Non-invasive assessment of the lymphedematous limb

Accurate assessment of the swollen limb is crucial to effective management, and usually consists of measurement of volume and assessment of skin condi tion. Here, we review the different methods available to measure volume, an d their accuracy, together with other non-invasive methods available to ass ess the characteristics of the swelling. These include the measurement of f luid mobility by recording deformation of tissue by a mass (tonometry) and the step compression method; the measurement of truncal swelling by skinfol d calipers; imaging techniques (magnetic resonance imaging, computed tomogr aphy, ultrasound) which provide information on size and other characteristi cs of the different tissue compartments; and measurement of impedance (amou nt of extracellular water and total water content). The varying quality of swelling, as well as its extent and distribution, indicates the need for ob jective methods of assessment other than simple limb volume measurement. Su ch detailed information should improve the understanding of peripheral lymp hedema.