Gas in Joints After Diving: Computed Tomography May Be Useful for Diagnosing Decompression Sickness

Area of Science:

• Diving Medicine
• Radiology
• Emergency Medicine

Background:

• Decompression sickness (DCS) is a risk associated with scuba diving.
• Early diagnosis and treatment are crucial for managing DCS.
• Computed tomography (CT) is an imaging modality used to visualize internal body structures.

Observation:

• A 26-year-old experienced diver developed scotoma scintillans after a 59-minute dive to 26 meters.
• Symptoms included headache, fatigue, and joint pain, with ultrasound revealing bubbles in the inferior vena cava.
• Whole-body CT identified gas in multiple joints and the intramedullary humerus.

Findings:

• CT imaging successfully detected gas in multiple joints and the intramedullary space, indicative of DCS.
• The presence of gas in the intramedullary space suggests a potential cause for dysbaric osteonecrosis.
• This case highlights the utility of CT in diagnosing DCS, particularly in identifying extraskeletal gas deposition.

Implications:

• CT may serve as a valuable tool for diagnosing decompression sickness and assessing its extent.
• Intramedullary gas deposition following diving could be an early indicator of dysbaric osteonecrosis.
• This report contributes to understanding the radiological manifestations of diving-related injuries.