Diagnosis and treatment of lymphedema

Although there is no unique signs or criteriae for defining lymphedema, the diagnosis is usually made clinically by thorough evaluation and physical examination. Physical examination consists of volume and shape discrepancies, and skin changes among the extremities. Volume can be measured by tape, water displacement or perometry.

Non-invasive measurements (tonometry, bioimpedence spectroscopy) and imaging techniques (lymphoscintigraphy, ultrasonography, computed tomography, and magnetic resonance imaging) may aid in the detection of lymphedema. Bioimpedence spectroscopy is a new diagnostic tool for the early evaluation of extracellular fluid compartments. Lymphoscintigraphy is a nuclear medicine study and demonstrates slow or absent lymphatic flow.

Treatment for lymphedema depends on the severity and extents of the condition. Complete/Complex decongestive therapy is commonly recommended for the first two stages of lymphedema. Treatment options may include;
1) Manual lymphatic drainage: light skin stretching technique that enhance the sequestration and transport of lymphatic system
2) Compression: non-elastic bandages or compression garments, such as elastic sleeves, put gentle pressure on the affected area. This helps it prevent fluid from refilling and an accumulation of fluid.
3) Exercise: with compression, special exercises improve lymphatic flow, restores flexibility and increases range of motion.
4) Skin care: keeping the skin clean and moisturized will help it prevent infection that often can happen with lymphedema.

Reducing risk of lymphedema

1. Avoid tight, restrictive clothes, such as tight bra straps and watches, tight belts and tight underwear.
2. Take care of your skin. Try to avoid cuts, scratches, burns and insect bites.
3. If possible, never allow injections, blood-taking or blood-pressure cuffs on the at-risk arm.
4. Protect yourself against excessive heat or cold. Avoid hot baths, saunas or sunburn.