MRI and Ultrasound of lower extremity subcutaneous adipose tissue: potential translational screening tools for lipedema

Lipedema is an underdiagnosed connective tissue disorder characterized by disproportionate subcutaneous adipose tissue (SAT) accumulation in the lower extremities. Lipedema is frequently misdiagnosed as obesity and objective diagnostic tools are lacking for lipedema. Patients with lipedema (n=22) and BMI-matched controls (n=7) underwent lower extremity MRI and ultrasound evaluations of SAT as potential diagnostic modalities. MRI and ultrasound measurement of SAT thickness yielded good concordance between modalities (Pearson’s r=0.95, reproducibility coefficient=3.3 mm), and demonstrated similar moderate effect sizes (Cohen’s d>0.5) for discriminating lipedema from controls. MRI and ultrasound are promising screening modalities for lipedema.