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Lymphedema
 
Basic Facts
Lymphedema occurs when lymphatic fluid accumulates in the soft tissue in certain parts of the body, usually in one or more of the arms or legs.
The condition can be inherited or caused by an injury to the lymphatic system. In developed countries, lymphedema is most commonly caused by cancer treatments that involve the lymph nodes or by surgical procedures that interrupt normal lymph drainage.
Management of lymphedema centers around relief of swelling and meticulous skin care.
Lymphedema is a disorder that occurs when lymphatic fluid accumulates in the soft tissues of a part of the body, usually in an arm or leg. Lymphedema is either inherited or acquired. The inherited condition is called primary lymphedema. It usually appears during adolescence and causes swelling in the foot or calf. Acquired lymphedema is known as secondary lymphedema. This condition is caused by injury to the lymphatic system and is far more common than primary lymphedema.

WHAT ARE THE SYMPTOMS?

The symptoms of lymphedema should be reported to the physician immediately and include:
  • Aching, weakness, redness, or a feeling of heaviness or tightness in a limb;
  • Decreased flexibility in the wrist or ankle; and
  • Tight-fitting rings or shoes.
CAUSES AND RISK FACTORS

The most common causes of secondary lymphedema are surgery or radiation treatment for certain types of cancer. Other causes of lymphedema include:
  • Vein stripping;
  • Surgery on the blood vessels in the limbs;
  • Lipectomy; and
  • Burns.
DIAGNOSIS

To diagnose lymphedema, physicians perform a complete history and physical exam and ask the patient to describe symptoms. To distinguish lymphedema from similar conditions, physicians may use the following imaging techniques:
  • Lymphoscintigraphy;
  • Magnetic resonance imaging (MRI);
  • Computed tomography (CT) scanning; and
  • Duplex ultrasound.
TREATMENT APPROACH

People who know they are at risk for developing lymphedema can take measures to prevent onset, and those with a mild case can act to keep the condition from worsening. These measures include:
  • Cleaning the affected limb regularly, carefully drying it off, and applying lotion;
  • Wearing gloves while gardening and cooking;
  • Shaving with electric razors;
  • Not going barefoot;
  • Not crossing legs while sitting; and
  • Not carrying a handbag with an affected arm.
No standards exist for successful treatment, and much research on the subject remains to be conducted. A systematic effort that combines treatments with a maintenance program is called complex decongestive therapy. These treatments, used as part of complex decongestive therapy or singularly, include:
  • Manual lymphatic drainage;
  • Specialized exercises while wearing compression stockings or bandages;
  • External pumps to aid movement of fluid through the body.
Lymphedema is currently not treatable with medication.

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