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Chapter 17 — 4
Prevention
Avoidance of the known predisposing factors is obviously desirable. Most sensible
recreational divers run little risk of this condition. Generally they should; avoid dives deeper
than 40 metres, avoid dives
requiring decompression, not
approach the no-decompression
limits and ascend slowly. It is
likely that the longer duration
dives permitted with many dive
computers, together with the
increased number of dives and the
ability to dive close to the edge of
decompression commitment, now
makes this disorder more likely for
recreational divers.
If indicated, in divers who develop
decompression sickness a follow-
up bone scan after 2–4 weeks
should detect areas of bone
damage. MRI imaging can often
be better used to determine the
extent of the lesion.
Fig. 17.2
Divers with high risk factors who develop unexplained joint pain should be assessed to
exclude this condition.
Occupational divers and other divers who are
at increased risk because of their diving
practices may require regular routine
screening
assessments.
Since
X-ray
investigations can involve worrisome
exposure to radiation, their frequency must
be weighed against the risk of osteonecrosis
development, and so MRIs are preferred.
Divers who are likely to be at risk are
required to have a baseline investigation
performed before they are employed. For
some susceptible occupational divers,
follow-up assessments at 5 year intervals are
recommended.
Fig 17.3