Lymphedema, a condition caused by abnormality or damage in the lymphatic system, can be managed effectively when diagnosed early. Lymphedema diagnosis especially at its earliest possible stage is important as this condition is progressive and can lead to chronic inflammation and infection.
Lymphedema Diagnosis
There are several conditions that can cause swelling but are not lymphedema.
True lymphedema is a swelling that results from abnormality or damage in the lymphatic system. It can be a result of congenital conditions or abnormalities in one’s lymphatic system (primary lymphedema). In many cases, lymphedema can happen as a result of other conditions such as cancer and its treatment (secondary lymphedema).
Different Ways of Diagnosing Lymphedema
For correct lymphedema diagnosis, evaluation of a physician or a lymphedema expert healthcare provider is needed. In most cases, diagnosis of lymphedema involved history and physical examination, imaging studies, and noting changes in electrical conductance and biomechanical properties.
History and Physical Examination
History and physical examination are accepted methods for diagnosing lymphedema of the neck, trunk, breast, and genitals.
During history-taking, the patient will be asked about his/her age when the affected area starts to swell, the location, and the progression of the swelling. He/she may also be asked about other signs and symptoms that appear with or after the swelling develops.
For physical examination, the patient’s vascular system, skin, and soft tissues will be evaluated. His/her lymph nodes are palpated and changes associated with the swelling and other symptoms are noted.
History and physical examination are done by a healthcare provider who has experience in diagnosing and treating lymphedema.
Imaging Studies
In some cases, imaging studies are needed to support the diagnosis. The doctor may recommend the patient to undergo magnetic resonance imaging (MRI), computed tomography scan (CT scan), and ultrasound in order to confirm the extra fluid in the tissues. Although these tests are helpful in detecting extra fluid in the tissues, they cannot determine the exact cause.
To determine if the swelling is caused by an abnormality in the lymphatic system, a test called lymphoscintigraphy may be done. It’s a nuclear medicine study that involves the injection of radio-labeled particles under the skin. This test will show a slow or absent flow of the lymphatic fluid. It can also show areas of backflow or reflux.
Bioimpedance Spectroscopy
Bioimpedance Spectroscopy (BIS) can measure the interstitial fluid, which can be helpful in confirming lymphedema diagnosis. It can detect early changes caused by lymphedema and is effective in diagnosing lymphedema caused by breast cancer.
Tissue Dielectric Constant and Tonometry
Aside from BIS, tissue dielectric constant and tonometry are also other tests that can measure the changes brought by lymphedema. Tissue dielectric constant measures tissue water content while tonometry is used to measure the degree of fibrosis.
These are just some of the tests involved in lymphedema diagnosis. It’s best to see a healthcare provider immediately if you notice swelling and other unusual symptoms even if you’re not sure if they are caused by lymphedema.
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