[Early detection of asymptomatic dysbaric osteonecrosis of the shoulder after type 1 decompression sickness: a case report]

Abstract : INTRODUCTION: Dysbaric osteonecrosis is a rare illness in professional divers and compressed-air workers. The correlation between dysbaric osteonecrosis and previous decompression sickness with osteoarthromuscular pain (type 1 decompression sickness) remains a controversial subject. The probability for ischemic lesions detected with MRI to turn into osteonecrosis after decompression sickness is still not established. EXEGESIS: The authors report the case of a military diver declared definitely medically unfit to dive after the occurrence of advanced dysbaric osteonecrosis of the shoulder, eight months after decompression sickness treated with hyperbaric oxygen, in the same area. A close link between those two events and the requirement for monitoring the follow-up of acute type 1 decompression sickness are discussed. CONCLUSION: Every decompression sickness with osteoarthromuscular pain should be early examined with MRI in order to screen osteomedullar damages liable to worse with diving and change subsequently in bone necrosis.