Diagnosis and staging

Your lymphoedema practitioner or another health professional will ask about your medical history, and check the level of swelling and any pitting, thickening or damage to the skin. The size of the affected limb will be compared to the other limb, and any differences will be assessed.

This is done in different ways:

• using a tape measure to measure the distance around the limb (circumference)
• using a device with a painless, low-frequency electric charge (bioimpedance spectroscopy) to calculate the amount of fluid
• using a high-frequency, low-power electromagnetic wave to measure the water content of the tissues
• taking photos of more difficult to measure areas, such as the head, neck, trunk, breast and genitals
• using a doppler ultrasound to rule out a blood clot
• less commonly, using magnetic resonance imaging (MRI), computerised tomography (CT) or an ultrasound to show extra fluid or fat in tissues or tissue changes
• using special imaging procedures – such as lymphoscintigraphy or indocyanine green (ICG) fluorescent lymphography – to see if there are problems with lymph fluid flow.

If lymphoedema is diagnosed, it will be staged from 0 (least severe) to 3 (most severe). All stages of lymphoedema need ongoing treatment and care. 

Who will provide treatment?

Lymphoedema usually requires care from a range of health professionals including a qualified  lymphoedema practitioner, doctors and allied health professionals (e.g. dietitian, exercise physiologist).

Lymphoedema practitioners – may be an occupational therapist, physiotherapist, massage therapist (may be called a myotherapist), podiatrist, speech therapist or nurse with specialist training in managing lymphoedema. Lymphoedema practitioners assess people with lymphoedema, develop treatment plans, prescribe compression garments, and provide ongoing treatment and care. They may work as part of a lymphoedema service in a public or private hospital or in private practice.

Doctors – your general practitioner (GP), surgeon or oncologist may diagnose the condition, coordinate  your treatment plan and refer you to a lymphoedema practitioner. If you develop a skin infection (cellulitis), your GP will help to manage this.

How to find a lymphoedema practitioner

You can ask your GP or specialist to refer you to a lymphoedema practitioner for assessment, or you may  find a practitioner yourself. The Australasian Lymphology Association has an online register of  lymphoedema practitioners. If you live in a rural or regional area, you may need to travel to visit a lymphoedema practitioner or some clinics provide telehealth consultations.