The use of the pressure cuff test in the diagnosis of decompression sickness

Records at the Hyperbaric Medicine Division, United States Air Force School of Aerospace Medicine, were reviewed to determine the utility of the pressure cuff test as an aid in the diagnosis of Type I decompression sickness (DCS). Applying local pressure with a blood pressure cuff has been described as a useful test to differentiate the pain of DCS from that of other musculoskeletal conditions. Records were reviewed from January 1985 to December 1989. During this period 179 patients were treated with recompression for extremity pain. Application of a blood pressure cuff to the painful area was used as a diagnostic aid in 87 patients. Only 53 patients (61%) with DCS had a positive test (relief of pain with local pressure). Results did not correlate with the rapidity of relief of symptoms during recompression. We conclude that the failure to respond to the application of local pressure should not be used to rule out the presence of DCS-this must be done with a test of pressure in a hyperbaric chamber.