How is lymphoedema diagnosed?

Lymphedema is diagnosed again through patients presenting to see vascular surgeons. We take a detailed history. We look at the past medical history of the patient and then we examine the areas of concern. And so if we see legs that are swollen, but that may not necessarily have skin changes, such as darkening of the skin around the ankles or any other sort of what we call venous eczema, so any skin changes that suggest that the swelling may be contributed by venous insufficiency, then we are more aligned to think that lymphedema may be a concern. So lymphedema is, by and large, a diagnosis of exclusion. So we carry out the same venous ultrasound duplex scan to see if there is any venous insufficiency or veins that aren't working that can be contributing to the symptoms. So if that scan is normal, then we consider carrying out a lymphosyncytogram, which is able to measure how well lymphatic fluid is drained from lymph nodes.