{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T09:29:25Z","timestamp":1789810165840,"version":"4.0.1"},"reference-count":35,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,2,22]],"date-time":"2023-02-22T00:00:00Z","timestamp":1677024000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Obesity"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Lipoedema is characterized by disproportionate painful fat accumulation mostly in the lower limbs. The presence of lymphoedema in lipoedema remains controversial. This study aimed to assess the presence or absence of lymphoedema in the lower limbs of women with lipoedema using indocyanine green (ICG) lymphography. A cross\u2010sectional retrospective study was undertaken in women with a clinical diagnosis of lipoedema whose lower limbs were examined with ICG lymphography. MD Anderson Cancer Center (MDACC) ICG staging was used to determine lymphoedema presence and severity. Patient characteristics, ICG lymphography findings, Stemmer sign, body mass index, waist\u2010to\u2010hip ratio, limb volume and bioimpedance spectroscopy measures were recorded. Forty women with lipoedema underwent ICG lymphography for the lower limbs from January 2018 to July 2022. Thirty\u2010four women (85.0%) were determined by ICG lymphography as MDACC ICG Stage 0 representing normal lymphatics. Of the six women who demonstrated dermal backflow on ICG lymphography, all were determined as ICG Stage 1, four had localized traumatic dermal backflow area at their ankles, one had previously diagnosed with primary lymphoedema and one was classified as lipoedema stage 4. ICG lymphography findings suggested the absence of lymphoedema in a clear majority of women with lower limb lipoedema.<\/jats:p>","DOI":"10.1111\/cob.12588","type":"journal-article","created":{"date-parts":[[2023,2,23]],"date-time":"2023-02-23T06:20:28Z","timestamp":1677133228000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Differentiation of lipoedema from bilateral lower limb lymphoedema by imaging assessment of indocyanine green lymphography"],"prefix":"10.1111","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9751-319X","authenticated-orcid":false,"given":"Helen","family":"Mackie","sequence":"first","affiliation":[{"name":"Australian Lymphoedema Education, Research &amp; Treatment (ALERT) Program, Department of Health Sciences, Faculty of Medicine, Health and Human Sciences Macquarie University  Sydney New South Wales Australia"},{"name":"Mount Wilga Private Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Belinda M.","family":"Thompson","sequence":"additional","affiliation":[{"name":"Australian Lymphoedema Education, Research &amp; Treatment (ALERT) Program, Department of Health Sciences, Faculty of Medicine, Health and Human Sciences Macquarie University  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroo","family":"Suami","sequence":"additional","affiliation":[{"name":"Australian Lymphoedema Education, Research &amp; Treatment (ALERT) Program, Department of Health Sciences, Faculty of Medicine, Health and Human Sciences Macquarie University  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asha","family":"Heydon\u2010White","sequence":"additional","affiliation":[{"name":"Australian Lymphoedema Education, Research &amp; Treatment (ALERT) Program, Department of Health Sciences, Faculty of Medicine, Health and Human Sciences Macquarie University  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robbie","family":"Blackwell","sequence":"additional","affiliation":[{"name":"Australian Lymphoedema Education, Research &amp; Treatment (ALERT) Program, Department of Health Sciences, Faculty of Medicine, Health and Human Sciences Macquarie University  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona","family":"Tisdall Blake","sequence":"additional","affiliation":[{"name":"Australian Lymphoedema Education, Research &amp; Treatment (ALERT) Program, Department of Health Sciences, Faculty of Medicine, Health and Human Sciences Macquarie University  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise A.","family":"Koelmeyer","sequence":"additional","affiliation":[{"name":"Australian Lymphoedema Education, Research &amp; Treatment (ALERT) Program, Department of Health Sciences, Faculty of Medicine, Health and Human Sciences Macquarie University  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,2,22]]},"reference":[{"key":"e_1_2_11_2_1","first-page":"184","article-title":"Lipoedema of the legs: a syndrome characterized by fat legs and orthostatic edema","volume":"15","author":"Allen EV","year":"1940","journal-title":"Proc Staff Meet Mayo Clinic"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0268355516639421"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1758-8111.2012.00045.x"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.12687\/phleb2418-3-2018"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11102836"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0274867"},{"key":"e_1_2_11_8_1","unstructured":"World Health Organisation.International Classification of Diseases 11th Revision. 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