Lymphedema Assessment & Limb Volume Measurement Flashcards

A patient presents with bilateral symmetric swelling of the legs that spares the feet, with tenderness and easy bruising. The most likely diagnosis is:

Answer: Lipedema

Lipedema causes symmetric painful fat deposition with a 'cuff' at the ankles and typically spares the feet.

A patient with stable arm lymphedema develops sudden calf swelling with warmth and tenderness. What should the therapist do?

Answer: Hold treatment and refer immediately for DVT evaluation

Acute unilateral painful, warm swelling suggests DVT, which requires urgent medical evaluation before lymphatic treatment.

When a patient has bilateral lymphedema, what is the best method for tracking change?

Answer: Compare each limb to its own baseline measurements over time

With both limbs affected, the contralateral limb is not a valid control, so serial comparison to baseline is needed.

On a 0–4+ pitting edema scale, a pit about 6 mm deep that rebounds in 10–15 seconds is graded as:

Answer: 3+

Typical scales assign roughly 2 mm to 1+, 4 mm to 2+, 6 mm to 3+ and 8 mm to 4+.

Why might a small inter-limb difference be normal in a patient's arms before any surgery?

Answer: The dominant arm is often slightly larger

The dominant arm can normally be a few percent larger, which is why pre-op baseline measurements are valuable.

Which skin finding during lymphedema assessment indicates leakage of lymph through the skin?

Answer: Lymphorrhea

Lymphorrhea is the seepage of clear lymph fluid through the skin, increasing infection risk.

Congenital primary lymphedema present at birth, often linked to FLT4 (VEGFR-3) mutations, is called:

Answer: Milroy disease

Milroy disease is hereditary congenital lymphedema typically associated with VEGFR-3 mutations.