Lymphedema usually occurs when the lymphatic system fails to drain excess fluids from a targeted body part. As a result, lymph fluid builds within affected areas, causing those areas to swell. Many confuse edema with lymphedema due to the symptoms being similar.
At New York Vein Treatment Center, our lymphedema treatment clinic has diagnosed and treated thousands of cases of lymphedema. We want you to better understand what lymphedema is, what commonly causes it, and how it’s diagnosed.
Defining Lymphedema
Lymphedema is a condition that occurs when lymph fluids accumulate in certain parts of the body. This condition manifests when the lymphatic system becomes incapable of diffusing lymph fluid from between the cells of the tissues.
While lymphedema is a form of edema, it’s important to note that lymphedema specifically involves the accumulation of lymphatic fluid. Edema is a generalized term involving the accumulation of fluid in the body.
Lymphedema almost always occurs in an extremity and is rarely seen isolated in a different body part. Lymphedema also involves the affected limb’s hand or foot. If swelling isn’t present in the affected limb’s distal extremity, it might not be lymphedema.
Primary Lymphedema
Primary lymphedema is idiopathic, meaning it arises from unknown causes and often happens spontaneously. It typically signals a flaw within the lymphatic development. Primary lymphedema is rare.
Secondary Lymphedema
Secondary lymphedema is common among adults but less commonly found in children. This type of lymphedema is acquired or results when a functioning lymphatic system becomes injured or impaired.
Causes of Lymphedema
Since primary lymphedema involves an improperly developing lymphatic system, it’s often diagnosed in children as opposed to adults.
Secondary lymphedema occurs due to impairment or injury of a normally functioning lymphatic system. Due to this, there are some common causes for this type of lymphedema.
Cancer Tumors
When cancer tumors reside next to lymphatic vessels, these tumors may block these vessels, causing lymph fluid to accumulate in the affected area.
Radiation Treatments
Radiation treatments may inflame or scar lymph vessels and lymph nodes, causing blockages and impairments that lead to lymph fluid accumulation.
Cancer Surgery
When the lymph nodes are removed, it may cause lymphedema.
Parasite Infestation
Threadlike worms called lymphatic filariasis are spread by mosquitoes and are commonly found in tropical developing countries. This parasite infection impairs the lymphatic system by blocking the lymph nodes.
Obesity
Severely obese patients (BMIs over 50) can develop “obesity-induced lymphedema.” This type of lymphedema usually manifests in the lower extremities.
Family History
Patients are often asked if their parents suffered from extremity swelling. If so, the patient is likely experiencing lymphedema.
Symptoms of Lymphedema
Lymphedema tends to be painless during onset. As the affected limb swells, musculoskeletal aches can develop. When affecting the lower limbs, movement may become impaired. Vessels may also bleed or leak fluid.
It’s crucial to note that lymphedema increases the risk of infection.
Diagnosing Lymphedema
A lymphedema treatment clinic’s doctor begins with a physical examination. This examination, imaging, and possibly additional testing will help doctors diagnose or rule out lymphedema.
Pitting Edema
Pitting edema occurs during the earlier stages of lymphedema. To test for this, the doctor will press on the distal extremity, the hand or foot, to see if an indentation (pit) remains.
As lymphedema progresses, pitting edema dissipates, making this evaluation less relevant.
Stemmer Sign
The swelling and inflammation from lymphedema thickens the skin, making it harder to pinch the skin from the tops of the hands and feet. If the doctor is unable to pinch the skin on the affected limb’s distal extremity, then it’s likely lymphedema.
Presence of Scars
Doctors look for scarring in the areas where lymph nodes reside. Scarring reveals possible injury to the lymphatics. Scars indicating radiation skin fibrosis are also assessed.
Associated Syndromes
Patients with primary lymphedema often exhibit additional syndromic characteristics:
- Extra row of eyelashes
- Yellow nails
- Sparse hair
- Generalized edema
- Developmental delays
- Flat faces
- Broad nasal bridge
Doctors also evaluate if patients have been diagnosed with Noonan or Turner syndromes, which are associated with lymphedema.
Imaging
While physical examinations and family history can be enough for lymphedema treatment clinics to diagnose lymphedema, additional imaging may be ordered to assess skin thickening or subcutaneous edema. Practitioners use ultrasounds, MRIs, and CT scans to assess these features.
Lymphoscintigraphy
Lymphoscintigraphy is the most conclusive diagnostic test for lymphedema. It involves injecting a tracer protein into the affected limb’s distal extremity, the hand or foot.
Once absorbed by the lymphatic vessels, a gamma camera is used to track the movement of the tracer protein through the lymphatic system to the lymph nodes.
Delayed migration, unequal node uptake, and dermal backflow are definitive signs of lymphedema.
Choose the Most Experienced Lymphedema Treatment Clinic
At New York Vein Treatment Center, we’ve been successfully diagnosing and treating lymphedema since 2007. Trust our experienced and reputable team of providers to accurately assess swelling causes while providing personalized treatment plans to improve patients’ quality of life.
Contact us today to learn more about our lymphedema treatment clinic.
Dr. Lev Mark Khitin, a leading cardiovascular and thoracic surgeon, is the founder of the New York Vein Treatment Center. With almost 20 years of experience and over 20,000 successful vein procedures, he is a renowned expert in the diagnosis and treatment of venous disease. Dr. Khitin’s patient-centered approach and advanced surgical skills have consistently delivered excellent results, making him a prominent figure in the field.
