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Lymphoscintigraphic Findings in Patients With Lipedema: A Systematic Review
Hatan Mortada1,2, Malak Abdulaziz Alsaif3,4, Abdulrahman AlJohani5,6
1From the Division of Plastic Surgery, Department of Surgery, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
Plastic and Reconstructive Surgery. Global Open
|August 11, 2026
Summary
Lymphoscintigraphy often shows normal findings or mild lymphatic abnormalities in lipedema patients, suggesting overload rather than insufficiency. Standardized imaging protocols are needed for accurate diagnosis and staging of this condition.
Area of Science:
- Vascular Medicine
- Diagnostic Imaging
- Medical Research Methodology
Background:
- Lipedema is a chronic adipose tissue disorder affecting lower extremities, often misdiagnosed as lymphedema.
- Lymphoscintigraphy is a key diagnostic tool to differentiate lipedema from lymphedema.
- Evidence on common lymphoscintigraphy findings in lipedema requires synthesis.
Purpose of the Study:
- To systematically review and synthesize lymphoscintigraphy findings in patients diagnosed with lipedema.
- To identify common imaging patterns and abnormalities observed during lymphoscintigraphy in lipedema.
- To clarify the utility of lymphoscintigraphy in the context of lipedema diagnosis.
Main Methods:
- Systematic review conducted following PRISMA guidelines.
- Comprehensive literature search across major databases (MEDLINE/PubMed, Embase, Web of Science).
- Inclusion criteria focused on studies reporting lymphoscintigraphy findings in lipedema patients with detailed imaging protocols.
Main Results:
- Seven studies involving 311 lipedema patients were analyzed.
- Normal lymphoscintigraphy findings were observed in 61.4% of lipedema patients.
- Common abnormalities included tortuous lymph vessels (56.8%), collateral vessels (49.1%), and popliteal node visualization (44.0%).
Conclusions:
- Lymphoscintigraphic findings in lipedema may indicate lymphatic overload, not outright insufficiency.
- Heterogeneity in study methods limits quantitative meta-analysis.
- Standardized imaging protocols are crucial for defining lymphoscintigraphy's role in lipedema diagnosis and staging.
