LIPODEMIA AND LYMPHEDEMA – differences
Lipid edema is diagnosed very rarely because it is often confused with lymphedema or simply being overweight. In this article, we have discussed methods that enable correct diagnosis.
How to distinguish between lipedema and lymphedema?
Usually, the differences between lipid and lymphatic edema are visible at first glance. However, it should be remembered that in advanced stages of lipid edema, secondary lymphatic edema may occur, which makes differentiation much more difficult. This is then referred to as fat-lymphatic or lipo-lymphatic edema.
Differences between lymphatic and lipid edema.
Obvious differences, visible at first glance
These are the differences between lymphedema and lipedema that can be determined based on the patient’s appearance.
- First of all, lipid edema can only occur in women. Therefore, men are not examined for this condition, and if they suffer from swelling of the legs, lymphatic edema is automatically suspected rather than fat edema.
- Lipid edema usually affects the legs, less often the arms. Lymphatic edema, on the other hand, can also occur on the arm, e.g., in women who have undergone a mastectomy.
- Lipid edema is usually symmetrical, affecting both legs to the same degree. If only one leg is swollen, it is likely to be lipid edema.
- Lipid edema does not affect the feet. It tends to be concentrated in the hips and thighs, and sometimes the calves. There is no swelling around the ankles or on the feet. Lymphatic edema, on the other hand, most often affects the lower legs, as lymph accumulates in the feet and around the ankles due to gravity.
- The appearance of the skin also differs. In the case of lymphedema, the skin thickens and hardens. In contrast, with lipedema, the skin remains unchanged and may even become slightly thinner. However, the subcutaneous fatty tissue thickens, hardens, and nodules may form in it.
- Lipid edema is characterized by easy bruising. Lymphedema does not cause this symptom. Therefore, if the limbs are covered with a large number of bruises, this may indicate lipid edema.
- In the case of lymphedema, the body’s immunity is reduced, so infections often occur. The presence of bacterial, viral, or fungal infections in the limbs may indicate lipedema.
Differences based on medical history
These are differences between lymphedema and lipedema that result from the medical history collected by the doctor. Every doctor must obtain the necessary information from the patient in order to make a diagnosis. Below are the most important questions a doctor should ask when trying to distinguish between lymphedema and lipedema.
Has there been a history of lipid edema or a tendency to obesity in the hips and legs in the patient’s family?
If the answer to this question is “YES,” it may mean that the patient is suffering from lipedema. One of the possible causes of lipedema is heredity.
Has the patient undergone surgery or trauma to the legs or reproductive organs?
An affirmative answer to this question could indicate lymphedema, as it often occurs as a result of damage to the lymphatic vessels, e.g., after trauma or surgery.
Is the swelling painful?
Lymphedema rarely causes pain. Lipedema, on the other hand, is almost always associated with severe pain, especially when touched.
Differences resulting from palpation (touch)
There are several types of examinations that require only touch. Below are palpation examinations that help distinguish between lipid and lymphatic edema.
Indentation caused by finger pressure
Indentation formed in the tissues as a result of pressing them with a finger.
To determine whether the edema is lymphatic or lipid, a simple test can be performed.
Press any point on the swollen limb with your finger for about half a minute. In the case of lymphatic edema, a clear indentation will appear.
This is the result of fluid accumulation in the limb, i.e., lymph, which, when pressure is applied to a specific point, drains from that area for a while and then gradually flows back.
Lipid edema does not produce this symptom.
Stemmer’s sign
In the case of lymphedema, the so-called Stemmer’s sign occurs. To check this, try to pinch the skin on the back of the second toe. If this proves impossible, it means that you are dealing with lymphedema. Lipid edema does not cause this symptom.
Differences resulting from clinical studies
Imfoscyntigraphy
This is a test that involves injecting a radioactive contrast agent into the foot and imaging its distribution using a gamma camera. In lipedema, the result will be normal, i.e., the contrast agent will reach the lymph nodes. In lymphedema, which prevents the proper flow of lymph, the contrast agent will not be present in the lymph nodes.
Lipid edema – treatment
