This condition often takes patients by surprise. It might be present at birth or develop after surgery or another treatment such as radiation for cancer. The leading cause of lymphedema in the legs is untreated chronic venous insufficiency, and often “hidden” varicose veins, that lead to “secondary” lymphedema and persistent and permanent ankle swelling. Blood clots that form in deep leg veins can lead to serious health risks such as pulmonary embolisms or deep vein thromboses (DVTs). DVTs in turn can result in swelling of the lower extremities and lymphedema. Developing a basic understanding of this disorder can help reduce stress in patients who suffer from it.
Lymphedema Overview
This condition is a disorder of the lymphatic system that causes swelling. It most often occurs in a leg or an arm. However, UCSanDiego Health indicates that other areas potentially affected include the abdomen, neck, face, genitals, and breast.
There are two types of this disorder. The primary type has no apparent cause and is often present when a child is born. The secondary type develops after an event such as an infection, radiation, surgery, trauma, or chronic venous insufficiency. According to Cedars-Sinai®, this condition is common after the removal of one or more lymph nodes because of surgery for breast cancer. Some cases develop after a DVT. MedlinePlus says that this type of clot most often develops in the thigh or the lower leg.
Symptoms might appear suddenly or over a period of time. The most common include:
- Less limb flexibility or mobility because of swelling
- A feeling or tightness or numbness around the swollen part
- Fever, warmth, redness, and tenderness indicative of an infection
The most common way to diagnose this condition is by visual exam by a venous and lymphatic medicine specialist. It involves checking the patient’s range of motion and looking for swelling and tenderness. If the exam is inconclusive, a physician might order any of these procedures to make a diagnosis:
- Lymphoscintigraphy, which involves injecting radioactive dye
- An MRI to view the swollen area
- A CT scan to check for a lymphatic blockage
- Ultrasound to detect any obstructions
Diagnosis and Treatment
Both invasive and noninvasive treatments are available to treat the disorder. Often a team of professionals treats the patient as part of an outpatient program. OncoLink reports that one of the specialists likely to provide services is an interventional radiologist.
UCSanDiego Health states that common noninvasive therapies include:
- A variety of exercises to improve range of motion and to stretch and strengthen the affected limb
- Manual lymph drainage using gentle massage
- Bandaging techniques that the patient uses at home
- Skin care to prevent infection that results from bacteria collecting
- Compression garments manufactured with flexible fabric to apply pressure and keep lymphatic fluid moving
Surgeons utilize two primary types of surgery to treat this lymphatic disorder, according to Cedars-Sinai. Vascularized lymph node transfer resettles lymph nodes from another area, primarily for patients with an upper-extremity problem. Lymphatic venous anastomosis reconnects lymphatic vessels in the affected limb to nearby veins to better drain fluid.
