Hot of the Press April 2025
Article to ponder
This systematic review examined 20 studies assessing imaging and measurement tools for quantifying the physical aspects of lipedema. A total of 13 different tools were identified, categorized into imaging (n=8) and measurement (n=5) methods. These tools were used to evaluate key physical characteristics, including lymphatic transport disturbances (n=8), limb size/volume (n=4), adipose tissue thickness/mass/volume (n=3), and tissue fluid presence (n=2).
Key findings include:
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Diversity of Tools: Various techniques were employed, including tape measure, perometry, bioimpedance spectroscopy, ultrasound, Dual-Energy X-ray Absorptiometry (DEXA), MRI, and lymphangiographic imaging.
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Lack of Standardization: Measurement protocols varied significantly across studies, including differences in anatomical locations, patient positioning, and calculation methods.
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Limited Clinimetric Data: The studies often lacked validation or reliability data, with most using small, heterogeneous cohorts.
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Recent Trends: Studies post-2020 incorporated multiple tools for assessment, indicating a growing trend toward multimodal evaluations.
Overall, while objective assessment methods exist for lipedema, a standardized, validated measurement protocol is lacking, necessitating further research for clinical and research applications.
Assessment Tools to Quantify the Physical Aspects of Lipedema: A Systematic Review
Eason HE, Kilbreath SL, Fearn N, Dylke ES, Lymphat Res Biol. 2025 Mar 5. doi: 10.1089/lrb.2024.0102. Epub ahead of print. PMID: 40042124.
Key Takeaway: The systematic review highlights the lack of standardized, validated assessment protocols for quantifying the physical aspects of lipedema, underscoring the need for further research to establish reliable measurement tools for clinical and research applications.
We have collated some great articles and material published over the last month. Click on the links below to read the abstract or download the full paper.
Anatomy / Physiology /Pathophysiology
The association between allostatic load and lymphedema in breast cancer survivors
Prevalence and Risk Factors
Incidence and predictors of lower extremity lymphedema after postoperative radiotherapy for prostate cancer
Assessment
The Comparative Evaluation of Depression, Life Satisfaction, and Quality of Life Between Female Patients with Lipedema and Lymphedema - click for abstract
The Comparative Evaluation of Depression, Life Satisfaction, and Quality of Life Between Female Patients with Lipedema and Lymphedema
Building evidence for diagnosis of lipedema: using a classification and regression tree (CART) algorithm to differentiate lipedema from lymphedema patients - click for abstract
Building evidence for diagnosis of lipedema: using a classification and regression tree (CART) algorithm to differentiate lipedema from lymphedema patients
I Forner-Cordero, J Muñoz-Langa, L Morilla-Bellido – International angiology. 2025 Feb 26.
Background: Discriminating lipedema from lymphedema becomes challenging in the absence of a pathognomonic test. The objective was to find the best manifestations that discriminate between lipedema and lymphedema and to build a diagnosis algorithm.
Methods: Prospective cohort study of two cohorts of patients, one with lipedema and another with lymphedema. Inclusion criteria for lipedema cohort involved bilateral lower limbs (LL) enlargement and at least three symptoms: pain/tenderness, bruising, familial history, no Stemmer’s sign, symmetrical involvement, and non-swollen feet. The lymphedema cohort included female patients with LL lymphedema. A univariate analysis was performed to determine which clinical features were different between both samples. We used a TREE procedure to create a tree-based classification model using the CART (Classification And Regression Tree) algorithm, in order to discriminate lipedema from lymphedema patients.
Results: Currently, 138 lipedema and 111 lymphedema patients were included. After univariate analysis, symmetrical involvement, disproportion between upper and lower parts of the body, spare feet, bruising, spider veins, family history, and pain were significantly more present in lipedema than in lymphedema (P<0.0001). Stemmer's sign, lymphangitis bouts, pitting and fibrosis were more representative of lymphedema (P<0.0001). The most important variables for discrimination were: disproportion (100%), spare feet (92.6%), bruising (92.3%) and symmetrical involvement (90.3%). After CART analysis, only three variables were retained in the final model: bruising, disproportion and spare feet. The model's accuracy was 100% with a probability error of 0.0% (SE: 0.00).
Historical Review and Clinical Uses of Skin Indentation to Assess Limb Lymphedema
HN Mayrovitz – Cureus, 2025
Management Strategies
Compression terms: Defining terminology of compression therapy - An international compression club consensus document - click for abstract
Compression terms: Defining terminology of compression therapy – An international compression club consensus document
BACKGROUND: The terminology in compression therapy is not always consistent. Confusion arises from layers, components, materials, whether elastic or inelastic, stiff or not stiff, compression class, and other terms. The aim of this paper is to define a standard terminology for compression therapy.
METHOD: the International Compression Club (ICC) board members prepared a draft consensus paper, which was circulated among the ICC members and refined by GM according to the comments and suggestions received.
RESULTS: All the terms used in compression therapy, from the definition to the materials, compression kits or systems, their physical properties, compression pressure, compression characteristics, and components and layers, were considered and agreed upon.
CONCLUSIONS: The given definitions allow for consistent classification of compression materials or devices. The International Compression Club hopes that the proposed terminology will be widely accepted and that papers and congress presentations on compression will use precise terminology.:10.1177/02683555241313422
Efficacy of Therapeutic Ultrasound Added to Complex Decongestive Therapy in Breast Cancer-Related Lymphedema - click for abstract
Efficacy of Therapeutic Ultrasound Added to Complex Decongestive Therapy in Breast Cancer-Related Lymphedema
Randomized Trial Assessing Prospective Surveillance and Exercise for Preventing Breast Cancer-Related Lymphedema in High-Risk Patients - click for abstract
Randomized Trial Assessing Prospective Surveillance and Exercise for Preventing Breast Cancer-Related Lymphedema in High-Risk Patients
Effects of aerobic cycling training in patients with gynaecologic cancer-related lower extremity lymphedema: A randomised comparative study - click for abstract
Effects of aerobic cycling training in patients with gynaecologic cancer-related lower extremity lymphedema: A randomised comparative study
Supporting patients with lymphoedema: the role of healthcare professionals in improving health-related quality of life - click for abstract
Supporting patients with lymphoedema: the role of healthcare professionals in improving health-related quality of life
A randomized controlled non-inferiority study of adjustable compression wraps compared with inelastic multilayer bandaging used in the intensive complex decongestive therapy of lower leg lymphedema
Effectiveness of Kinesio Taping for Lymphedema in the Post-Mastectomy Patient: A Systematic Review of Randomized Controlled Trials
Physical activity and lower extremity lymphedema among endometrial cancer survivors: A population-based cross-sectional study
“Do I buy my children shoes, or do I get a compression garment for my lymphoedema?” Australian stakeholder perspectives on cancer-related lymphoedema care
Prospective Evaluation of the Safety and Compression Performance of Novel Compression Denim Jeans in Healthy Volunteers and Patients With Lymphedema
Justification of the role of rehabilitation assistance in lymphedema of the upper extremities based on foreign experience (a literature review)
Solomiia Kopytkoa,b, Olha Basa,b, Andriy Hrynkiva,b, Andriy Vovkanycha, Myroslava Hrynkivc. Physical Rehabilitation and Recreational Health Technologies. Vol 10. No1,2025.
The MD Anderson Algorithm for Lymphedema Management