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The easiest way to differentiate lipedema from lymphedema is to detect lipedema-associated clinical symptoms (e.g., cuffing sign, retromalleolar fat pads, tenderness of the skin). Physical examinations including the Streeten test, waist-to-height ratio, capillary fragility, and pain measurements can also aid in differential diagnosis. The last two methods can be used to follow and measure therapeutical efficacy. Imaging techniques (ultrasound, computed tomography, magnetic resonance imaging, lymphoscintigraphy, infrared fluoroscopy) and cardiovascular methods (aortic stiffness determination, three-dimensional speckle tracking echocardiography) are sensitive tools to find subtle differences.

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