can doppler u/s rule out LE???

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Lia13
Lia13 Member Posts: 52
edited June 2014 in Lymphedema
can doppler u/s rule out LE???
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  • Lia13
    Lia13 Member Posts: 52
    edited April 2014

    Hi everybody, I hope you're all doing well! :-) 

    Today I had a doppler ultrasound (legs) as per angiologist's request, and with that opportunity she asked the tech to take a look at my arm. She told me the clinical edema that does exist is not from LE, but edema (I was also evaluated by the PT she works with and they both suspect muscular issues may be the cause of limited motion/inflammation/edema). I don't know whether they didn't want to charge me for an extra doppler or whether the doppler is not officially used in that context, but the doc gave me that opinion unofficially (without images and/or a diagnosis on paper). I tried to find out some info on line about doppler and LE diagnosis, but there is so little. It is mentioned as a diagnostic test when other reasons of edema are suspected or need to be addressed, but nowhere did I find that it can rule out LE and I sure don't understand how it works.

    Would anyone have an idea where I could look for more info on this? It's difficult for me to ask medical questions in Spanish and understand the answers, but if I have a general idea of what's going on I'll be able to ask the angiologist for more explanation, if I need any, next time I see her.

     At this point, this (a LE misdiagnosis of all things!!!) was so unexpected that I don't know whether to believe it or not... I've been let down by docs before and I'm a bit skeptical...

    Any thoughts would be very much appreciated

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  • Moderators
    Moderators Member Posts: 25,912
    edited April 2014

    Lia, the main Breastcancer.org site discusses Doppler ultrasound as one of the imaging studies most often used to rule out other problems that could be causing lymphedema. There are members who are very knowledgeable about LE, and may be able to give you more information and experiences.

    • The Mods

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  • Lia13
    Lia13 Member Posts: 52
    edited April 2014

    Thanks for the link Mods :-) After reading the bco info, I don't understand whether Doppler can help us evaluate edema in the compromised area (and diagnose if it is common edema or lymph-edema), or whether ANY edema in the compromised area is considered lymph-edema and the Doppler help us further examine the trigger.

    I ask for everybody's patience, as my brain sometimes just really refuses to comprehend medical information that affects my life in a major way! 

    Truth is, being told that I don't have LE but "common" edema was more of a shock than when I was first diagnosed with LE a few months back...

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  • LymphActivist
    LymphActivist Member Posts: 64
    edited April 2014

    Lia,

    Doppler studies image blood flow, and are usually used to determine whether swelling (edema) is due to obstructions or valve problems in the venous system. It is not useful for visualizing lymphatic flow. It is an important tool in differentiating whether the swelling is caused by venous or lymphatic dysfunction, and then guides the treatment and compression garment characteristics necessary for maintaining the swelling.

    An excellent and easy-to-read article on the use of various types of imaging to diagnose lymphedema may be found in "Imaging of lymphatics, LE and lymphatic function" by Prof. Neil Piller, Journal of Lymphoedema, 2011, Vol 6, No 2

    I would suggest that you obtain a referral to a physical or occupational therapist who is trained or certified in lymphedema therapy (look for CLT or CLT-LANA after their name). They will be able to diagnose whether your problem is lymphatic in nature and provide you with a treatment plan.

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  • vlnrph
    vlnrph Member Posts: 1,632
    edited April 2014

    Another opinion would help clarify. Especially with truncal or stage 0, "pre-clinical" LE, signs & symptoms can be subtle. There may be no change in measurements so using those as a diagnostic parameter is problematic. 

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  • Lia13
    Lia13 Member Posts: 52
    edited April 2014

    thanks everyone! :-) 

    LymphActivist, I tried to find the article online, but the only source I could locate requires library registration, which is not possible at the moment. Is there any link you could provide? 

    vlnrph, a few months back I was diagnosed with mild LE (arm measurements are slightly different and have been stable) by a physical therapist supposedly specialized in LE, but I wasn't happy with the care I received and didn't go back. The (albeit slight) swelling is clinically evident. My onc refused to give me a referral, the PT who first diagnosed me wasn't of much help, I can't find a national data base (I live in Chile) with certified specialists, language/culture barriers can sometimes be a problem, so I feel I'm pretty much on my own... Which is ok, except that I cannot diagnose myself. For the angiologist to change my first diagnosis from mild LE to non-lymph related edema possibly due to muscular issues, she must be pretty convinced or she wouldn't put me in danger of further LE damage, right?. But are there any similar experiences/data re Doppler to support her conviction or is it a very subjective opinion?

    She didn't explain anything else about the findings of the Doppler (other than "everything is ok"), so I decided to call her office and ask for another appointment, but in the meantime I'm also trying to understand as much as I can, to ask her the right questions. :-) 

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  • purple32
    purple32 Member Posts: 3,188
    edited May 2014

    I was diagnosed with mild LE (arm measurements are slightly different and have been stable) by a physical therapist supposedly specialized in LE, but I wasn't happy with the care I received and didn't go back.


    Yikes!  Sounds familiar.  Many of us have trouble finding a good therapist - keep trying!
    Sorry to hear.  Perhaps you need to change therapists.  May I ask what you didnt like spoecifically ?


    I would daresay that most of us did not have doppler US to DX...  just  went by symptoms and LE therapist etc ...

    If your (lymph?) edema is clinically evident, you would want treatment.

    In the meantime, this link may help you:

    http://www.stepup-speakout.org/

    Good Luck!

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