Lipedema or lymphoedema: how to tell them apart

Two simple signs your doctor will look for: the fold on the toe, and the cuff at the ankle.

Lipedema or lymphoedema: how to tell them apart

Both make the legs swell, and they are often confused. Two signs separate them, and you can know what to expect at the appointment.

Stemmer''s sign

The doctor tries to pinch the skin at the base of the second toe.

If the fold lifts, the sign is called negative. That is what is seen in lipedema.
If the skin cannot be pinched, the sign is positive, and it points towards lymphoedema.

The cuff

In lipedema, the fat stops dead above the ankle or the wrist, leaving the foot or the hand untouched. That sharp cut-off is very characteristic. Lymphoedema, on the other hand, readily invades the foot.

The other differences

	lipedema	lymphoedema
Symmetry	both legs, equally	often one limb only
Pain	almost always present	often absent
Feet and hands	spared	affected
Easy bruising	common	not characteristic

The two can coexist

At an advanced stage, lipedema can be complicated by lymphatic involvement. This is then called lipo-lymphoedema, and it is one more reason to see someone early rather than late.

These pointers are there to help you understand the examination, not to replace it. Only a doctor can decide.