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
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
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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