Lower Limb Lymphedema

ABSTRACT: Differential Diagnosis, Investigation, and Current Treatment of Lower Limb Lymphedema

Hypothesis: The causes and management of lower limb lymphedema in the Western population are different from those in the developing world.

Objective: To look at the differential diagnosis, methods of investigation, and available treatments for lower limb lymphedema in the West

Conclusions: The common differential diagnosis in Western patients with lower limb swelling is secondary lymphedema, venous disease, lipedema, and adverse reaction to ipsilateral limb surgery. Lymphedema can be confirmed by a lymphoscintigram, computed tomography, magnetic resonance imaging, or ultrasound. The lymphatic anatomy is demonstrated with lymphoscintigraphy, which is particularly indicated if surgical intervention is being considered.

The treatment of choice for lymphedema is multidisciplinary.

In the first instance, combined physical therapy should be commenced (complete decongestive therapy), with surgery reserved for a small number of cases.

[02/25/2003; Archives of Surgery]

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