48 year old woman presents with abnormal fat deposition on her legs that started after childbirth at age 23. She said she may have noticed it as a teen, but was not completely sure. Her mother and 3 sisters have the same condition. In one of her sisters, she complains of pain in her legs. She told me "The top half of me and the bottom half of me are 2 different sizes!".
What’s your diagnosis?

Diagnosis: Lipedema.

The cause is relatively unknown, but there seems to be a genetic basis. The condition involves the deposition of extra adipose tissue deep in the skin of the backside, upper and lower extremities. The deposition can occur in any or all of these areas. Some cases and be mild and others can be extremely pronounced. In certain cases, the excess adipose can be associated with pain and discomfort. Patients report the condition occurring and/or worsening in adolescence, after childbirth and during menopause.

Treatment:
Weight reduction and exercise, although good for health in general, are not effective in treating this condition. A modified form of liposucition is showing promise in treating this condition.

For more information see:
		Lipedema
		Lipedema symptoms treatment causes
		Lipedema, a Rare Disease
		Cases of the Month Archives