Dysbaric osteonecrosis: Case series osteonecrosis in divers

Area of Science:

• Diving Medicine
• Occupational Health
• Radiology

Background:

• Decompression illness (DCI) results from inert gas bubbles forming during improper underwater decompression.
• Algerian diving conditions, particularly for red coral divers, present unique challenges.
• Dysbaric osteonecrosis (DON) is a rare complication linked to decompression sickness (DCS).

Purpose of the Study:

• To report the first cases of DCI and DON in Algerian divers.
• To investigate the association between DCS and DON in professional divers.
• To highlight the importance of early diagnosis and monitoring for divers.

Main Methods:

• Presentation of three case reports of dysbaric osteonecrosis of the humeral head in Algerian divers.
• Review of diving practices and decompression illness incidence in the region.
• Discussion of diagnostic challenges and potential progression of DON.

Main Results:

• Three cases of dysbaric osteonecrosis of the humeral head were observed in Algerian divers.
• One professional diver was declared permanently unfit due to advanced DON following type 1 DCS.
• The link between type 1 DCS and the progression to DON remains under investigation.

Conclusions:

• Early MRI evaluation of DCS cases with musculoskeletal pain is crucial for detecting osteo-medullary damage.
• Prompt diagnosis and monitoring can prevent the progression of bone lesions to necrosis.
• This study underscores the risks associated with diving in Algerian waters and the need for awareness of DCI and DON.