decisions.
Advanced Diagnostic Techniques for Lymphedema
While physical examination and medical history are often sufficient for diagnosis, advanced diagnostic techniques may be employed in certain cases to provide more detailed information or confirm the diagnosis.
Imaging Studies for Lymphedema
Several imaging techniques can be used to visualize the lymphatic system and assess lymphedema:
- Lymphoscintigraphy: A nuclear medicine technique that tracks the movement of a radioactive tracer through the lymphatic system
- MRI (Magnetic Resonance Imaging): Provides detailed images of soft tissues and can help identify lymphatic abnormalities
- Ultrasound: Used to evaluate tissue characteristics and fluid accumulation
- CT (Computed Tomography) scan: Can visualize lymph nodes and surrounding structures
These imaging studies help healthcare professionals understand the underlying anatomy and functionality of the lymphatic system in patients with suspected lymphedema.
Volumetric Measurements in Lymphedema Assessment
Accurate measurement of limb volume is crucial for diagnosing lymphedema and monitoring its progression. Several methods are available for this purpose.
Techniques for Measuring Limb Volume
Healthcare professionals may use one or more of the following techniques to assess limb volume:
- Tape measure method: Circumference measurements are taken at specific intervals along the limb to calculate volume
- Water displacement: The affected limb is submerged in water, and the volume of displaced water is measured
- Perometry: Infrared light is used to create a 3D image of the limb, allowing for precise volume calculations
These measurements provide objective data to track changes in limb size over time, helping to evaluate the effectiveness of treatment.
Bioimpedance Testing for Lymphedema
Bioimpedance analysis is a non-invasive technique that can detect early-stage lymphedema before visible swelling occurs. This method is particularly useful for monitoring patients at risk of developing lymphedema.
How Bioimpedance Testing Works
During a bioimpedance test:
- Small electrodes are placed on different parts of the body
- A painless electric current is passed through the tissues
- The resistance to this current is measured
- Changes in resistance can indicate the presence of excess fluid in tissues
Bioimpedance testing is particularly valuable for early detection and long-term monitoring of lymphedema.
The Importance of Medical History in Lymphedema Diagnosis
A comprehensive medical history is essential for accurate diagnosis and effective management of lymphedema. Healthcare professionals rely on patient-reported information to understand the condition’s onset, progression, and potential causes.
Key Questions in Lymphedema History Taking
During a medical history assessment, healthcare providers typically ask:
- When did you first notice symptoms?
- Do your symptoms improve with elevation or overnight rest?
- Have you experienced any infections in the affected area?
- What medications are you currently taking?
- Is there a family history of similar symptoms?
- Have you undergone any surgeries or cancer treatments?
This information helps healthcare professionals differentiate between primary and secondary lymphedema and identify potential risk factors or triggers.
Differential Diagnosis: Ruling Out Other Conditions
Accurate diagnosis of lymphedema requires careful consideration of other conditions that may cause similar symptoms. Healthcare professionals must rule out alternative explanations for swelling and associated symptoms.
Conditions That May Mimic Lymphedema
Several conditions can present with symptoms similar to lymphedema:
- Venous insufficiency
- Lipedema
- Deep vein thrombosis
- Chronic heart or kidney failure
- Protein deficiency
- Infections
Distinguishing lymphedema from these conditions often requires a combination of clinical assessment, imaging studies, and laboratory tests.
The Role of Blood Tests
Blood tests play a crucial role in the differential diagnosis process. They can help:
- Assess kidney and liver function
- Check for signs of infection or inflammation
- Evaluate thyroid function
- Screen for protein deficiencies
These tests provide valuable information that helps healthcare professionals narrow down the potential causes of swelling and make an accurate diagnosis.
Specialized Lymphedema Centers: Comprehensive Diagnosis and Care
For complex cases or when initial assessments are inconclusive, patients may be referred to specialized lymphedema treatment centers. These facilities offer comprehensive diagnostic services and expert care for individuals with lymphedema.
Benefits of Specialized Lymphedema Centers
Specialized lymphedema centers provide several advantages:
- Access to lymphedema experts and certified therapists
- Advanced diagnostic equipment and techniques
- Comprehensive treatment planning
- Patient education and self-management support
- Ongoing monitoring and care coordination
These centers play a crucial role in ensuring accurate diagnosis and optimal management of lymphedema, particularly for complex or challenging cases.
The Future of Lymphedema Diagnosis: Emerging Technologies and Approaches
As our understanding of lymphedema grows, new diagnostic technologies and approaches are being developed to improve accuracy and early detection. These advancements hold promise for better management and outcomes for individuals with lymphedema.
Innovative Diagnostic Techniques on the Horizon
Several emerging technologies show potential for enhancing lymphedema diagnosis:
- Near-infrared fluorescence imaging: Allows real-time visualization of lymph flow
- 3D scanning and AI-assisted volume measurements: Provide more precise and efficient limb volume assessments
- Genetic testing: May help identify individuals at risk for primary lymphedema
- Biomarker analysis: Could enable earlier detection of lymphatic dysfunction
These innovations may lead to more personalized and effective approaches to lymphedema diagnosis and management in the future.
Patient Empowerment: Self-Monitoring and Early Detection
While professional diagnosis is essential, patient awareness and self-monitoring play crucial roles in the early detection and management of lymphedema. Empowering individuals with knowledge and tools for self-assessment can lead to better outcomes and quality of life.
Strategies for Patient Self-Monitoring
Patients at risk for or living with lymphedema can engage in self-monitoring through:
- Regular self-examination of at-risk areas
- Keeping a symptom diary
- Using at-home measurement tools, such as tape measures or smart devices
- Practicing good skin care and hygiene
- Recognizing and promptly reporting changes or new symptoms
By actively participating in their care, patients can contribute to early detection and more effective management of lymphedema.
Collaborative Approach to Lymphedema Diagnosis and Management
Effective diagnosis and management of lymphedema often require a multidisciplinary approach, involving various healthcare professionals working together to provide comprehensive care.
Key Players in Lymphedema Care
A collaborative lymphedema care team may include:
- Primary care physicians
- Lymphedema specialists
- Physical therapists
- Occupational therapists
- Vascular surgeons
- Oncologists (for cancer-related lymphedema)
- Dietitians
- Mental health professionals
This team-based approach ensures that all aspects of lymphedema care are addressed, from diagnosis to long-term management and support.
The Importance of Ongoing Assessment
Lymphedema is a chronic condition that requires ongoing monitoring and management. Regular follow-up assessments are crucial for:
- Evaluating treatment effectiveness
- Detecting changes in lymphedema severity
- Adjusting treatment plans as needed
- Preventing complications
- Addressing new concerns or symptoms
By maintaining ongoing communication with healthcare providers and adhering to follow-up schedules, patients can ensure optimal management of their lymphedema over time.
Navigating the Challenges of Lymphedema Diagnosis
Despite advancements in diagnostic techniques, lymphedema diagnosis can still present challenges. Understanding these obstacles is crucial for both healthcare providers and patients in ensuring timely and accurate diagnosis.
Common Diagnostic Challenges
Several factors can complicate the diagnosis of lymphedema:
- Subtle early symptoms that may be overlooked
- Similarity to other conditions causing swelling
- Lack of awareness among some healthcare providers
- Limited access to specialized diagnostic equipment
- Variability in symptom presentation
Addressing these challenges requires ongoing education, improved access to specialized care, and continued research into diagnostic methods.
Overcoming Diagnostic Barriers
To improve lymphedema diagnosis, several strategies can be employed:
- Increasing awareness among healthcare providers and the public
- Implementing standardized diagnostic protocols
- Enhancing access to specialized lymphedema centers
- Incorporating lymphedema education into medical and allied health curricula
- Encouraging patient advocacy and self-education
By addressing these barriers, we can work towards more timely and accurate diagnosis of lymphedema, leading to better outcomes for patients.
The Role of Patient Education in Lymphedema Diagnosis and Management
Patient education is a critical component of effective lymphedema diagnosis and management. Informed patients are better equipped to recognize symptoms, seek timely medical attention, and actively participate in their care.
Key Elements of Patient Education
Comprehensive patient education for lymphedema should cover:
- Understanding lymphedema and its causes
- Recognizing early signs and symptoms
- Importance of early intervention and regular follow-ups
- Self-care techniques and lifestyle modifications
- Available treatment options and their benefits
- Coping strategies and emotional support resources
By empowering patients with knowledge, healthcare providers can foster better outcomes and improved quality of life for individuals living with or at risk of lymphedema.
Tools for Patient Education
Various resources can support patient education in lymphedema:
- Printed materials (brochures, fact sheets)
- Online resources and educational websites
- Video tutorials on self-care techniques
- Support groups and peer mentoring programs
- Mobile apps for symptom tracking and management
Utilizing a range of educational tools can help cater to different learning styles and preferences, ensuring that patients have access to the information they need to manage their condition effectively.
Lymphoedema – Diagnosis – NHS
See a GP if you have symptoms of lymphoedema. If you’re being treated for cancer and are at risk of developing lymphoedema, you’ll be monitored for the condition afterwards.
In many cases, it’s possible to diagnose lymphoedema by:
- asking about your symptoms and medical history
- examining the affected limb and measuring the distance around it to see if it’s enlarged
The GP may refer you to a specialist lymphoedema treatment centre for further assessment.
Early diagnosis and treatment can help prevent the condition from getting worse.
In most cases, further tests are not necessary, but they may occasionally be used to assess and monitor your condition.
Measuring limb volume
In some cases, tests to calculate the volume of an affected limb may be carried out.
These may include:
- using a tape measure – to measure the circumference of the limb at certain intervals to calculate its volume
- water displacement – where the affected limb is placed in a tank of water and the amount of water that’s displaced is measured to calculate the volume of the limb
- perometry – where infrared light is used to measure the outline of an affected limb and calculate its volume
Bioimpedance testing
During a bioimpedance test, small metallic discs called electrodes are placed on different parts of your body.
The electrodes release a small, painless electric charge that’s measured using a handheld device. Changes in the strength of the current can indicate the presence of fluid in your tissue.
Imaging tests
Imaging tests may also be used if there’s uncertainty around the diagnosis or to rule out other causes of swelling.
These include:
- a lymphoscintigram – where you’re injected with a radioactive dye that can be tracked by a scanner; this shows how the dye moves through your lymphatic system and can check for any blockages
- a MRI scan – a strong magnetic field and radio waves are used to produce detailed images of the inside of your body
- an ultrasound scan – high-frequency sound waves are used to create an image of the inside of your body
- a CT scan – X-rays and a computer create detailed images of the lymph nodes
These scans can be used to create a clearer picture of the affected tissue.
Page last reviewed: 29 March 2023
Next review due: 29 March 2026
Diagnosis of Lymphedema – LymphCare
There is no specific test or tool to diagnose lymphedema. This makes the diagnosis difficult and a lot of patients struggle without a correct diagnosis for a long time. There are two main types of lymphedema – primary and secondary lymphedema.
Primary lymphedema is a rare disease that occurs when the lymphatic system has not developed adequately (or is not functioning as it should) from birth due to a genetic reason. Although the symptoms of primary lymphedema often occur in early life, symptoms may also occur after years and it may not be the first diagnosis that healthcare professionals (HCPs) think about. Secondary lymphedema is caused by injuries or diseases and is more common than primary lymphedema.
Who makes the diagnosis of lymphedema?
Your general practitioner (GP) or a nurse is likely to be your first contact person when you notice any signs or symptoms of lymphedema. The first step is to rule out any other reasons for your swelling.
Your Health Care Professional (HCP) will do a general check-up that includes a complete exam of your body, including your skin and soft tissues, lymph nodes, the function of your arteries and veins and any swollen areas. In addition, blood samples provide information about the function of your heart, kidneys, your thyroid glands and blood count.
A complete physical exam and your medical history are important in determining the type of your lymphedema.
After that, your HCP should refer you to a specialist for lymphedema to confirm the diagnosis and to develop a holistic treatment plan with you.
How is lymphedema diagnosed?
Basic diagnostics
Your medical history and the physical exam of your body are the main elements in the diagnosis of lymphedema.
Here are some typical questions that your HCP will ask you:
- When did you first notice any signs or symptoms?
- Do your swellings improve overnight?
- Did you have any infections in the affected area?
- Do you take any medications at the moment and if so, what kind of medication do you take?
- Is there someone in your family with the same signs and symptoms?
Your HCP will examine your affected limb as well. This usually includes the following steps:
- Check-up of your skin to rule out any injuries or infections
- Palpation of your tissue (is it hard or soft?) and lymph nodes (are they larger than usual or painful?)
- Check your body for other swollen areas
- Measurement of the affected area to monitor the size over time
- Measurements of your blood vessels (veins and arteries) to check your blood circulation
Advanced diagnostics
Your medical history and the examination of your affected limb are often enough for the diagnosis of lymphedema. Your HCP may need further information, for example when you have other diseases that can cause swelling or in the very early stages of lymphedema. Several diagnostic tools can be useful in such a case:
- Ultrasound scan – uses high-frequency waves that create a picture of your tissue from the outside
- Lymphography – uses a radiocontrast agent that visualizes your lymphatic system under X-ray
- Lymphoscintigraphy – uses a nuclear medicine that visualizes the lymph drainage and your lymph nodes
- MRI (Magnetic Resonance Imaging) scans – uses a magnetic field to create pictures from the inside of your body
- CT (Computed Tomography) scans – uses X-ray to create a detailed picture across your body.
An early diagnosis of lymphedema is important for effective treatment and to prevent progression of your lymphedema. Be aware of your body and stay in contact with your HCP when you notice any changes or new signs and symptoms.
Find the right HCP here
Facial lymphedema
Head and neck lymphedema is a very common late treatment side effect for head and neck cancer. It is a chronic disease with potentially severe consequences for quality of life. Unfortunately, knowledge of the condition is poor and clinical studies are rare. Here we present an overview of the current clinical understanding of the condition and how it can be managed.
Want to know more about how your experience compares to other patients? Check: “Is my head and neck lymphedema “normal”?”
Contents [hide]
1 Part 1. Clinical features of head and neck lymphedema
1.1 what is lymphedema?
1.2 What is head and neck lymphedema and how does it happen?
1.3 What are the symptoms of head and neck lymphedema?
1. 4 How is head and neck lymphedema diagnosed?
1.5 Risk factors for head and neck lymphedema after cancer treatment
1.6 Prevalence of head and neck lymphedema after cancer treatment
2 Part 2: Prevention and treatment of secondary head and neck lymphedema
2.1 Prevention and self-regulation of head and neck lymphedema after cancer treatment
2.2 Professional management of head and neck lymphedema after cancer treatment
2.2.1 gold standard treatment
2.2.2 Surgical options
2.2.3 Pharmaceuticals and supplements
3 comments or questions?
4 references
Part 1: clinical features of head and neck lymphedema
what is lymphedema?
Lymphedema is a chronic condition of swelling caused by damage to the lymphatic system (“secondary lymphedema”) or malformation of the lymphatic system (“primary lymphedema”). A disruption in the normal function of the lymphatic system in an area of the body results in insufficient clearance of the lymphatic fluid (lymph) from that area. As the blood transports oxygen and nutrients to the cells of the body and collects waste products for excretion, 80% of the fluid returns to the bloodstream while 20% enters the lymphatic system as lymph, the colorless liquid that makes up the bulk. Eventually the lymph returns to the bloodstream in the heart.
More than just a fluid collection system, the lymphatic system is an essential component of the immune system, transporting immune cells around the body. Consequently, the blockage of lymphatic flow causes fluid buildup as well as other deleterious changes, including localized immune depression. Lymphedema is usually seen in the extremities (arms and legs) but is also very common in people treated for head and neck cancer. Learn more about lymphedema here.
what is head and neck lymphedema and how is it caused?
Secondary lymphedema of the head and neck usually results from damage to the local lymphatic system during cancer biopsy or treatment (see Figure 1 for an illustration of some of the lymph nodes and vessels of the head and neck). Removal of lymph nodes during cancer biopsy or tumor resection is the main cause of secondary lymphedema in patients with head and neck cancer. This is a direct consequence of the essential role of the lymph nodes in collecting lymphatic fluid from small lymphatic vessels and draining it into larger vessels leading to the heart.
Radiation therapy can also cause damage to any remaining lymph nodes and lymph vessels located in the radiation field, another potential cause of lymphedema. Unfortunately, the large number of nodes in the head and neck area makes radiation-induced damage more difficult to avoid. Stimulation of the normal lymphatic flow in the head and neck leads to a buildup of lymphatic fluid and then a chronic and progressive swelling that can affect various areas of the head, neck and face.
Lymph glands and vessels-of-the-head-and-neck Figure 1. Superficial lymph glands (nodes) and lymphatic vessels of the head and neck (Ref. 1).
As with arm or leg, head and neck lymphedema, lymphedema should be caught and treated early to relieve symptoms and prevent or delay the progression of the disease.
Uncontrolled edema causes additional damage by overstressing the remaining normal lymphatic vessels, and may also initiate a cascade of deleterious events, including localized inflammation, immune system impairment, and eventually hardening of the edema (which is termed “non-punctate lymphedema”) , further exacerbating the problem.
Hardening is the result of compositional changes occurring in tissue, including fibrosis (scarring), connective tissue proliferation, and fat (and to a lesser extent muscle and bone) accumulation, possibly the result of altered stem cell behavior. This advanced stage of the disease is less responsive to typical treatments and may require surgery (see below).
what are the symptoms of head and neck lymphedema?
The main symptom of head and neck lymphedema is swelling, usually developing 2-6 months after cancer treatment. In the early stages of swelling, head and neck lymphedema can be difficult to observe. Head and neck lymphedema can develop internally in the larynx and pharynx (which are the various structures that make up the mouth and throat), or externally in the neck and face, or a combination of both, depending on which lymphatic channels are obstructed.
More rarely, the tumor may progress to the point where it creates serious functional problems such as difficulty breathing and swallowing, as well as obvious problems with body image and associated social output arising from deformity of the neck and face (art. 2). Overall, head and neck lymphedema has the potential to seriously impair the quality of life of patients. To see how your symptoms compare to a group of 1,202 head and neck cancer patients at the M.D. Anderson Cancer Center (MDACC) in Texas, check out our post: “Is my head and neck lymphedema ‘normal’?“.
Symptoms of mild to moderate lymphedema of the head and neck may include:
Visible swelling under the chin, in the neck, or in the face, including the eyes and lips.
Feeling of tightness or limited movement in these areas, including the jaw or shoulders.
Symptoms of moderate to severe lymphedema of the head and neck may include:
Severe swelling of the face and neck
Swelling feels hard and hard to the touch
Visual or auditory impairment
Difficulty breathing, swallowing, eating, or speaking
Nasal congestion, chronic ear pain
How is head and neck lymphedema diagnosed?
Lymphoscintigraphy or other imaging modalities involving injections of contrast agents to visualize lymphatic fluid flow pathology may lead to a definitive diagnosis of lymphedema, but this is usually diagnosed by mild means. The presence of lymphedema is usually assessed based on observations, the results of the physical examination, the patient’s symptoms, and a review of the patient’s history. Alternative causes of the tumor need to be identified. Accordingly, the early stages of the disease can be particularly difficult to diagnose.
The patient’s subjective findings (such as feeling “tight” or “heavy”) are often the earliest indications, while objective measurements of volume change may be more difficult to obtain. This is especially true for early internal lymphedema and early external lymphedema in areas such as the chin, where there is no symmetrical counterpart that can be compared (as opposed to swelling on one side of the face that can be compared to the other unaffected side).
External lymphedema is often classified into one of four common weights. However, standardization is lacking, and this scale appears to be imperfectly suited for capturing the stage of head and neck lymphedema (Model Number/Ref. 3).
Modification of the Foldy scale for categorizing extrinsic lymphedema does a good job of capturing the range of soft tissue changes seen with progression of untreated head and neck lymphedema (see Table 1), although further validation of the scale is warranted (see Table 1). 4).
Lymphedema Feldi score modified for head and neck Lymphedema Table 1: Modified Feldi score for head and neck clients (ref. 5). This is beyond the time that normal acute post-treatment edema is usually seen.
External lymphedema is identified by visible swelling of the face or neck, and can be best quantified using a “composite facial score” consisting of seven measurements, as well as a “composite neck score” consisting of 3 measurements (model number / Ref. 4) . Measurements are needed to establish baselines, monitor changes, and improve tracking.
In contrast to internal edema, swelling of the mucous membrane and soft tissues of the pharynx and larynx is visible. Internal lymphedema is more difficult to quantify. An endoscopy or examination mirror by an experienced practitioner can be used to measure 11 internal anatomical sites and two Patterson scale sites (art. 5).
risk factors for head and neck lymphedema after cancer treatment
Fundamentally, the risk of lymphedema increases as a function of lymphatic damage. Perhaps the best predictor of likelihood is the number of lymph nodes that were removed during surgery; the more nodes removed, the more likely it is to develop head and neck lymphedema. Studies on head and neck lymphedema show that the total dose of radiotherapy as well as the number of days of radiotherapy also increase the risk of developing lymphedema (Ref. 6).
In addition to the number of lymph nodes removed, additional factors may change your chances of developing head and neck lymphedema. A study of arm lymphedema secondary to breast cancer shows that the chance of lymphedema increases for patients who:
Received chemotherapy before or after surgery (ref. 7),
Have a high Body Mass Index (BMI) of
Have genetic factors associated with lymphedema
Report about lower general health indicators (see 7)
Lymphedema – diagnosis and treatment
Lymphedema of the extremities is a visible and palpable swelling of the legs resulting from stagnant lymphatic fluid. Lymph is a pale yellow or colorless fluid that contains blood plasma and lymphocytes (white blood cells).
There are many causes of the disease. Often, this is a blockade of the lymph nodes. The pressure in the vessels rises, and the lymph protrudes from the lymphatic channels, filling the tissues. The second reason is heredity. The patient may have too few lymphatic vessels or they may be different from the norm, so they cannot perform their function properly. At the same time, the risk of inheriting the disease is 50%.
The disease is rare. Women suffer from it 9 times more often than men. Usually, lymphedema manifests itself in the return of 15 to 20 years. And even less often the disease occurs in patients older than 35 years.
Diagnosis of Lymphedema of the Lower Extremities
Diagnosis for the presence of lymphedema of the legs begins with a physical examination of the patient. An anamnesis is collected, that is, the patient’s memories of his lifestyle, when he first noticed changes in the lower extremities, past diseases, operations, injuries, allergic reactions, chronic diseases and heredity. All this information helps the doctor determine the possible source of provoking the disease.
Lymphedema has primary and secondary forms. In primary, the patient’s toes will be square in shape. This bright distinguishing feature immediately excludes venous edema.
Imaging is not required to make a diagnosis. It is needed when determining the degree of tissue involvement in the pathological development of the disease. That is, to determine how much tissue has been damaged.
The main tests that are prescribed for lymphedema:
- X-ray Needed to rule out bone anomalies.
- Computed tomography. Usually prescribed for suspected malignancy.
- Magnetic resonance imaging.
- Indocyanine green lymphography.
- Ultrasonography. Evaluation of the condition of the lymphatic and venous vessels for damage.
- Lymphoscintigraphy. The state of the lymphatic system is being assessed.
Secondary lymphedema is characterized by an association with some previous disease, injury or operation. It is important to establish the cause and determine the extent of the disease in order to prescribe the correct treatment.
After getting acquainted with the clinical symptoms, the stage of the course of the disease is determined:
Stage 1 – edema is not visible from the outside, but the natural ability of the lymphatic system to circulate the lymph is already reduced;
Stage 2 – swelling of the legs occurs in the evening;
stage 3 – onset of inflammation and irreversible symptoms;
Stage 4 Abnormal swelling of parts of the body.
At stages 1 and 2, the disease can be cured. Lymphedema is completely eliminated. In stages 3 and 4, the disease is irreversible.
Treatment of lymphedema
Lifestyle recommendations should be followed if diseased. For example, if you have stage 3 or 4 lymphedema, then you need to undergo therapy to reduce external pressure on the body. Do not wear tight, tight or tight clothing. You need to protect yourself as much as possible from possible injuries. At the first signs of inflammation, such as fever, chills, redness, you should immediately consult a doctor.
Treatment of primary lymphedema
In case of hereditary lymphedema, complex therapy is prescribed: lymphatic drainage, drugs (diuretics, benzopyrones), compresses, gymnastics, foot skin care to prevent ulcers or injuries, surgery.
Treatment of secondary lymphedema
If the patient has a secondary form of the disease, then the cause of the lymphedema should be treated.