Summary
Definition
History and exam
Key diagnostic factors
- hx of malignancy
- hx of travel to endemic filariasis area
- hx of previous surgery
- hx of radiotherapy
- painless unilateral swelling of extremity or genitalia
- involvement of distal extremity
- positive Stemmer's sign
Other diagnostic factors
- hx of penetrating trauma to the axilla or groin
- limb heaviness and/or weakness
- non-pitting oedema
- skin changes
- FHx of lymphoedema
Risk factors
- breast cancer treatment
- nematode infection (filariasis)
- surgery near axillary or inguinal lymph nodes
- advanced tumour, nodes, and metastasis (TNM) stage
- radiotherapy
- trauma
- curvilinear scars
- FHx of lymphoedema
- genetic syndrome
- obesity
Diagnostic investigations
Investigations to consider
- MRI scan of affected extremity
- CT scan of affected extremity
- ultrasound of affected area
- lymphangiography
- blood smear for filariasis
- genetic testing
Treatment algorithm
Contributors
Authors

Department of Plastic and Reconstructive Surgery
Instructor of Surgery
Children’s Hospital Boston
Harvard Medical School
Boston
MA
Disclosures
RAM is an author of a number of references cited in this monograph.

Department of Plastic and Reconstructive Surgery
Children's Hospital Boston
Co-director
Lymphedema Clinic
Associate Professor
Harvard Medical School
Boston
MA
Disclosures
AKG is an author of a number of references cited in this monograph.
Dr Reid A. Maclellan and Dr Arin K. Greene would like to gratefully acknowledge Dr Sumner A. Slavin and Dr Carolyn C. Schook, previous contributors to this monograph. SAS and CCS are authors of a number of references cited in this monograph.
Peer reviewers
Senior Consultant Plastic Surgeon
Department of Plastic and Reconstructive Surgery
Lund University
Malmoe University Hospital
Malmoe
Sweden
Disclosures
HB is an author of a number of references cited in this monograph.
Professor
Harvard Medical School
Senior Surgeon
Children's Hospital Boston
Boston
MA
Disclosures
NRF declares that he has no competing interests.
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