Lymphedema

Diagnosis

Healthcare provider may make a diagnosis of lymphedema based on the signs and symptoms if they are at risk for the condition, such as if they recently underwent lymph node-related cancer surgery.

If the lymphedema’s underlying reason is less clear, healthcare provider could request imaging tests to look at the lymphatic system. Imaging test may include:

• Magnetic resonance imaging (MRI): An MRI creates 3D, high-resolution images of the affected tissue using a magnetic field and radio waves.
• Computed tomography (CT) scan: The structures of the body are shown in great detail with this X-ray technology. Blockages in the lymphatic system can be seen with CT imaging.
• Doppler ultrasound: This test creates visualizations of interior structures using sound waves. It may help in identifying vascular and lymphatic system blockages.
• Lymphoscintigraphy: The subject of this test receives a radioactive dye injection before being automatically scanned. The dye’s passage through the lymph vessels is visible in the ensuing photographs, which also indicate any obstructions.

Staging of lymphedema

• Stage 0: Although there are no visible symptoms of edema, the affected area may feel tight, heavy, and swollen.
• Stage I: There may occasionally be edema, but it goes away when the affected area is elevated.
• Stage II: The skin in the affected area may feel firmer than the surrounding area and is virtually always swollen.
• Stage III: Significant swelling in the affected area is present, and the skin’s color and texture have changed.

Treatment

Lymphedema does not have a cure. The goal of treatment is to reduce edema and avoid complications.

• Medications: If you have lymphedema, your likelihood of developing skin infections, specifically cellulitis, is significantly higher. To prevent complications, your healthcare provider may suggest antibiotics for you to have readily available, enabling you to begin taking them as soon as symptoms arise.
• Therapy: Patient can learn from specialized lymphedema therapists about the methods and tools that can assist them to lessen lymphedema swelling. Some therapy are:
  • Exercises: Moving the excess fluid out of the swollen limb might be assisted by gently contracting the arm or leg muscles.
  • Compression bandages: Lymph fluid flows back into the body’s trunk when low-stretch bandages are used to cover the entire limb.
  • Manual lymph drainage: The trapped fluid in the swollen limb is moved into a location with functioning lymph vessels by skilled therapists in this massage-like method using very mild pressure. If a person has a skin infection, a blood clot, or active cancer in the affected limb, they should refrain from manual lymph drainage.
  • Compression garments:  Tightly-fitting sleeves or stockings made of elastic material can apply pressure to the arms or legs, promoting the drainage of lymphatic fluid. It is usually necessary to obtain a prescription for these garments to ensure that the right amount of compression is used. Additionally, a professional may need to take measurements to ensure that the garments fit properly.
  • Sequential pneumatic compression: A pump that is attached to a sleeve that is worn over the affected arm or leg periodically inflates the sleeve, applying pressure to the limb and drawing lymph fluid away from the fingers or toes.
• Surgical and other procedures: Surgery for lymphedema may consist of:
  • Lymph node transplant: In order to treat an affected limb, lymph nodes are removed from another part of the body and linked to the lymphatic system there. Many persons with early-stage lymphedema experience positive outcomes from this procedure, which reduces the amount of compression required.
  • New drainage paths: This treatment establishes new connections between the lymph network and blood arteries and is another option for treating early-stage lymphedema. Following that, blood arteries are used to drain the extra lymph fluid from the limb.
  • Removal of fibrous tissue: The soft tissues of the limb stiffen and become fibrous in severe lymphedema. Improved limb function can result from some of this hardened tissue being removed, frequently through liposuction. A scalpel may be used to remove hardened tissue and skin in extremely severe situations.