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Related Experiment Video

Updated: Jul 24, 2025

A Murine Tail Lymphedema Model

A Murine Tail Lymphedema Model

Published on: February 10, 2021

Fluid Distribution Patterns in Early-Stage Upper Extremity Lymphedema.

Rosie Friedman¹, Clarissa Lee², JacqueLyn R Kinney¹

¹From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School.

Annals of Plastic Surgery

|July 3, 2023

Summary

Early-stage upper extremity lymphedema shows fluid accumulation along the ulnar forearm and posterior upper arm, aligning with lymphatic pathways. Radial forearm sparing suggests robust drainage in this area.

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Area of Science:

Medical Imaging
Lymphedema Research
Anatomy

Background:

Early-stage (Stage 1) upper extremity lymphedema involves subcutaneous fluid infiltration not exceeding 50% of extremity circumference.
The spatial distribution of this fluid in early lymphedema is not well-detailed.
Understanding fluid patterns may reveal compensatory lymphatic channels.

Purpose of the Study:

To investigate the spatial distribution pattern of fluid infiltration in early-stage upper extremity lymphedema.
To determine if fluid distribution corresponds to known lymphatic pathways in the upper extremity.

Main Methods:

Retrospective review of patients with MRI Stage 1 upper extremity lymphedema.
Standardized scoring system used by a radiologist to grade fluid severity at 18 anatomical locations.
Creation of a cumulative spatial histogram to map fluid accumulation frequency.

Main Results:

Eleven patients with Stage 1 lymphedema were analyzed (mean age 58, mean BMI 30).
Forearm fluid concentrated on the ulnar aspect, with radial aspect sparing.
Upper arm fluid concentrated distally and posteriorly.

Conclusions:

Fluid infiltration in early lymphedema concentrates along the ulnar forearm and posterior distal upper arm, consistent with the tricipital lymphatic pathway.
Sparing of the radial forearm suggests efficient lymphatic drainage, potentially via the lateral upper arm pathway.