ASEPTIC BONE NECROSIS IN COMMERCIAL DIVERS: A Report from the Decompression Sickness Central Registry and Radiological Panel

Abstract

The prevalence and incidence of aseptic necrosis of bone was studied in 4980 commercial divers. 207 divers (4·2%) had at least one definite bone lesion. The highest incidence of new cases of bone damage was 6/1000 /year of experience. The prevalence of definite bone lesions among divers has increased from 0 ·9% in 1975 to 4·8% in 1979. Joint damage has developed in 9 (14·5%) divers out of 62 with potentially disabling juxta-articular lesions. Age, length of diving experience, type of diving, and factors such as weight, height, and skinfold thickness were studied in relation to bone necrosis. Although there is a significant relation between acute decompression sickness and bone necrosis this does not necessarily imply a common cause. No bone damage was found in divers who had never been deeper than 30 m. The prevalence of bone damage rises in proportion to the depth dived, up to 22% in men who have dived to 300 m. There is no firm evidence that men with shaft lesions have an increased susceptibility to juxta-articular lesions. Regular radiological skeletal surveys are recommended.