How Is Lymphedema Diagnosed Explained By Breast & Lymphedema Therapist

Uploaded by Lymphconnect on 30.05.2012

>>> Joan Shulmistras: Lymphedema is diagnosed in the clinic on a clinic-level in several
ways. First most obviously is physical examination and taking the patient history.
We also visually look at the limb. We palpate or we touch the limb. We want to get a feel
for what the skin feels like. Does it feel like down the normal side or is it feeling
a little ‘boggy’ – I love that term, that’s a strong medical term? Does it feel
hard? Are there skin changes?
And then also two, we take measurements. We take circumferential measurements, so we will
start down at the hand, work away up to the wrist. Though in our clinic we go every 10
cm to take a measurement. We can plug that in and get a volumetric measurement, get a
circumferential measurement, compare it to the uninvolved arm and we can get a feel for
just how much swelling there is.
That’s on a clinical basis when you can’t see some evidence of swelling. On a subclinical
level, it is not used as a form of diagnosis for lymphedema but it does give us kind of
a heads-up that there might be something going on. It’s what bioimpedance, which is an
L-Dex measurement. What they use is a very, very low electric charge that goes through
and they measure one arm to the other arm. It’s done on a unilateral basis – one
arm involvement.
So we can kind of get an idea of what is the relative amount of fluid, and the way they
do that is that electrical charge travels through the fluid that’s in the arm. The
more fluid, the faster it travels. So obviously that gives us an idea and then there’s a
range of what’s normal and what is abnormal. And then if it’s abnormal then we can proceed
with other course of action.
But as far as really doing a diagnosis, it would be done as I said. History/physical,
look at the tissues, feel the tissues, take measurements of the tissues, and go from there.