Lipedema is a chronic and progressive condition. Getting the correct diagnosis can sometimes take time, but early detection is crucial to slow down its progression and manage symptoms effectively. The diagnostic process usually begins with a detailed evaluation of the patient’s medical history. At this stage, a vascular surgeon or another relevant specialist reviews the patient’s medical background, family history, and current complaints.
Family History and Symptom Evaluation
Since lipedema can have a genetic component, doctors often ask whether similar conditions exist in the family. The most common signs of lipedema include:
Symmetrical fat accumulation,
Tenderness to touch,
Easy bruising,
Persistent pain and swelling.
The duration of these symptoms and their impact on the patient’s daily life are also considered when diagnosing lipedema.
Physical Examination
A physical exam is one of the most important steps in diagnosing lipedema. The physician examines the affected areas in detail:
Symmetrical fat deposits: Lipedema usually affects both legs, hips, or arms symmetrically and often stops at the ankles or wrists.
Pain and tenderness: Affected areas are typically sensitive to touch.
Subcutaneous nodules: Uneven, nodular fat tissue can often be felt under the skin, which is a hallmark of lipedema.
Easy bruising: Even minor trauma may result in visible bruising.
Imaging Techniques
Several imaging methods can be used to support the diagnosis:
Ultrasound: Helps evaluate soft tissue and fat layers beneath the skin.
MRI (Magnetic Resonance Imaging): Provides detailed images of fat distribution and the severity of lipedema.
Lymphoscintigraphy: Useful when distinguishing lipedema from lymphedema by assessing lymphatic flow.
Laboratory and Genetic Tests
There is no specific blood test for lipedema. However, certain tests may be conducted to rule out similar conditions:
Blood tests: Used to exclude infections, inflammation, or metabolic disorders.
Genetic testing: May be considered if there is a family history of lipedema.
Differential Diagnosis
Lipedema is often mistaken for other conditions, so differential diagnosis is essential:
Lymphedema: Unlike lipedema, lymphedema typically affects the ankles and feet.
Obesity: Characterized by overall fat accumulation, whereas lipedema affects specific body areas symmetrically.
Chronic venous insufficiency: Causes swelling and pain due to vein problems, but lipedema is marked by nodular subcutaneous fat.
Which Specialist Diagnoses Lipedema?
Lipedema requires a multidisciplinary approach. Depending on the case, several specialists may be involved in the diagnostic process, including:
Vascular surgeons,
Internal medicine specialists,
Endocrinologists,
Plastic and reconstructive surgeons,
Lymphedema therapists.
Once the correct diagnosis is made, a personalized treatment plan is created, and the patient’s condition is closely monitored.
