{
  "id": "SCR-LIP-000002",
  "statement": "Clinical signs that help diagnose lipedema and distinguish it from lymphedema include a usually negative Kaposi-Stemmer sign, the cuff sign with foot sparing, fat painful on palpation, easy bruising, and minimal pitting edema (Stemmer becomes positive only when secondary lymphedema/lipolymphedema develops).",
  "statement_pt": "Sinais clínicos que auxiliam o diagnóstico do lipedema e o distinguem do linfedema incluem sinal de Kaposi-Stemmer geralmente negativo, sinal do manguito com preservação dos pés, gordura dolorosa à palpação, equimoses fáceis e edema pouco depressível (Stemmer torna-se positivo apenas no lipolinfedema).",
  "claim_type": "diagnostic",
  "context": {
    "population": "patients with lipedema",
    "condition": "lipedema",
    "exposure": "clinical examination signs",
    "comparator": "lymphedema",
    "outcome": "clinical differentiation",
    "scope": "diagnostic criteria"
  },
  "knowledge_state": "probable",
  "evidence_confidence": "moderate",
  "evidence": [
    {
      "ref": "DOI:10.1590/1677-5449.202301832",
      "stance": "supporting",
      "study_design": "consensus",
      "n": 113,
      "risk_of_bias": "moderate",
      "year": 2025,
      "amato_authored": true,
      "note": "consensus on Stemmer, pain, bruising, pitting"
    },
    {
      "ref": "Amato ACM, 2019",
      "stance": "supporting",
      "study_design": "case_report",
      "n": 1,
      "risk_of_bias": "high",
      "year": 2019,
      "amato_authored": true,
      "note": "comparative table"
    }
  ],
  "relations": [
    {
      "type": "contextualizes",
      "target_hint": "lymphedema differential"
    },
    {
      "type": "co_occurs",
      "target_hint": "lipolymphedema"
    }
  ],
  "gaps": "Signs lack validated sensitivity/specificity; diagnosis remains clinical and operator-dependent.",
  "primary_amato_source": "DOI:10.1590/1677-5449.202301832",
  "curators": [
    {
      "name": "Alexandre C. M. Amato",
      "orcid": "0000-0003-4008-4029",
      "role": "lead_curator"
    }
  ],
  "created": "2026-05-30",
  "updated": "2026-05-30",
  "license": "CC-BY-4.0",
  "answers_questions": [
    {
      "id": "SQ-LIP-000001",
      "role": "context",
      "question": "Is lipedema a distinct disease, separate from obesity and lymphedema?",
      "url": "https://scientificclaims.org/q/SQ-LIP-000001.html"
    }
  ],
  "url": "https://scientificclaims.org/c/SCR-LIP-000002.html"
}