Which investigations should be considered to confirm a diagnosis of lymphoedema in a primary care setting?

Investigations to confirm a diagnosis of lymphoedema in primary care are primarily clinical, as there is no specific diagnostic test routinely recommended in this setting. Diagnosis is usually based on history and physical examination, including assessment of limb swelling and exclusion of other causes.

Imaging such as lymphoscintigraphy or ultrasound may be used but are typically arranged by specialist lymphoedema services rather than in primary care.

In primary care, it is important to assess for other treatable underlying factors such as nodal disease or cellulitis before starting lymphoedema management. If lymphoedema is suspected, referral to a specialist lymphoedema service for further assessment and management is recommended as soon as possible.

Blood tests or imaging to exclude malignancy or infection may be considered if there is unexplained lymphadenopathy or systemic symptoms, but these are not specific for lymphoedema diagnosis.