Does fibrotic tissue alter the L-Dex measurement?
L-Dex is best used pro-actively to detect and treat early stage (fluid-like) lymphedema. However, L-Dex values will still respond to decreases in the extracellular fluid in the arm of fibrotic limbs. This allows the effectiveness of treatment to be assessed in patients with developed lymphedema where some fibrosis may be present. In patients with advanced cases of fibrosis where there is little excess fluid the L-Dex results may not correspond to the physical size of the arm.
L-Dex is best used to aid in the clinical assessment of extracellular fluid differences between the arms. Based on the pathophysiology of lymphedema, the earlier stages are often represented by changes in this compartment. In later stages, where the condition has become chronic, and tissue changes have occured due to fibrosis, extracellular fluid levels can decrease. In chronic cases, L-Dex, as an aid in the clinical assessment, has less relevance and total arm measurements need to be considered by the medical provider.
