Materiały źródłowe

• #1 Lipedema—Pathogenesis, Diagnosis, and Treatment Options

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7465366/

  Lipedema is often unrecognized or misdiagnosed; despite an estimated prevalence of 10% in the overall female population, its cause is still unknown. […] The diagnosis of lipedema remains a challenge because of the heterogeneous presentation of the condition and the current lack of objective measuring instruments to characterize it. […] The diagnosis is generally made on clinical grounds after the exclusion of competing diagnoses. […] The clinical constellation of the major manifestations of the disorder appearing together tissue tenderness, a feeling of tightness, and an excessive tendency toward hematoma formation, with worsening symptoms over the course of the day, in a patient with a bilaterally symmetrical, disproportionate proliferation of fatty tissue on the limbs but not on the hands/feet points toward the diagnosis of lipedema.

• #2 Patient Guide to Self-Diagnosing Lipedema and Lipo-Lymphedema

  https://torontophysiotherapy.ca/patient-guide-to-self-diagnosing-lipedema-and-lipo-lymphedema/

  Lipedema appears to be a progressive condition (although it isn’t) and this makes it more complicated to diagnose. Early lipedema starts out as lipohypertrophy (an abnormal accumulation of fat that is pain-free) that eventually reaches the point of inducing pain, thereby achieving the definition of ‘lipedema’. As a result, the earliest onset of lipedema can be very difficult to differentiate from simple weight gain in otherwise healthy individuals. If the individual’s weight and health remain stable, it is likely that the lipedema would not worsen. In reality, it’s common for an individual’s general health and wellness not to remain static over their lifetime, and instead weight gain and obesity are common. […] Given the variety of symptoms, lipedema is commonly diagnosed not very well, and not very often. Even though it has been reported that as many as 11% of women suffer from the condition of lipedema, appreciation and understanding of the disease is still limited. In fact, we don’t yet know for certain what the true prevalence is; published estimates vary widely from 1 in 72,000 to 1 in 5 women. Since lipedema is not very well known, it is often incorrectly diagnosed as simple obesity or as primary lymphedema (a congenital form of lymphedema that often affects both sides of the body). It doesn’t help that there are no standard protocols or diagnostic tests to diagnose lipedema at this time.

• #3 Lipoedema – diagnosis, treatment, and experiences – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK580170/

  No scientific studies assessing tests to diagnose lipoedema, or methods to distinguish between lipoedema and other conditions were identified. […] Internationally accepted diagnostic criteria should be considered as a reference standard in future studies investigating methods to diagnose lipoedema. Such studies are needed to assess the diagnostic accuracy of such methods. […] There are no known tests or internationally accepted diagnostic criteria for lipoedema. The Swedish diagnostic code for lipoedema is R60.OB. A diagnosis of lipoedema is made based on a combination of the persons medical history, their symptoms and a clinical examination, as well as by ruling out other conditions with similar symptoms such as lymphoedema, Dercums disease, and obesity (BMI30). Lipoedema is distinguished by the symmetrical accumulation of fat on the hips, thighs, lower legs and or arms that does not involve the hands or the feet. The condition is characterized by pain and sensitivity to pressure in the affected tissues. […] After a systematic literature search and assessment of the retrieved studies, no scientific study assessing a method to diagnose lipoedema was found.

• #4 Lipedema Stages & Diagnosis – Lipedema Medical Solutions

  https://lipedema.net/lipedema-diagnosis/

  There is no specific blood test or imaging test widely available to diagnose lipedema. The diagnosis of Lipedema is made based on a clinical evaluation using the below criteria by a physician knowledgeable and experienced in the diagnosis of the disease and with supporting tests that rule out other diagnoses. […] The recognition of the characteristic features of Lipedema early stages and elimination of other conditions that can be confused with lipedema is the key to the proper diagnosis of lipedema. […] The diagnosis of Lipedema is made based on a clinical evaluation from a physician with specific knowledge and experience of the disease and with supporting tests that rule out other diagnoses. […] Currently, there is not specific coding for lipedema in the coding system the US is currently using.

• #5 Diagnosing Lipedema — Lipedema Foundation

  https://www.lipedema.org/diagnosing-lipedema

  Lipedema requires a clinical diagnosis, meaning there is not yet a standardized test such as bloodwork or imaging that can confirm the presence of Lipedema. Diagnosis should be reached in the context of a thorough patient history and physical exam. […] Clinicians should complete a detailed history with the patient, taking note if the following symptoms are reported: Family history of similar body type, Difficulty losing fat in affected areas, Onset/worsening at time of hormonal change, Pain, tenderness, heaviness in affected areas, Fatigue, Brain fog, Easy tendency to bruise, Decreased functional ability (including mobility), Decreased quality of life, History of joint issues. […] Physical examination includes visual inspection and physical palpation. Clinicians may also complete the Stemmer sign test to assess for co-morbid Lymphedema.

• #6

  https://dermnetnz.org/topics/lipoedema-definition-and-pathogenesis

  Lipoedema is primarily a clinical diagnosis. […] A patient history must be taken eliciting information about the age of onset, signs and symptoms of swelling, sensitivity of the tissue to pressure, tendency to develop oedema when standing, weight gain, and stress. […] General investigations can be carried out to identify reasons for the limb swelling and rule out any underlying medical disorder. […] Imaging is not usually necessary, but may include: Ultrasound examination of lipoedema may show normal dermis, and thickened subcutis with increased echogenicity. […] Colour duplex ultrasonography is used to diagnose chronic venous insufficiency. […] CT scan shows thickened skin alone in lipoedema; fluid accumulation, honeycomb pattern, and muscle enlargement in seen in lymphoedema. […] MRI is sometimes used to evaluate lymphatic circulation.

• #7 Diagnosing lipedema | JOBST USA

  https://www.jobst-usa.com/living-with-your-condition/diagnoses/diagnosing-your-condition/lipedema

  Most patients who notice the first signs and symptoms of lipedema read about it on the internet first. After that, they try to find a healthcare professional who is able to diagnose this disease, which can be a roller-coaster in itself. The first point of contact might be their general practitioner or an experienced nurse. Specialized healthcare professionals can be required to rule out other diseases, such as lymphedema, obesity, heart failure, kidney or liver dysfunction, or venous diseases. All these conditions can present similarly to lipedema or can appear together with lipedema. […] There is no specific test to confirm the diagnosis of lipedema, which can make it difficult for healthcare professionals. However, the medical history and a physical exam are usually sufficient to diagnose lipedema.

• #8 Diagnosing Lipedema — Lipedema Foundation

  https://www.lipedema.org/diagnosing-lipedema

  Today, the most frequently cited components of a Lipedema diagnosis include: Bilateral, symmetrical buildup of fat in extremities and/or lower trunk that is resistant to diet, exercise, or bariatric surgery, Feet/hands are typically spared, sometimes causing the appearance of an ankle or wrist cuff, Almost exclusively affects women, Complaints of pain, tenderness, heaviness, in affected areas, Fatigue, Starts or worsens at times of hormonal changes: puberty, pregnancy, or menopause, Easy bruising, Presence of nodular and/or fibrotic texture beneath the skin that can create an uneven, dimpled appearance, Edema and joint hypermobility may also be present. […] A Lipedema diagnosis and treatment plan may vary depending on the clinician and the country in which the patient is being seen. […] Although a Lipedema diagnosis requires the expertise of a skilled professional, this may be supported in the future by research that is currently leveraging our growing understanding of Lipedema biology to create tools that will help health care providers differentiate Lipedema from other similar conditions.

• #9 Lymphedema vs lipedema: Similar but different | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/91/7/425

  Lipedema is a chronic, painful progressive disease characterized by an abnormal distribution of fat that affects the abdomen, buttocks, hips, legs, and arms disproportionately. The fat distribution is resistant to weight loss or limb elevation. […] Lipedema is often confused with lymphedema, lifestyle-induced obesity, lipodystrophy, or lipohypertrophy. Its management must be multifaceted to support and improve the quality of life of the patient. […] Clinical criteria for the diagnosis of lipedema, proposed by Wold et al and amended by Herbst and Kruppa et al, are as follows: Female patient (almost exclusively), bilateral, symmetrical, disproportionate fatty tissue hypertrophy of the limbs and abdomen, sparing of the hands and feet (cuff phenomenon), minimal pitting edema, can involve the arm (in about 30% of cases), negative Stemmer sign, feeling of heaviness and tension in affected limbs, pain and tenderness on pressure or touch, easy bruising and a tendency to form hematomas, stable limb circumference despite weight reduction or caloric restriction, worsening of symptoms over the course of the day, telangiectasias and visible vascular markings around fat deposits, hypothermia, hypermobile joints.

• #10 Lipedema: Symptoms, Treatment, Diet, Causes, and More

  https://www.webmd.com/women/lipedema-symptoms-treatment-causes

  Lipedema sometimes gets misdiagnosed as something else with similar symptoms. No single test can diagnose lipedema, so a health care provider can diagnose it by taking your medical history and doing a physical exam, which may include feeling the texture of the affected areas. […] Your health care provider may ask you about or check for several things that are common in people with lipedema, including: enlargement in both legs symmetrically, pain or tenderness when pressure is applied, easy bruising, and legs that are affected but feet that are not. […] They also may use the Stemmer sign, which is pinching the skin over the second toe. If the skin is thick and difficult to lift, that may mean you have lymphedema rather than lipedema. […] Your health care provider also may order tests to help find out whether you have lipedema. These tests may include: MRI (magnetic resonance imaging), a scan that provides images of the inside of your body; CT scan, a scan that provides images of your bones and soft tissues; Ultrasound, an imaging test that uses sound waves; DEXA scan, an imaging test that measures bone density; Nuclear medicine imaging, a scan that makes images by finding radiation from parts of the body after a radioactive material is injected.

• #11 Lipedema: diagnostic and management challenges | IJWH

  https://www.dovepress.com/lipedema-diagnostic-and-management-challenges-peer-reviewed-fulltext-article-IJWH

  A helpful diagnostic tool to distinguish lipedema from lymphedema is to pinch the skin over the dorsum of the base of the second toe (Stemmer sign); thickened skin that is difficult to lift off of the underlying tissue is considered diagnostic for lymphedema. […] Understanding the distinguishing features between these conditions and lipedema can help to accurately diagnose lipedema, which is often not considered as an initial diagnosis and thus may not be diagnosed until a potentially unnecessary workup has been done. […] The gold standard for diagnosing lymphedema is lymphoscintigraphy, which can demonstrate impaired lymphatic flow in the affected extremity following radiotracer injection. […] Distinguishing lipedema from other conditions causing fatty excess in the lower extremities can be difficult.

• #12 Lipedema: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17175-lipedema

  Lipedema is a long-term condition that causes abnormal fat buildup in the lower part of your body. […] A healthcare provider can diagnose you by doing a physical exam and collecting your medical history. Painful fat deposits make lipedema different from ordinary body fat, which doesn’t hurt. […] Providers don’t have a go-to test they use to diagnose lipedema. But they can do blood tests and imaging to rule out other issues or find other conditions you may have with lipedema. […] Tests they may order include: Ultrasound, which uses sound waves. […] Lipedema slowly worsens with time in many people. […] Researchers haven’t found a cure, but lipedema treatments can help you feel better by reducing pain and inflammation. […] Liposuction can remove fat and help with pain and mobility. Providers recommend wet-jet assisted liposuction because it’s less likely than standard liposuction to damage your lymph vessels. […] Early diagnosis and treatment may help you avoid complications.

• #13 Diagnosing lipedema | JOBST USA

  https://www.jobst-usa.com/living-with-your-condition/diagnoses/diagnosing-your-condition/lipedema

  Typically, healthcare professionals ask questions about when the first symptoms were noticed, how they affect daily life on a physical or psychological level, any medication one might be taking at the moment, and if female members of the family have experienced similar symptoms. […] The physical exam should include the following steps: Check-up of your limbs, including palpation of the tissue; Weight measurement, including the waist-to-height ratio; Mobility and range of motion; Check-up of your blood circulation (arteries and veins); Assessment of your skin. […] Advanced diagnostic tools are ultrasound scans to evaluate the tissue, X-ray measurements of the lymphatic system (lymphography), venous duplex ultrasound to evaluate the vein function or lymphoscintigraphy, a method using nuclear medicine to visualize the lymph drainage and the lymph nodes.

• #14 Lymphedema and Lipedema: Notes on Diagnosis | Cleveland Clinic

  https://my.clevelandclinic.org/podcasts/cardiac-consult/lymphedema-and-lipedema-notes-on-diagnosis

  The diagnosis and treatment of lymphedema and lipedema are complex. […] Clinical exam remains top of mind when it comes to diagnosing both lymphedema and lipedema. It requires really a thorough examination and a thorough history. […] Something that we’ve been doing recently is using a special dye, ICG, indocyanine green, and using that to visualize the superficial lymphatics in the limbs or either the upper or lower limbs. […] Another thing that we didn’t used to do, but we do now is collect blood, and we have a biorepository of blood samples both from lymphedema and lipedema patients. […] The treatment of lipedema is expanding and now there are new medications for weight loss, which will help the overweight lipedema patient and maybe the lymphedema patient as well. […] A good physical exam as well. You can differentiate between lipedema and lymphedema.

• #15 Differential Lipedema Diagnosis // The Lipedema Project

  https://lipedemaproject.org/lipedema-differential-diagnosis/

  Lipedema is just one of several existing fat disorders, and is often misdiagnosed because it is difficult to differentiate from related conditions. While there are similarities between these disorders, conditions such as lipedema, lipolymphedema, primary lymphedema, obesity, and venous insufficiency are all distinct, and their differences must be understood in order to make an accurate diagnosis. […] NOTE: ICD10 codes for lipedema are now included in Germany (as of early January 2017). The codes are listed below and include Stage 1, Stage 2, Stage 3, and Other. Check for ICD10 inclusion for your country (ICD10 codes do not as of yet include lipedema in the USA). […] If lipedema progresses, patients can develop secondary lymphedema, a condition characterized by fluid retention and significant swelling. The two conditions together are known as lipolymphedema. This condition appears as patients progress beyond Stage 3 lipedema into Stage 4 lipolymphededema.

• #16 Patient Guide to Self-Diagnosing Lipedema and Lipo-Lymphedema

  https://torontophysiotherapy.ca/patient-guide-to-self-diagnosing-lipedema-and-lipo-lymphedema/

  Lipedema is a chronic condition that causes an abnormal accumulation of painful adipose tissue (fat) in specific areas of the body (typically the legs). This condition is frequently accompanied by obesity and psychological vulnerability/distress, and less frequently by fluid swelling commonly referred to as “lipo-lymphedema.” Individuals with lipedema are often misdiagnosed as simply being overweight, or their condition is mistaken to be a different swelling condition known as lymphedema. Rather, lipedema is its own distinct condition, and a non-trivial one. Lipedema is a chronic and chronically misunderstood disorder with unique health implications. A “typical” sufferer of lipedema appears to have a disproportionately overweight lower body as compared to their upper body, which is also accompanied by pain. Patients with lipedema are seldom “typical,” and the abnormal accumulation of fat is only the most visually obvious symptom. If aggravating factors such as high body weight/obesity are unmanaged, symptoms will invariably worsen. Management requires ongoing pain control and lifestyle intervention to alleviate the symptoms and avoid the possibility of more advanced dysfunction including ‘lipo-lymphedema’, a combination of lipedema, obesity, and lymphedema.

• #17 Lipoedema

  https://www.nhs.uk/conditions/lipoedema/

  Lipoedema is an abnormal build-up of fat in your legs and sometimes arms. It can be painful and affect daily life, but there are things you can do that may help. […] Lipoedema is more common in women. It usually affects both sides of the body equally. […] Lipoedema can make your bottom, thighs, lower legs and sometimes your arms look out of proportion with the rest of the body. […] You may also have pain, tenderness or heaviness in the affected limbs, and you may bruise easily. […] Lipoedema affects people differently. […] If the GP thinks you have lipoedema they may refer you to a specialist for treatment. […] There’s currently no cure, but there are things that can help and stop it getting worse. […] Compression therapy can sometimes help manage lipoedema. […] The exact cause of lipoedema is not clear. […] It’s not caused by being overweight you can be a healthy weight and still get it.

• #18 Lipedema – Diagnosis and management

  https://heartcare.sydney/lipedema/

  Lipedema is a unique medical condition that predominantly affects women. […] Despite its distinct nature, lipedema remains remarkably underdiagnosed, leading many to suffer from this condition in silence. […] It is crucial to distinguish lipedema from other causes of lower limb edema, such as chronic venous insufficiency, to avoid unnecessary investigations and ineffective treatments. […] Lipedema is often misdiagnosed as general Obesity, leading to misconceptions about the condition. […] The management of lipo-lymphedema requires a combined approach that addresses both the excessive fatty deposits of lipedema and the impaired lymphatic drainage of lymphedema. […] Regular check-ups with a healthcare provider experienced in lipedema can help monitor the condition, evaluate the effectiveness of treatments, and adjust management strategies as necessary. […] It is crucial to raise awareness and improve understanding of Lipedema to prevent misdiagnosis and provide the best possible care for patients.

• #19 Diagnosis and management of lipedema – UpToDate

  https://www.uptodate.com/contents/diagnosis-and-management-of-lipedema/print

  Lipedema is defined by an International Consensus as „a chronic condition characterized by a disproportionate increase in adipose tissue and pain in the lower extremities, and sometimes, the upper extremities of females.” […] Patients with lipedema were historically erroneously diagnosed with lymphedema and referred to lymphedema programs. […] Unlike patients with lymphedema, subjects were always female, both lower extremities were affected, the feet were spared, and the patients did not have infections. […] However, because „edema” was included in the name of the disease, a misconception has existed that swelling is a primary component of the disorder, causing confusion and mislabeling as lymphedema. […] Lipedema is a chronic condition with symmetric deposition of subcutaneous adipose tissue disproportionately in primarily the lower extremities. […] Reported pain may be related to inflammation from increased numbers of macrophages, hypoxia, and fat necrosis. […] Because of the association with pain, International Consensus Guidelines have recommended renaming the disorder „lipalgia syndrome.”

• #20 Lipoedema | Diagnosis & treatment | Royale Distributing Agency Ltd.

  https://mediireland.ie/diagnosis-treatment/lipoedema/

  Lipoedema is not a fat reservoir resulting from obesity. It is the result of an increased number of fat cells with pathological changes. Since lipoedema occurs almost exclusively in women, experts assume hormonal causes. The few men who develop lipoedema often have liver damage. […] One of the signs of lipoedema is to do a Stemmer’s test – if you can pinch a skin fold at the base of the toe or a finger then this is a negative Stemmer’s sign. In lymphoedema, this is not possible (Stemmer’s sign is positive). Other signs of lipoedema are a tendency to develop spider veins, bruises or increased swelling of the calf in the second half of the day. […] In contrast to lymphoedema, lipoedema is always symmetrical. Lipoedema is painful to pressure and touch. In the advanced stages, even wearing tight clothing is painful. In contrast to lymphoedema, Stemmer’s sign is always negative in lipoedema.

• #21 Diagnosis of lipedema – lipœdème france

  https://lipoedeme-france.com/en/diagnosis-of-lipedema/

  A key sign of lipedema is the symmetrical and bilateral damage observed on the patients body. […] After passing stage III, lipedema can evolve into lipo-lymphedema (stage IV): A disorder of lymphatic flow is added to the lipedema, leading to an accumulation of lymph in the tissues. […] During an initial consultation, the plastic surgeon specialising in lipoedema will ask for various examinations to be carried out before a possible operation. […] A study of the deep and superficial venous network, or Doppler ultrasound, will allow the radiological signs of the patient to be established. […] In addition, in advanced cases, often stages 2, 3 and 4 of the medical classification of lipedema, Dr. Nicolas Zwillinger will ask for a lymphoscintigraphy performed in nuclear medicine centres. […] In order to perform a liposuction W.A.L. operation, the plastic surgeon needs a pre-operative blood analysis to prevent possible anaemia or iron deficiency.

• #22 Differential Lipedema Diagnosis // The Lipedema Project

  https://lipedemaproject.org/lipedema-differential-diagnosis/

  Venous insufficiency occurs when the valves in the veins that keep blood flowing in one direction are damaged or weakened, and the veins cannot properly pump blood back to the heart. The condition usually occurs in the legs and is fairly common in lipedema patients. Patients with venous insufficiency may have varicose veins, feel heaviness or pain in their legs, and experience swelling or redness. […] Lipedema fat can be very painful, and the condition can worsen if not kept in check through a healthy lifestyle. If lipedema continues to advance, patients can become progressively less mobile. Pain and immobility may lead to obesity, which exacerbates lipedema and causes increased risk for venous insufficiency and further swelling. […] Fibrosis is a condition that occurs when tissues of the body have been damaged or stressed in some way. In many lipolymphedema patients, swelling in their legs from the lymphedema causes hard connective tissue to form. Fibrosis is painful and inhibits proper circulation of lymph fluid through the extremities.

• #23 Lipedema | Lipedema Diagnosis and Treatment | Seattle, WA | Lipedema Diagnosis Near Me – Boxbar Vascular

  https://boxbarvascular.com/services/lipedema/

  Lipedema is not the same thing as Lymphedema or general obesity. […] Since Lipedema gets worse over time, its very important to get a proper diagnosis and treatment as soon as you can. […] Usually the best way to determine if you have Lipedema or venous insufficiency is to have an ultrasound to check for venous reflux. […] There is no specific test for Lipedema. However, there are several diagnostic tests that we perform at BoxBar Vascular. The results of those tests, combined with a physical exam, help us to make a diagnosis. […] An ultrasound can detect venous insufficiency. An ultrasound is a painless, non-invasive, and inexpensive test that gives us a lot of useful information about your venous circulation. The ultrasound not only helps us find underlying venous problems, but it also gives us critical information for managing Lipedema. If venous insufficiency is present, it is important that you begin treatment, since increased venous pressures can greatly aggravate Lipedema.

• #24 Stages | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/blood-heart-circulation/lipedema/stages.html

  Lipedema is a rare, chronic condition that involves an abnormal buildup of fatty tissue, usually in the lower body but sometimes in the arms. […] Stanford is one of the few hospitals in the country and the only one in the Bay Area that has a center dedicated to accurately diagnosing lipedema, understanding it, and successfully treating this debilitating disease. […] Precise, accurate diagnosis of lipedema to rule out other conditions such as obesity or lymphedema, so you can begin the right treatment promptly. […] Surgical treatment (tumescent liposuction and reductive surgery) is the most effective treatment to remove the fatty tissue. […] Tumescent liposuction is the most effective treatment for Lipedema, and it can prevent recurrence for an average of five years. […] Reductive surgery and nonsurgical therapies are helpful for people who have lipo-lymphedema, an advanced stage of lipedema in which lymphatic fluid builds up in addition to excess fatty tissue.

• #25 How do I recognise lipedema? | LIPOCURA®

  https://www.lipocura.com/lipodemia/how-do-i-recognise-lipoedema/

  The legs look like columns due to the uniform accumulation of fat from top to bottom, hence the term columnar leg. […] Axial misalignment of the knee joints, also known as knock-knees or genoa valga, is a common consequence of lipoedema with a pronounced increase in volume in the thigh. […] As lipoedema progresses, the swollen fatty tissue stretches the skin and connective tissue considerably. […] Lipoedema patients tend to bruise quickly, even with light touches or bumps. […] In the advanced stages of lipoedema, the fatty tissue can harden. […] Mental strain such as stress or depression can exacerbate lipoedema symptoms. […] Some areas of the body, particularly the arms and legs, often feel colder than other areas. […] Even without external influence or movement, many sufferers experience pain that can be felt during periods of rest.

• #26 Stages | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/blood-heart-circulation/lipedema/stages.html

  There is only one type of lipedema, but it has four distinct phases as the condition progresses. […] In this early stage, it may be difficult to distinguish lipedema from excess fat on the lower body. […] Without treatment, lipedema will progress to the next stage. […] This advanced stage is also known as lipo-lymphedema. […] At this point, you may experience swelling over the entire lower body, including previously unaffected areas such as the ankles and feet.

• #27 Lipedema stage 1: causes, symptoms, treatment

  https://www.lipocura.com/lipedema-stage-1/

  Stage 1 lipedema is the first stage of the chronic fat distribution disorder that occurs mainly in women. It is characterised by disproportionate fat deposits on the legs, buttocks and sometimes the arms. In stage 1, the symptoms are often more subtle and can be easily overlooked. Those affected therefore often do not receive any support from their environment, as the findings are often only noticed by themselves. […] Diagnosis of stage 1 lipedema usually requires a careful examination with an eye trained in the condition and a detailed history. General practitioners family doctors are usually the first to be consulted for a diagnosis. This is where lipedema can be diagnosed (or ruled out). However, since lipedema has only become a medical focus in recent years, not every doctor is familiar enough with it, which makes it difficult to diagnose. It is therefore always advisable to consult a doctor who specialises in lipedema.

• #28 Differential diagnoses and treatment of lipedema

  https://www.oaepublish.com/articles/2347-9264.2019.51

  Lipedema is a frequently unrecognized and misdiagnosed disorder of the fatty tissue of extremities and hips, which affects almost purely women. […] Accurate diagnosis and treatment are essential. […] The diagnosis of lipedema is usually based on medical history and clinical features. One criterion is the onset of the disease in parallel with hormonal changes and occurrence mainly in women. […] Lipedema typically presents with a disproportionate enlargement of the limbs in relation to the upper part of the body. […] Other clinical criteria of lipedema comprise spontaneous or minimal trauma induced bruising, pain, and worsening during the day. […] The severity of lipedema can be classified into four clinical stages according to skin conditions and the sizes of the palpable and visible fat nodules.

• #29 Finding a Lipedema Specialist — Lipedema Foundation

  https://www.lipedema.org/findspecialists

  Finding a Lipedema specialist near you is not always easy. […] Lipedema patients often seek surgery in order to alleviate pain, increase mobility, decrease joint stress, and improve their quality of life. The most common procedure to remove Lipedema tissue is liposuction. […] It is also important to note that pre- and post-operative liposuction protocols vary widely amongst surgeons treating Lipedema. […] Individual results may vary, and patients and referring clinicians should always do careful research when considering surgical procedures as an intervention. […] On average, it can take 10 years to receive a Lipedema diagnosis after seeking medical attention. Many patients report being dismissed by medical professionals, who claim that their pain is imagined or exaggerated, or that they need to diet and exercise more rigorously to lose Lipedema-related fat.

• #30 Diagnosis – Lipoedema UK

  https://lipoedema.co.uk/about-lipoedema/diagnosis/

  Obtaining a Lipoedema diagnosis can be a daunting experience. […] Research studies suggest that Lipoedema is poorly recognised and often misdiagnosed as a weight issue or lymphoedema. However, an early diagnosis is crucial for effective symptom management and it can empower individuals to introduce lifestyle changes that make a positive impact to overall health and wellbeing. […] It is important to obtain an early diagnosis of Lipoedema. This will start the process of finding the most effective way to manage symptoms. […] A survey by Lipoedema UK (2021) highlighted that 57% of respondents experienced symptoms around puberty but only 2% received a diagnosis. […] An early diagnosis of Lipoedema can help the person and their family, friends and colleagues understand the condition and why the changes in their body are happening, plus what can be done to help manage symptoms.

• #31 What Is Lipoedema? Diagnosis And Treatment | Prof. Dr. Saliha Eroğlu Demir

  https://drsalihaerogludemir.com/en/uncategorized/what-is-lipoedema-diagnosis-and-treatment/

  Lipedema is a frequently underdiagnosed or misdiagnosed condition. […] Lipedema is usually diagnosed clinically. The characteristics of lipedema are symmetrical disproportionate fat tissue accumulation in both extremities, unaffected hands and feet, sometimes involvement of the arms, negative Stemmer sign, feeling of heaviness and tension in the affected extremities, pain caused by touching and pressure, a clear tendency to the formation of hematomas, no change in the circumference of the extremities even if calories are restricted and weight is lost, worsening of complaints as the day progresses, low skin temperature, telangiectasias around fat accumulations, and visible vascular markings. […] There is no specific diagnostic method for lipedema. However, ultrasound, computed tomography, or magnetic resonance imaging can be used to evaluate the skin and subcutaneous fat tissue. […] Lymphoscintigraphic examinations can be performed to evaluate the structural or functional status of the lymphatic system. However, these examinations do not provide a specific or diagnostic finding for the diagnosis of lipedema.

• #32 Finding a Lipedema Specialist — Lipedema Foundation

  https://www.lipedema.org/findspecialists

  The path to Lipedema diagnosis and treatment can be long. Since there is no easy laboratory or imaging test for Lipedema, there is also no single profession that administers the diagnosis. […] The best data for this comes from the Lipedema Foundation Registry. Data analyzed from nearly a thousand women collected between 2019 and 2021 reveal that about 21% of Lipedema diagnosis is performed by surgeons. 22% are first identified by a therapist as having Lipedema, the official diagnosis being performed later by a physician. But aside from these, most diagnoses come from physicians with a non-surgical background (43%). Nurse Practitioners/Physicians Assistants and other types of healthcare providers account for the remaining diagnoses, along with a small number who received their diagnosis by participating in research.

• #33 Diagnosis – Lipoedema UK

  https://lipoedema.co.uk/about-lipoedema/diagnosis/

  Receiving a diagnosis can empower individuals to make changes to their lifestyle, health and wellbeing, which in turn can help manage symptoms and concerns. […] There are currently no diagnostic tools or tests for Lipoedema, so identifying the condition can be challenging and relies on clinical assessment, including history taking, examination and ruling out other conditions. […] It is important to obtain an early diagnosis in order to be able to discuss treatment options that can help you to better manage symptoms and conditions. […] Individuals with Lipoedema may be referred by their GP to a local Lymphoedema Clinic as there are no specialist Lipoedema clinics in the NHS. […] Your GP can also refer you to other services if appropriate, such as weight management or psychological services.

• #34 Diagnosing Lipedema — Lipedema Foundation

  https://www.lipedema.org/diagnosing-lipedema

  The Lipedema Foundation is actively funding research to develop tools to aid diagnosis. These technologies range from imaging and clinical laboratory tests that might one day be used to directly diagnose a patient, to genetic approaches that might help understand a person’s risk for developing Lipedema.

• #35 Lipedema—Pathogenesis, Diagnosis, and Treatment Options

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7465366/

  The diagnosis should be confirmed by an experienced lymphologist in doubtful cases. […] The basic diagnostic evaluation consists of history-taking, inspection, and palpation, with particular attention to the manifestations listed in the Box. […] The onset of lipedema is typically triggered by hormonal changes (puberty, pregnancy, menopause); this helps in the differentiation of lipedema from simple obesity. […] The diagnosis is only rarely made on the patients first contact with a physician, and there is often a delay of several years before specific treatment is initiated. […] Current research focuses on the pathophysiology of lipedema and on the development of tools to facilitate its correct diagnosis and the exclusion of competing diagnoses. […] The diagnosis should be confirmed by an experienced lymphologist in doubtful cases.

• #36 New discoveries make steps toward lipoedema diagnosis and treatment – Biotech

  https://biotechdispatch.com.au/news/new-discoveries-make-steps-toward-lipoedema-diagnosis-and-treatm

  New research from St Vincents Institute of Medical Research (SVI) on lipoedema could support the development of new treatments and the development of a diagnostic screening test. […] The new study has identified a stem cell in lipoedema and a gene that drives excess fat growth elements key to diagnosing and treating the condition. […] Our findings confirm, consistent with the lived experience of families, that lipoedema is a legitimate medical condition, and that it is not the same as obesity, said Dr Karnezis. […] We investigated tissue from people with and without lipoedema and identified stem cells that are only found in lipoedema patients. […] The team identified a gene involved in cellular growth within the abnormal lipoedema stem cells that can drive more stem cells to form more fat cells. […] Dr Karnezis said the next step is to confirm the laboratory findings and test potential drug therapies in animal models.

• #37 Patient Guide to Self-Diagnosing Lipedema and Lipo-Lymphedema

  https://torontophysiotherapy.ca/patient-guide-to-self-diagnosing-lipedema-and-lipo-lymphedema/

  Lipedema, obesity, and ‘lipo-lymphedema’ (lipedema with simultaneous lymphedema) are most effectively diagnosed by physical examination with palpation combined with an examination of patient clinical history and family history, rather than through diagnostic tests. Family history can be helpful because lipedema does have a hereditary component; it is estimated that 15% of people with lipedema have a family member with it. […] If you suspect you do have this condition, use the strategy I outline below to attempt to self-diagnose it. Many family doctors have limited knowledge of lipedema and so your self-investigations could give you a big leg up on getting a formal diagnosis. A self-diagnosis obviously can’t replace a formal diagnosis by a knowledgeable health professional, but if you can speak effectively about your symptoms you may be able to better direct your care and get the diagnosis you’re seeking.

• #38 Patient Guide to Self-Diagnosing Lipedema and Lipo-Lymphedema

  https://torontophysiotherapy.ca/patient-guide-to-self-diagnosing-lipedema-and-lipo-lymphedema/

  Here’s how you can self-diagnose lipedema and ‘lipo-lymphedema’, as well as effectively seek out a formal diagnosis: Find out if you have a family history of the condition. Familiarize yourself with the ‘stages’ of lipedema and the related conditions of obesity and lymphedema described above, and the associated symptoms. Investigate your symptoms and write them down. Which symptoms above are you currently experiencing? This includes feeling for textural differences between the fat in your affected area, and fat in other areas of your body. Do they feel different? Do your symptoms fit with one of the stages of lipedema above? Keep in mind that it can be hard to do a good objective assessment of one’s own body (even for health professionals), and especially without experience. Are you having pain in the fatty tissue? […] If you think you may have lipedema you can learn how to best manage it and prevent further progression of your symptoms.

• #39 Who to see for a Lipoedema diagnosis? | Lisa Higgins

  https://www.lisahiggins.com.au/2021/08/lipoedema-diagnosis/

  Who to see to get a Lipoedema diagnosis? […] Most likely youve come across that old chestnut you need to lose some weight and your legs will return to normal. […] Youll need a Category 1 practitioner for diagnosis a physio, OT, nurse or other APHRA-registered professional. […] Lipoedema Australia has a list of practitioners on their FB page who can either diagnose or treat. […] There are specialist surgeons who diagnose and operate on Lipoedema. […] The vascular and lymphatic systems work very closely together so they are aware of some lymphatic conditions and may recognise Lipoedema. […] Believe it or not, there are some GPs who diagnose. […] When you go to see a new practitioner Id suggest you go armed with some information about Lipoedema. […] And if some obnoxious GP tells you youve made up Lipoedema you can suggest they go onto PraxHub and do the module on Lipoedema delivered by Ramin Shayan. […] Diagnosis and surgeons are discussed in my Living Well With Lipoedema Medical Intuition package for more details click here.

• #40 Treatment — Lipoedema Australia

  https://www.lipoedema.org.au/treatment

  If your doctor is unable to diagnose lipoedema, we suggest that you ask for a referral to a vascular or lymphoedema specialist at a lymphoedema clinic. […] A diagnosis of lipoedema is made on clinical grounds that are based on the history and examination of the patient. When the fat is touched, it will feel like round peas in a plastic bag. Larger nodules can also be felt. Currently, there are no known blood or urine biomarkers, nor are there any specific diagnostic tests for lipoedema. […] When visiting your health professional, feel free to print out the Lipoedema Australia resources to take with you. The Notes for Your GP Consult is a checklist of common symptoms for you to tick so that you have all of your symptoms noted in one place. The Information for Health Professionals brochure is a reference guide for your health professional, explaining the signs and symptoms of lipoedema.

• #41 Diagnosis of lipedema – lipœdème france

  https://lipoedeme-france.com/en/diagnosis-of-lipedema/

  It is important to diagnose yourself early. This disease affects people regardless of their BMI (Body Mass Index). It is therefore difficult, in the case of obesity, to diagnose lipedema just by the appearance of the lower and/or upper limbs alone. […] The diagnosis of lipedema can be made by different health professionals (angiologists, general practitioners, plastic surgeons, etc.). This professional will rely on a set of clinical signs specific to lipedema, by questioning and physical examination. […] During the physical examination, the first thing that will be looked at is the visual appearance of your body. In people with lipedema, there is a disproportionality between the upper and lower limbs and the rest of the body: in particular, the waist will remain thin compared to the limbs.

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