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Review
. 2000 Jun 3;320(7248):1527-9.
doi: 10.1136/bmj.320.7248.1527.

Swollen lower limb-2: lymphoedema

P S Mortimer
Review

Swollen lower limb-2: lymphoedema

P S Mortimer. BMJ. .
No abstract available

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Figures

Figure
Figure
Classification of primary lymphoedema
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Figure
Primary lymphoedema with bilateral below knee swelling due to hypoplasia of peripheral lymphatic vessels
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Figure
Kaposi-Stemmer sign: inability to pinch a fold of skin at base of second toe because of thickened skin indicates lymphoedema
Figure
Figure
Dilatation of upper dermal lymphatics with consequent fibrosis gives rise to papillomatosis
Figure
Figure
Armchair legs (elephantiasis nostras verrucosis) develop in patients who sit in a chair day and night with their legs dependent. Patients with with cardiac or respiratory disease, stroke, spinal damage, or arthritis are predisoposed to this condition
Figure
Figure
Lipoedema only affects women and causes swelling between hip and ankle with sparing of the foot. The condition is symmetrical. The skin and subcutaneous tissues are soft and often tender with easy bruising
Figure
Figure
Lymphoscintigraphy. Radiolabelled colloid or protein is injected into the first web space of each foot and followed with a gamma camera as it moves to the draining lymph nodes. Tracer can be seen within the main lymphatic channels and lymph nodes as well as within the infection site. Collateral drainage is seen within the left thigh
Figure
Figure
Computed tomogram showing sections through normal thigh (left) and thigh with lymphoedema (right). Note thickened skin and honeycomb pattern
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