Part 2 – How is Lymphoedema diagnosed?
Blog by Alyaa Mokh’ee (Lymphoedema Physiotherapist)
In Part 1 we learnt about our lymphatic system and how it works. In Part 2, we will be exploring how Lymphoedema gets diagnosed.
Confirmation of Diagnosis
It may be suspected by family, friends, yourself or your medical practitioner as a potential diagnosis. It could also be discussed when you go for routine Specialists’ appointments after or during cancer treatment.
Most doctors and specialists will refer you to a certified Lymphoedema Therapist for a thorough assessment and confirmation of the diagnosis.
A majority of sufferers will have had significant swelling prior to seeing a therapist, although, there is a significant number of cases where swelling may not be as obvious but other symptoms may be present.
Lymphoedema Therapists will:
- Explore your swelling history and changes in its presentation over the course of time.
- Request specific tests from your medical practitioner to exclude other causes of swelling; for example Cellulitis or Deep Vein Thrombosis (DVT)
- Complete a Bioimpedance Measure (if available) to calculate how much fluid is present in affected versus un-affected limbs
- Undergo a Volume Assessment to construct a baseline and to monitor fluid changes over time
- A Full Body Assessment which includes establishing the location of swelling, skin changes and potential limitations present. Photos may be taken to track progress and stability of your condition.
In some cases, your Specialist or Medical Practitioner might arrange for you to have further imaging procedures to examine the capacity and functionality of your lymphatic system.
With this comprehensive assessment model, your certified Therapist will be able to determine if it is actual Lymphoedema or a condition that only presents like the condition.
Before we go on to how it would be managed, it is also important to note that there are 2 types of Lymphoedema – Primary and Secondary Lymphoedema.
Primary Lymphoedema is caused by a congenital defect in the development of lymphatic vessels and is usually present from a young age. This could include an abnormal number of lymphatic vessels with impaired function.
Secondary Lymphoedema is caused by any potential damage to your lymphatic system.
Your lymphatic system can potentially be damaged by:
- Radiation / Radiotherapy and associated scarring
- Removal of lymph nodes
- Surgery around sites of lymph nodes and/or major lymph vessels, and associated scarring
- Side effects from cancer treatment
- Cancer itself (invasion into lymph nodes or encroaching onto lymph vessels)
- Recurrent infections like Cellulitis
- Trauma/ Extensive injury
- Lack of movement
PART 1 – What is Lymphoedema?