The Diagnosis, Imaging and Management of Lymphedema

Lymphedema is a chronic, progressive disorder caused by impaired lymphatic drainage. It leads to swelling, inflammation, fibrosis, increased infection risk, and reduced quality of life. Diagnosis is primarily clinical and is supported by limb measurements, functional assessment, and imaging. Ultrasonography helps exclude mimicking conditions, lymphoscintigraphy assesses lymphatic transport, and magnetic resonance lymphangiography defines lymphatic anatomy to guide treatment planning. Management should be multidisciplinary and tailored to disease stage. Complex decongestive therapy remains the first-line treatment, while surgical options such as lymphaticovenular anastomosis, vascularized lymph node transfer, and liposuction are increasingly used in selected patients. Early recognition and individualized treatment are essential for durable disease control. This article reviews the current evidence on the diagnosis, imaging, and management of lymphedema and highlights recent developments in the field.