ABSTRACT
This chapter includes recommendations from the Union Internationale de Phlebologie, and position statements from National and International lymphoedema groups. Imaging is rarely needed to diagnose lymphoedema but can be used to confirm the diagnosis and assess its extent and severity. Lymphoscintigraphy is particularly helpful to investigate chronic oedema of uncertain origin and to assess clinically diagnosed primary lymphoedema. The technique is not as accurate with advanced fibrotic oedema and cannot differentiate lymphoedema from other types of oedema. The intensity and sequencing for treating lymphoedema largely depends on the clinical stage, but also on the patient's age and general health. Decongestive lymphatic therapy may be required regardless of whether lymphoedema is primary or secondary. Lymphangiography was once the front-line investigation but is now rarely used because of potential adverse effects. A compression garment or short-stretch bandages should be worn between pump treatments to maintain oedema control.
