There is no specific test or tool to diagnose lipoedema. This makes the diagnosis difficult, and many patients struggle without a specific diagnosis for a long time. However, awareness of the condition among healthcare professionals (HCPs) is increasing.
Who diagnoses lipoedema?
Your general practitioner (GP) or an experienced nurse is likely to be your first contact person when you notice any signs or symptoms of lipoedema.
Your HCP will carry out a medical examination of your body, including your skin and soft tissues, and the function of the arteries and veins. Blood samples provide information about the function of your heart, kidneys, liver, and thyroid gland. A full blood count is used to check your glucose and protein levels, amongst others.
An examination is important to rule out any other reasons for your medical conditions. Symmetrical swelling of your limbs may be due to other reasons like lymphoedema, obesity, heart failure, kidney or liver dysfunction, drugs, venous diseases, or gravitational oedema.
How is lipoedema diagnosed?
Your medical history and a physical examination of your body are the main elements in the diagnosis of lipoedema. Here are some typical questions that your HCP will ask you:
- When did you first notice any signs or symptoms?
- Have your signs and symptoms become worse over time?
- How do your symptoms affect your daily life (work, leisure activities, personal relationships) on a physical and/or psychological level?
- Do you take any medications at the moment, and if so, what kind of medication do you take?
- Is there someone in your family with the same signs and symptoms?
Your HCP will examine your affected limbs as well. This usually includes the following steps:
- Check-up of your affected limbs: what parts of the body are affected, and are your limbs affected symmetrically?
- Palpation of your tissue: are there differences in the texture, temperature, and sensation?
- Assessment of your weight (Body Mass Index) and, more important, disproportions between your waist and height (waist-to-height ratio)
- Mobility and range of motion: does the tissue enlargement affect your gait, and do you have pain in the knees or hips?
- Testing of your blood vessels (veins and arteries) to check your blood circulation
- Assessment of your skin to rule out any infections
Your medical history and an examination of your affected limbs are often enough to confirm a diagnosis of lipoedema. Your HCP may need further information, e.g. if you have experienced another medical condition that can cause your symptoms. There are a few diagnostic tools that can help to distinguish between lymphoedema and lipoedema, to rule out any diseases of your venous system, or to decide whether the conditions occur together:
- Ultrasound scan – uses high-frequency waves that create a picture of your tissue from the outside
- Lymphography – uses a radiocontrast agent that visualises your lymphatic system under X-ray
- Lymphoscintigraphy – uses a nuclear medicine that visualises the lymph drainage and your lymph nodes
- Venous duplex ultrasound – a specific ultrasound method to assess the functions of your veins
Early diagnosis and treatment can prevent the progression of your lipoedema. Be aware of your body and stay in contact with your HCP when and if you notice any changes, or new signs and symptoms.
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