SPECIAL ARTICLE   Free access

European Journal of Physical and Rehabilitation Medicine 2022 February;58(1):108-17

DOI: 10.23736/S1973-9087.21.06853-2

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

From histo-anatomy to sonography in lymphedema: EURO-MUSCULUS/USPRM approach

Vincenzo RICCI ¹ ✉, Costantino RICCI ^{2, 3}, Fabrizio GERVASONI ¹, Arnaldo ANDREOLI ¹, Levent ÖZÇAKAR ⁴

¹ Unit of Physical and Rehabilitation Medicine, “Luigi Sacco” University Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy; ² Unit of Pathology, Maggiore Hospital, Bologna, Italy, 3 Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy; ⁴ Hacettepe University Medical School, Department of Physical and Rehabilitation Medicine, Ankara, Turkey

Lymphedema is a disorder characterized by the accumulation of protein-rich lymphatic fluid in the cutaneous and subcutaneous tissue. Based on the underlying causes, it is classified into primary and secondary forms. The use of ultrasound has recently become widespread in the field of lymphedema - especially for its diagnosis and treatment planning. In this study, we briefly reviewed the anatomy and histology of the skin and subcutaneous tissue - to propose a standardized ultrasound assessment of the superficial tissues in patients with upper-/lower-limb lymphedema. We believe that identification of the sono-histological patterns of the dermo-epidermal complex and subcutaneous tissue has place to serve as a simple and reproducible strategy to evaluate their edema diseases that are often subject to an inaccurate diagnosis in daily clinical practice.

KEY WORDS: Extremities; Edema; Ultrasonography; Dermis; Subcutaneous tissue