Lymphoedema 2: classification, signs, symptoms and diagnosis

Abstract

The second article in this series describes the different types of lymphoedema and the signs and symptoms associated with the condition. In the preceding article (Vol 11(5): 304-9) we examined the anatomy, physiology and functions of the lympathic system in relation to the condition of lymphoedema, and demonstrated how, by acting as a one-way drainage system, the lympathics maintain tissue homeostasis through the removal of excess fluid from the interstitial spaces. Failure or dysfunction of the system can result in lymphoedema, a condition characterized by the accumulation of fluid in the soft tissues. Lymphoedema is classified into two main groups - primary and secondary. Defining the causative factors and pathogenesis of both conditions and other forms of chronic oedema will assist the reader in the clarification of the condition. The article concludes with an overview of assessment criteria for diagnosis, which should assist all healthcare professionals in appropriate referral. The third article in this series will look at the treatment of lymphoedema.

The New Era of the Lymphatic System: No Longer Secondary to the Blood Vascular System

“…Luckily, several attempts have been made to establish new classifications and categorizations of primary lymphedema based on clinical phenotypes, familiar history, onset age, associated abnormalities, local and systemic involvement, and underlying genetics (Szuba and Rockson 1998;Miller et al 1999;Board and Harlow 2002;Northup et al 2003;Honnor 2008;Connell et al 2010). …”

A needs assessment of lymphoedema services in Fife and resulting recommendations

“…As oedema accumulates, tissue changes result in the development of fibrotic, thickened skin. This can lead to considerable discomfort, and in some cases, severe pain (Pain and Purushotham, 2000;BLS, 2001;Board and Harlow, 2002). Individuals with lymphoedema usually experience reduced quality of life as a result of impaired function, altered body image, and impacts on social and sexual confidence (Tobin et al, 1993;Woods, 1993;Hare, 2000;Pain and Purushotham, 2000).…”

Compression bandaging in patients with venous insufficiency

“…the capacity in the vein, therefore reducing the leakage of fluid and red blood cells into the tissue. The compression will also push fluid in the tissues back into the venous system and the oedema will reduce (Board and Harlow 2002). As the flow is now much more efficient there will be an improvement in the supply of nutrients to the skin and a subsequent reduction in dryness and sensitivity.…”