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What causes lymphoedema, and what tests should be performed?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hi doctor,

I have consulted a vascular radiologist for calf edema. There was no discomfort or redness. I am in my perimenopausal period.

These were the findings.

Technique: Duplex ultrasound of the left lower extremity venous system was performed with the patient in a standing position, and manual compression for flow augmentation was used to assess for superficial and deep venous insufficiency.

Images were obtained using 2D grayscale (B-mode) imaging, Doppler spectral analysis, and color flow Doppler.

Findings:

Left lower extremity deep system:

  1. Common femoral vein: Patent and compressible; Antegrade flow; Reflux duration: 0 seconds.
  2. Saphenofemoral junction: Patent and compressible; Antegrade flow.
  3. Profunda femoral vein: Patent and compressible; Antegrade flow.

Femoral Vein

  1. Upper: Patent and compressible; Antegrade flow.
  2. Mid: Patent and compressible; Antegrade flow; Reflux duration: 0 seconds.
  3. Lower: Patent and compressible; Antegrade flow.
  4. Popliteal Vein: Patent and compressible; Antegrade flow; Reflux duration: 0 seconds.

Superficial System:

Great saphenous vein

  1. Saphenofemoral junction: Diameter: 6.8 mm; Reflux duration: 0 seconds.
  2. Upper thigh: Diameter: 5.4 mm; Reflux duration: 0 seconds.
  3. Mid-thigh: Diameter: 4.0 mm; Reflux duration: 0 seconds.
  4. Lower thigh: Diameter: 4.0 mm; Reflux duration: 0 seconds.
  5. Upper calf: Diameter: 4.1 mm; Reflux duration: 4 seconds.
  6. Lower calf: Diameter: 2.5 mm; Reflux duration: 0 seconds.

Small saphenous vein

  1. Saphenopopliteal junction: Does not join the popliteal vein.
  2. Upper calf: Diameter: 2.0 mm; Reflux duration: 0 seconds.
  3. Lower calf: Diameter: 2.7 mm; Reflux duration: 0 seconds.

The doctor feels the targeted swelling is caused by a vein, though this is not common. However, he said the vein might still be the cause.

Since I suffer from medical anxiety, I would like to know if this Doppler ultrasound shows lipoedema. I am confident he overlooked the lipoedema. Please help.

Thank you.

Hello,

Welcome to icliniq.com.

I understand your concern.

Based on your statement, I understand that you have been experiencing leg swelling beneath the knee.

A venous Doppler ultrasonography is required to diagnose lipoedema. Lipoedema has many characteristics of venous insufficiency, which may be validated with venous Doppler ultrasonography.

On the other hand, lymphedema may be detected with Doppler ultrasonography and lymphoscintigraphy.

Lipoedema is often symmetrical, affecting both sides of the body due to fat distribution.

Other medical diseases that might induce comparable clinical symptoms include primary valve deficit, protein C and S deficiency, popliteal cyst, deep vein thrombosis, post-surgical infection, leg ulcer or ischemia, and so on.

There is no need to be concerned because nothing further is revealed in the findings. Lipoedema is a benign illness with a good prognosis. However, it may be something else because venous Doppler ultrasound does not prove it.

Again, FNAC (fine needle aspiration cytology) or biopsy can be used to determine the underlying pathology of the swelling in the leg under the knee, after which you can begin therapy.

I hope this helps.

Please revert so I can assist you further.

Thank you.

Patient's Query

Hi doctor,

Thank you for your reply.

I had taken another ultrasound the day before, and the results revealed that there were no lumps or fluid, and the soft tissue was normal, but there was adipose tissue buildup surrounding that spot.

Thank you.

Hello,

Welcome back to icliniq.com.

I read your query and can understand your concern.

According to the ultrasound findings, there is adipose tissue deposition around the swelling, suggesting that it is lipoedema. Women with lipoedema frequently have psychosocial concerns such as anxiety and depression, which can lead to eating disorders like binge eating. Lipoedema is a chronic benign condition. According to some clinical studies, 85 percent of lipoedema patients are obese. According to certain research, anxiety is also linked to lipoedema.

When the lymphatic system is affected, lipoedema might progress to lymphoedema. It usually does not require treatment if there are no accompanying issues, such as pain. Lipoedema can be effectively treated by circumferential liposuction. The most significant test for diagnosing lipoedema is venous Doppler ultrasonography. Before taking any medications, consult your doctor.

I hope this helps.

Please revert so I can assist you further.

Thank you.

Medically reviewed byiCliniq medical review team

Published At July 13, 2022
Reviewed AtMay 19, 2026

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