Ultrasonographic Anatomy and Examination of the Subcutaneous Tissue (in Lymphedema)

Lymphedema is the excessive accumulation of protein-rich lymphatic fluid within the (sub)cutaneous compartments. In recent years, ultrasound examination has emerged as an indispensable tool for its prompt diagnosis and management. This pictorial essay offers a focused review of the anatomical and histological features of the subcutaneous tissue, to provide better insight into understanding the sono-anatomy in lymphedema. By delineating distinct sono-histological patterns within the subcutaneous tissue (fluid, cobblestone, snowfall, lymphatic lakes and sclerotic), a streamlined and reproducible method is illustrated for optimal evaluation of lymphedema-related conditions that are often/otherwise subject to diagnostic inaccuracy in clinical practice.