NON-INVASIVE ASSESSMENT OF THE LYMPHEDEMATOUS LIMB

Abstract

Accurate assessment of the swollen limb is crucial to effective management, and usuallyconsists of measurement of volume and assessment of skin condition. Here, we review thedifferent methods available to measure volume, and their accuracy, together with other noninvasive methods available to assess the characteristics of the swelling. These include themeasurement of fluid mobility by recording deformation of tissue by a mass (tonometry) and thestep compression method; the measurement of truncal swelling by skinfold calipers; imagingtechniques (magnetic resonance imaging, computed tomography, ultrasound) which provideinformation on size and other characteristics of the different tissue compartments; andmeasurement of impedance (amount of extracellular water and total water content). The varyingquality of swelling, as well as its extent and distribution, indicates the need for objective methodsof assessment other than simple limb volume measurement. Such detailed information shouldimprove the understanding of peripheral lymphedema.