The medical history (history of the patient) represents an important component in the diagnosis of lipedema. Family history What is the general health of your relatives? Are there any diseases in your family that are common? Are there any hereditary diseases in your family? Social anamnesis Current medical history/systemic medical history (somatic and psychological complaints). … Lipedema: Medical History
Endocrine, nutritional, and metabolic diseases (E00-E90). Obesity (obesity), alimentary; note that obesity is usually old generalized obesity. Benign symmetric lipomatosis (Launois-Bensaude adenolipomatosis) – disease associated with diffuse subcutaneous fat proliferation; adipose tissue distribution in the area: Neck (cerviconuchal type, so-called Madelung fat neck). Shoulder girdle (pseudoathletic type). Pelvis (gynecoid type) Lipohypertrophy – cosmetic disorder in … Lipedema: Or something else? Differential Diagnosis
The following symptoms and complaints may indicate lipedema: Bilateral (bilateral) symmetrical, dysproportional adipose tissue hypertrophy (circumferential increase due to excessive enlargement (hypertrophy) of subcutaneous adipose tissue) Exclusion of the hands and feet (“cuff phenomenon”). Involvement of the arms in about 30% of cases. Feeling of heaviness and tension of the affected extremity. Significant sensitivity to … Lipedema: Symptoms, Complaints, Signs
Pathogenesis (development of disease) A genetic predisposition (disposition) is likely. It is theorized that lipedema results from compression of the lymphatic capillaries on the one hand and an accompanying abnormality of the lymphatic capillaries on the other. The pathologically (pathologically) altered fatty tissue also tends to edema (water retention) due to a disturbance in capillary … Lipedema: Causes
The following are the most important diseases or complications that may be contributed to by lipedema: Endocrine, nutritional, and metabolic diseases (E00-E90). Obesity (obesity) as a result of psychosocial stress. Cardiovascular system (I00-I99) Secondary lymphedema – accumulation of protein-rich fluid. Infectious and parasitic diseases (A00-B99). Erysipelas (erysipelas; esp. A streptococcus). Musculoskeletal system and connective tissue … Lipedema: Complications
Severity levels Type Severity description I Adipose tissue proliferation in the gluteal region (buttock region) and hips (saddle-breech phenomenon). II Lipedema extends to the knees, fat flap formations in the area of the inner side of the knee III Lipedema extends from the hips to the ankles IV Arms and legs are affected up to … Lipedema: Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination-including blood pressure, pulse, body weight, body height, BMI (body mass index)/body mass index), and “waist-to-hip ratio” (WHR; waist-to-hip ratio (THV)) or “waist-to-height ratio” (WTR; waist-to-height ratio) [baseline determination as well as for follow-up]; furthermore: Inspection (observation) Of the body [noticeable … Lipedema: Examination
2nd order laboratory parameters – depending on the results of the history, physical examination and obligatory laboratory parameters – for differential diagnostic clarification. Small blood count Inflammatory parameters – CRP (C-reactive protein). Electrolytes – calcium, chloride, potassium, magnesium, sodium. Fasting glucose (fasting blood glucose). Liver parameters – alanine aminotransferase (ALT, GPT), aspartate aminotransferase (AST, GOT). … Lipedema: Test and Diagnosis
Medical device diagnostics are usually not required or are primarily used to evaluate for any comorbidities/coexisting conditions (see below). Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics, and obligatory medical device diagnostics – for differential diagnostic clarification. Sonography (ultrasonography) [homogeneous widening of the subcutis (subcutaneous cell tissue) … Lipedema: Diagnostic Tests
1st order Liposuction (liposuction) under tumescent local anesthesia (TLA* ) – several sessions may be necessary; after surgery, physical therapy (see under “Further therapy”) should be continued and a special compression bandage should be worn.The procedure leads to a permanent reduction of the pathologically increased fatty tissue as well as to a reduction of tissue … Lipedema: Surgical Therapy
Prevention of lipedema is not possible. Prevention measures If there is a family predisposition to lipedema, the following preventive measures should be taken: Regular weight control Balanced diet (see also under “Further therapy“). Physical activity or sports (see also under “Further therapy“). if possible waiver of hormonal contraceptives (birth control pill) or hormone replacement therapy … Lipedema: Prevention
Causal therapy, that is, therapy that addresses the causes of the disease, is not known. Symptom-relieving procedures are first-line agents. General measures Note: Lipedema is not to be equated with lifestyle-related obesity! Nevertheless, lipedema is associated with an increased risk of developing morbid obesity (BMI (body mass index, body mass index) > 40). Aim for … Lipedema: Therapy
