What Is Lipoedema? Diagnosis And Treatment

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What Is Lipoedema?

Lipedema is a chronic metabolic disease of the adipose tissue, characterized by symmetrical swellings caused by the accumulation of subcutaneous adipose tissue in the lower extremities. It is thought to be a progressive condition. It most commonly affects women, but a few male cases have been reported.

Lipedema is a frequently underdiagnosed or misdiagnosed condition. Its prevalence is estimated to be 10% in women. The cause is still unknown. Awareness of this condition is increasing.

Why Does Lipoedema Occur And Which Areas Are Most Affected?

Initially, it usually occurs with hormonal changes. Hormonal changes during puberty, pregnancy and menopause are the periods when lipoedema becomes prominent. In lipoedema, disproportionate distribution of body fat in the extremities is the defining feature, the trunk remains thin.

Fat tissue is usually located in the legs. Sometimes the arms are affected. Hands and feet are not involved. In many cases, adipose tissue hangs over the ankles.

The cause of lipoedema is not known exactly. Up to 60% of patients have a history of lipoedema in first-degree relatives. Autozonal dominant inheritance is suggested.


Since it usually occurs during periods of hormonal changes, it is thought to be mediated by estrogen. It is not fully understood whether there is an increase in the number or size of subcutaneous fat cells in lip oedema.

Oedema occurs in the tissue with an increase in capillary permeability. This is initially compensated by increased lymph drainage, but as the disease progresses, the drainage capacity of the lymphatic vessels is exceeded.

Does Lipoedema Patients Have Pain?

In lipoedema, pain perception is impaired and hypersensitivity occurs. Simple stimuli that are not expected to cause pain may be perceived painful, and painful stimuli may be felt extremely painful.

Does Secondary Lymphedema Develop In Lipoedema?

In the later stages of lipedema, secondary lymphedema may develop when the lymphatic system capacity is exceeded. Skin damage may occur due to mechanical irritation of large fatty deposits around the joints. These types of accumulations around the thigh and knee joint can affect normal gait and lead to secondary arthritis.

How Is Lipoedema Diagnosed?

Lipedema is usually diagnosed clinically. The characteristics of lipedema are symmetrical disproportionate fat tissue accumulation in both extremities, unaffected hands and feet, sometimes involvement of the arms, negative Stemmer sign, feeling of heaviness and tension in the affected extremities, pain caused by touching and pressure, a clear tendency to the formation of hematomas, no change in the circumference of the extremities even if calories are restricted and weight is lost, worsening of complaints as the day progresses, low skin temperature, telangiectasias around fat accumulations, and visible vascular markings.

In lipedema, calories can usually be lost from the upper body, face, and neck region by dieting and exercise, but the characteristic thickened subcutaneous fatty tissue in the hips and legs, where there is the most fat tissue, softens.

Lipedematous tissues are painful when examined by hand, have a rubbery feel. With time, hardening occurs and hard nodules are found in the tissues that can be palpated by hand.

People affected by this condition often have family members who suffer from a similar condition.

Is It Necessary To Perform Laboratory Tests In Lipoedema?

Kidney and liver dysfunction, hypothyroidism, lipid profile, and human restanser should be investigated. Any disorder that can cause hormonal or edema should be treated. However, there is no evidence that this treatment affects the severity or course of the earthquake.

There is no specific diagnostic method for lipedema. However, ultrasound, computed tomography, or magnetic resonance imaging can be used to evaluate the skin and subcutaneous fat tissue.

Lymphoscintigraphic examinations can be performed to evaluate the structural or functional status of the lymphatic system. However, these examinations do not provide a specific or diagnostic finding for the diagnosis of lipedema.

What Is Done In Lipoedema Treatment?

In conservative treatment, the patient is advised to explain his/her condition and to develop a lifestyle appropriate to this condition. The aim of treatment is to relieve the symptoms. Improving the appearance of the extremities is not the main goal.

  • Manual lymph drainage
  • Compression therapy
  • Physiotherapy and exercise therapy
  • Diet regulation and weight control
  • Patient education
  • Surgery

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