Dysbaric osteonecrosis (DON) is the destruction of bone tissue in the long bones, hips and shoulders associated with diving and compressed-air work. Dysbaric osteonecrosis is a term used to describe aseptic or avascular bone necrosis due to ischemia caused by gas bubbles, although the exact mechanism is. Dysbaric osteonecrosis (DON) was first identified in the s and was found to be relatively common in the s and early s in some.

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This research was supported by research funds to promote the hospital functions of Japan Labour Health and Welfare Organization. Support Center Support Center. A contract partner of the Croatian Institute for Health Insurance.

Dysbaric osteonecrosis

Since we have actively followed divers who experienced musculoskeletal DCS. Pain and disability are related to the damage of joints. Dysbaric osteonecrosis is djsbaric type of avascular necrosis of the bone most commonly found in undersea divers and workers breathing compressed air or gas. This leads to venous thrombosis causing retrograde arterial flow and increasing the overall intraosseous pressure.

High PAI-1 levels may potentially have been present in divers before their repeated decompressions. Risk factors for dysbaric osteonecrosis K.

Dysbaric osteonecrosis: a reassessment and hypothesis.

Diaphyseal damages are painless. Importantly, however, not all series have found a correlation between dysbaric osteonecrosis and ‘the bends’. Clear Turn Off Turn On.


I agree to the terms and conditions. This result suggests that a pharmacological approach incorporating the use of an anticoagulant may represent osteonecrisis potential strategy for the prevention of DON.

There are many reasons for this discrepancy; principal among them is the small number of subjects. HBOT is usually provided in long series of up to exposures, if not even longer. Those affected were mainly experienced divers who performed repetitive, long, deep air dives using dive computers and did not violate decompression procedures. Thus, it is osteonecrosie to state that technical diving itself does not carry a higher risk of DON as long as decompression rules are strictly obeyed.

In comparison to the risk of osteonecrosis in the general population, the risk of DON was 10 times greater in Navy divers and times greater in fishermen.

Clin Cases Miner Bone Metab. Copyright Harcourt Publishers Ltd. The lesion begins as a localised area of infarctionusually without symptoms. Detection of clotting-factor disorders that may contribute to the occurrence of DON is promising, but additional research is needed.

Author Information Authors Tyler C. On the basis of this knowledge of steroid-induced osteonecrosis, we hypothesized that coagulation abnormalities or hyperlipidaemia might be present in divers with DON. Diving, Dysbaric Osteonecrosis Tyler C. Non-articular lesions commonly occur in the femoral and humeral shafts and are much less likely to become symptomatic as they rarely involve the cortex or lead to pathologic fracture. History of decompression research and development History of scuba diving Researchers in osteonecorsis diving Timeline of diving technology.


Differential Diagnosis Diagnoses to consider include: These results suggest that, in addition to strict decompression tables, a pharmacological approach using an anticoagulant such as warfarin may be a potential method for the prevention of DON.

Total PAI-1 was measured by latex photometric immunoassay [ 9 ]. Thank you for submitting a comment on this article. This may be due to safe decompression protocols or the use of more oxygen, or it may be underdiagnosed. If the diver has not been exposed to excessive depth and decompression and presents as DON, there may be a predisposition for the condition. In both cases screening for DON lesions osteoncrosis negative.

Ascending and descending diving Boat diving Buddy breathing Buddy diving Canoe and Kayak diving Controlled buoyant lift Controlled emergency swimming ascent Decompression diving Decompression practice Dive planning Diver communications Diver navigation Diver rescue Diver trim Dive log Drift diving Emergency ascent Finning techniques Night diving Penetration diving Recreational diver training Scuba gas planning Scuba skills Solo diving Surface-supplied diving skills Underwater search and recovery Underwater searches.

Disease duration in EK familial Creutzfeldt-Jakob disease is correlated with clinical, radiological, and laboratory variables. Diving, Dysbaric Osteonecrosis – StatPearls. The best prevention of dysbaric osteonecrosis is recompression therapy in all cases of decompression sickness. Juxta-articular lesions in the hips and shoulders are the most likely to become symptomatic. Etiological and pathogenetic concepts. Show details Treasure Island FL: The prevailing view is that recreational divers are at lower risk than commercial divers and compressed-air workers since they are supposed to perform dives with conservative exposures.


Fifty-six male divers received skeletal examinations by radiography to assess the occurrence of DON. Edaravone, a novel free radical scavenger, prevents owteonecrosis osteonecrosis in rabbits.

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Dysbaric osteonecrosis: a reassessment and hypothesis.

Clin J Sport Med. MRI is useful to characterize the nature of any lesions as well. Radiographic findings were classified based on a system reported by Ohta and Matsunaga which includes type A juxta-articular dysbaic type B head, neck and shaft lesions [ 5 ].

Enzymatic determination of total serum cholesterol. Bone lesions in compressed air workers, with special reference to men who worked on the Clyde Tunnels to Retrieved from ” https: The patient may report pain that radiates from the joint down the limb as well as restriction of the range of motion.

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