Objective: The aim of this article is to collect and compare lipodystrophy assessment and severity grading methods. Electronic databases, bibliographies, and specialist publications were reviewed. Methods: Medical databases and repositories of scientific articles were reviewed, including PubMed, Scopus, PMC-NCBI, Science.gov, and Google Scholar. Specialized publication sources were also searched. Based on the collected material, a list of available cellulite assessment and severity grading methods was prepared. Results: The article presents all available scales for examining the advancement of cellulite changes. Based on available data and scales, it is possible to estimate the actual severity of GLD. Due to the multifactorial pathogenesis of the changes, the selection of appropriate treatment and prevention methods depends on good diagnostics. Conclusions: The conducted literature research allowed us to select papers published in the selected databases concerning comparative lipodystrophy assessment and severity grading methods. The obtained material will facilitate the selection of proper therapy and contribute to appropriate diagnostics, prevention, and treatment of changes. It will also facilitate understanding the pathophysiology and genesis of GLD.

Background/Objectives: Cellulite is a common aesthetic condition in women, traditionally assessed using visual inspection and palpation-based scales that are inherently subjective. Therefore, image-based methods that may support standardized severity grading are of growing interest. To evaluate infrared thermography as an imaging-based method for grading cellulite severity and to perform methodological validation of a newly developed thermographic classification scale by comparing it with clinical palpation and anthropometric parameters. Methods: This retrospective, non-interventional study analyzed anonymized clinical and thermographic data from 81 women with clinically assessed cellulite. Cellulite severity was evaluated using the Nürnberger–Müller palpation scale and a newly developed five-point thermographic scale based on skin surface temperature differentials and histogram pattern analysis. The associations between the assessment methods were evaluated using ordinal statistical measures, and agreement was assessed using weighted Cohen’s kappa statistics. Results: Thermographic grading demonstrated high agreement with palpation-based assessment, with a percentage agreement of 93.8% and an almost perfect agreement based on weighted Cohen’s κ. A strong ordinal association was observed between the methods. Thermography consistently classified a subset of cases as one grade higher compared with palpation. No statistically significant associations were observed between thermographic grade and body mass index or waist-to-hip ratio. Conclusions: Infrared thermography enables image-based grading of cellulite severity and shows a strong concordance with established palpation scales. The proposed thermographic classification provides preliminary methodological validation of an imaging-based grading approach. Further multicenter studies involving multiple assessors and diverse populations are required to assess reproducibility, specificity, and potential clinical applicability.

Background/Objectives: Clinical cellulite grading relies on inspection and palpation and is susceptible to examiner variability. A single experienced assessor previously evaluated a five-grade infrared thermographic classification, but its reproducibility across raters was unknown. To assess inter-rater and intra-rater reliability of a standardized thermographic grading workflow applied by trained novice raters. Methods: This secondary reliability study included 78 anterior FLIR P620 scans. Five raters analyzed each scan twice, one week apart, using standardized FLIR Tools settings and a ΔT-based 0–IV scale. The prespecified principal agreement analysis used Gwet’s AC2 with quadratic weights across the full 0–IV scale; a sensitivity analysis recalculated AC2 using only the observed categories. Confidence intervals were estimated by scan-level bootstrap. Results: The scans yielded 780 ratings, all within grades 0–II. Full five-rater exact agreement was 26.9% and 33.3% in rounds 1 and 2, respectively, while within-one-grade agreement was 89.7% and 92.3%. Observed-category AC2, which restricts quadratic weighting to the grades represented in the data (0–II), was 0.786 (95% CI 0.730–0.840) and 0.845 (0.794–0.885). The corresponding prespecified full-scale AC2 values calculated across the theoretical 0–IV weighting range were 0.949 (0.936–0.962) and 0.963 (0.951–0.972). Intra-rater exact agreement ranged from 66.7% to 97.4%, with 100% agreement within one grade for all raters. Conclusions: The workflow demonstrated reproducible ordinal grading within the lower severity categories represented in the dataset, although exact five-rater agreement remained limited. The findings do not establish reliability for grades III–IV, diagnostic accuracy, or clinical utility.