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

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 sense/paper, we briefly review the anatomy and histology of the skin and subcutaneous tissue - in an attempt 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 dermoepidermal 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.