Ultrasound criteria for lipedema diagnosis

Abstract

Background Lipedema is characterized by the deposition of abnormal fat in the lower and upper limbs bilaterally. It is a disease with high prevalence and genetic characteristics. Non-specific and non-quantified increases in the thickness of the subcutaneous tissue have previously been demonstrated using magnetic resonance imaging and computed tomography. Objectives To evaluate the thickness of the dermis and subcutaneous tissue in predetermined areas as a distinguishing feature between individuals with and without lipedema using ultrasound. Methods Ultrasound images of 89 female patients were analyzed, including patients undergoing clinical investigation for venous insufficiency or lipedema who underwent ultrasound evaluations at our institution. Patients were divided in two groups: with lipedema clinically diagnosed and those without lipedema. They underwent a common Doppler protocol for venous mapping to assess venous insufficiency associated with the evaluation of dermis and subcutaneous thickness at pre-defined points of the lower limbs. Results There were 63 patients with lipedema. Anterior thigh, pre-tibial and lateral aspect of the leg and supra-just medial malleolar region were significantly different. Supra-just medial malleolar region was significantly different with BMI above 25. An optimal cutoff value was calculated for the ultrasound diagnosis of lipedema using thickness of the dermis and subcutaneous tissues. Conclusions Studied criteria allow use of simple and reproducible ultrasound cutoff values to diagnose lipedema in the lower limbs. Pre-tibial region thickness measurement, followed by thigh and lateral leg thickness are recommended for the ultrasound diagnosis of lipedema.

Lipedema Can Be Treated Non-Surgically: A Report of 5 Cases

“…Pitting edema over her feet suggested associated lymphedema, and the bilateral edema also suggested that the right lymphangitis was not the only cause of lymph-edema ( Figure 7 ). EDCV-MMII revealed only small superficial varicosities, while pre-tibial skin and subcutaneous thickness of 57.27 mm left and 55.9 mm right confirmed lipedema [ 23 ]. Lymphoscintigraphy was not requested because of infection.…”

Prevalência e fatores de risco para lipedema no Brasil

“…It predominantly occurs in women. 5 Imaging exams such as ultrasound, 10 magnetic resonance, 11 and computed tomography 12 can confirm the diagnosis. Recently, Amato et al 13 published methodology for individual screening for lipedema using a self-administered questionnaire that showed excellent diagnostic accuracy, 14 making it possible to estimate the prevalence of lipedema using Brazilian census data.…”

Ultrasound examination for en-suite measurements in lipedema

“…To the Editor, We read with great interest the article by Amato et al 1 which was recently published in your journal. We agree with the authors that it is important to determine the cut-off values using a simple and reproducible method for the diagnosis of lower extremity lipedema.…”

“…3 Second, the authors defined the measured thickness for lipedema from dermis to the point where the subcutaneous tissue transforms into the fascia. 1 Herein, it is noteworthy that the etiopathogenesis of lipedema is still unclear and there are various hypotheses on the issue. 4 Because dermo-epidermal complex changes in lipedema (e.g.…”