Lipoedema is a disproportionate, symmetrical fatty swelling on the legs of unknown etiology with pain, orthostatic oedema, frequent haematomas associated, and sometimes involving arms. It affects women above all and brings a reduction in quality of life as well as psychological problems. The diagnosis is clinical, but in this study the author decided to request lymphoscintigraphy to analyze the morphological-functional features of the lymphatic system.

59 patients affected by lipoedema of the lower limbs were evaluated through a clinical examination which led to differential diagnosis versus obesity and lymphedema, as well as to 3 clinical stages. Lymphoscintigraphy was required in all patients.

The results of lymphoscintigraphy were analyzed within each clinical stage:
-28 stage I: a normal radiotracer flow was noted in 32% of the cases and a morphological-functional abnormality in 68%of the cases,
-23 stage II: a normal radiotracer flow was noted in 14% of the cases and a morphological-functional abnormality in 86% of the cases,
-8 stage III:  the morphological-functional abnormality was highlighted in all cases.
No lymph-nodal alteration was noted in every clinical stage.

In this study in progress, lymphoscintigraphy has highlighted how significant the presence of lymph flow impairment is in each clinical stage. The use of lymphoscintigraphy is important for the detection of alterations of the lymphatic system, with no apparent clinical evidence, in order to decide adequate conservative care to prevent evolution.

M.Cestari, ESL 2014
I.Forner-Cordero,Clinical Obesity 2012