Annals Consult Guys - Swollen Legs: Thinking Beyond Lymphedema
Authors: Geno J. Merli, Howard H. Weitz
Journal: Annals of Internal Medicine (2020)

Web Exclusives17 November 2020Annals Consult Guys - Swollen Legs: Thinking Beyond LymphedemaFREEGeno J. Merli, MD and Howard H. Weitz, MDGeno J. Merli, MDThomas Jefferson University, Philadelphia, Pennsylvania (G.J.M., H.H.W.)Search for more papers by this author and Howard H. Weitz, MDThomas Jefferson University, Philadelphia, Pennsylvania (G.J.M., H.H.W.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/W19-0044 Eligible for CME Point-of-CareCME/MOC SectionsSupplemental MaterialAboutVisual Abstract ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In this episode, the Annals Consult Guys discuss the differential diagnosis of bilateral leg swelling and the underrecognized diagnosis of lipedema.For more videos from and information on Annals Consult Guys, visit go.annals.org/ConsultGuys. Comments0 CommentsSign In to Submit A Comment Harvey M KramerMDDanbury Hospital18 November 2020 I learned something new today I try to learn something new every day. Today, thanks to you both, I did! As a practicing cardiologist, the dx of Lipedema is something new for me which I will incorporate into my diagnositic armementarium. This will help me better care for my cardiac patients. Not all leg edema that a cardiologist sees is due to right heart failure. Thank you! H. Kramer, MD Joseph Jumao-asInspira Health26 November 2020 Lipidema Very informative lecture on how distinguish lipidema from other causes of leg edema. Jeremy KaplittWeill Cornell (medical student)29 November 2020 Fantastic video! This was an excellent case to work through, and I appreciated the thorough discussion of distinguishing factors between potential items on the differential diagnosis. I'll be looking for more videos in this series in preparation for the wards! William SpisakProvidence Med Center- Portland27 November 2020 Lipedema Can this turn into lymphedema? also in diff- May thurner. Jyothsna BandaruPrimary Care Practice29 November 2020 Very Interesting! Awesome video, very interesting! Especially liked the articles, figures, tables included. Complete compact package of learning in short time video Rekha SundarLowell General Hospital6 December 2020 Such an appropriate title Thank you for this excellent presentation. I have a patient which fits this diagnosis, for years I had been wondering what I was dealing with. The patient had undergone weight loss surgery and other usual diagnositc work up with no response to any therapy. This has been frustrating for the patient as she had no answers. I presumed it to be lymphadema but was not convinced. Such an appropriate title for your presentation. Today I learned this new diagnosis to add to my differntial for leg swelling. Now I have an answer for my patient. Thank you very much. Nilufer Norsworthy, MDUW8 December 2020 Compression therapy Thank you very much for this brief and excellent summary. I do see these patients at my practice more often than average as I work with wound patients. Just talking about the lower leg lipedema cases: interestingly they do benefit from light compression garments despite at least during the initial phase the lymphatic drainage is not impaired. My theory on this is most of them present with mixed disease. Especially advanced cases have component of lymphedema to various degree as a concequence of anatomically impaired lymphetic network and with added venous insufficiency. I wonder what your thoughts on these. Thanks. Michael Halle,MDnone7 February 2021 Thorough review of leg edema I never heard of this diagosis, Lipedema. All my years of practicing medicine it would have been very useful. I'm glad to know at least that my management, primarily compression garments, was correct. Yaseer Muhammad Tareq KhanLeeds teaching Hospitals NHS Trust11 March 2021 Lipedema Excellent and very educational. Thank you for great discussion. Author, Article, and Disclosure InformationAffiliations: Thomas Jefferson University, Philadelphia, Pennsylvania (G.J.M., H.H.W.)Disclosures: Geno J. Merli, MD, and Howard H. Weitz, MD, report that they have no financial relationships or interests to disclose.Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that her spouse has stock options/holdings with Targeted Diagnostics and Therapeutics. Stephanie Chang, MD, MPH, Deputy Editor, reports employment with the Agency for Healthcare Research and Quality, travel compensation from the Guidelines International Network, and participation in the Patient-Centered Outcomes Research Institute methodology committee. Deborah Cotton, MD, MPH, Deputy Editor, reports that she has no financial relationships or interests to disclose. Eliseo Guallar, MD, MPH, DrPH, Deputy Editor, Statistics, reports that he has no financial relationships or interests to disclose. Christina C. Wee, MD, MPH, Deputy Editor, reports employment with Beth Israel Deaconess Medical Center. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Yu-Xiao Yang, MD, MSCE, Deputy Editor, reports that he has no financial relationships or interest to disclose.Correction: The summary and CME/MOC activity for this article was corrected on 18 November 2020 a typhographical error. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 17 November 2020Volume 173, Issue 10Page: CG1 ePublished: 17 November 2020 Issue Published: 17 November 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.Loading ...