{
  "id": "SCR-LIP-000011",
  "statement": "Echogenic (hyperechoic) subcutaneous nodules in lipedema can be subclassified into at least four morphological variants (LDHC 3a-3d) whose distribution corresponds most strongly to the patient's most painful site.",
  "statement_pt": "Os nódulos subcutâneos ecogênicos do lipedema podem ser subclassificados em pelo menos quatro variantes (LDHC 3a-3d), cuja distribuição se associa mais fortemente ao ponto de maior dor.",
  "claim_type": "diagnostic",
  "context": {
    "population": "lipedema patients classified LDHC 3, obesity excluded",
    "condition": "lipedema",
    "exposure": "ultrasound nodule morphology",
    "comparator": "",
    "outcome": "nodule subclassification and pain correlation",
    "scope": "single-center, two radiologists"
  },
  "knowledge_state": "speculative",
  "evidence_confidence": "very_low",
  "evidence": [
    {
      "ref": "DOI:10.4236/jbise.2025.1810029",
      "stance": "supporting",
      "study_design": "case_series",
      "n": 20,
      "risk_of_bias": "high",
      "year": 2025,
      "amato_authored": true,
      "note": "Foureaux et al.; 62 nodules; distribution tied to most painful site, not BMI/age"
    }
  ],
  "relations": [
    {
      "type": "diagnoses",
      "target_hint": "echogenic nodule subclassification"
    },
    {
      "type": "associates",
      "target_hint": "pain"
    }
  ],
  "gaps": "Small descriptive series; no histopathologic confirmation of subtypes.",
  "primary_amato_source": "DOI:10.4236/jbise.2025.1810029",
  "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-000003",
      "role": "refines",
      "question": "Can ultrasound diagnose or classify lipedema?",
      "url": "https://scientificclaims.org/q/SQ-LIP-000003.html"
    }
  ],
  "url": "https://scientificclaims.org/c/SCR-LIP-000011.html"
}