Radiographic findings in commercial divers

The primary method of detecting and recording the changes of dysbaric osteonecrosis is bone and joint radiographic survey. This is not the routine medical and orthopedic roentgen technique, but is a special purpose examination with special technical requirements. The findings indicate selective sites of damage and each should have meticulous study. Fine detail and heavily penetrated radiographs produce needed bony, especially trabecular, and detail and allow the film reviewers to exlude simulating lesions. The incidence of osteonecrosis in American commercial divers has been found to be quite low and considerably less than in other types of compressed gas workers and shell divers. The major radiographic observation is an area of sclerosis, but other changes occur. Juxta-articular lesions can lead to joint damage and are, therefore, potentially disabling. The immediate significance of a lesion in the shaft of a long bone is in its value as a basis for disqualification of an individual for further work in dysbaric environments.