The Role of Radiology in Dive-Related Disorders

Abstract

Recreational scuba diving has continued to grow in popularity in the past several decades, and military diving remains an integral part of ship husbandry, explosives and ordinance disposal, and special warfare. Although relatively uncommon, disorders such as decompression sickness and arterial gas embolism can be fatal, whereas disorders such as ear baro-trauma and dysbaric osteonecrosis are not fatal but can cause significant morbidity. An extensive literature search was performed to comprehensively examine the current role of diagnostic radiology with respect to diving medicine. In selected cases, diagnostic imaging can be of potential benefit for evaluation. Diagnostic imaging plays a useful role in the screening of certain individuals for future fitness to dive. Radiological imaging has also been of paramount importance in postmortem evaluation of dive casualties.

Diplopia Due to Mask Barotrauma

“…Orbital hemorrhage after mask barotrauma during scuba diving is an infrequent occurrence (1)(2)(3)(4). In this case, the patient developed the symptom of diplopia quickly after a rapid ascent, which could suggest an AGE.…”

Magnetic resonance imaging in a guinea pig model of inner ear decompression sickness and barotrauma

“…Diagnostic imaging is an established method of diagnosing a range of scuba diving-related injuries, including arterial gas embolism, pneumocephalus, pulmonary barotrauma, and is occasionally used forensically. [20][21][22] Imaging is not routinely used in obvious cases of systemic decompression sickness due to the urgency of recompression. 10 Cases of isolated IEDS (i.e., without systemic signs of decompression sickness) should be rare, as decompression sickness is a systemic process.…”

“…Diagnostic imaging is an established method of diagnosing a range of scuba diving–related injuries, including arterial gas embolism, pneumocephalus, pulmonary barotrauma, and is occasionally used forensically . Imaging is not routinely used in obvious cases of systemic decompression sickness due to the urgency of recompression .…”

Dysbaric Osteonecrosis

“…Because only 29% of lesions are considered to be symptomatic, 27 imaging is crucial for diagnosis of DON. X-rays should be performed to look for any signs of necrosis (decalcification, cystic lesions, osteosclerotic patterns, nontraumatic fractures, bone islands, and a subchondral crescent sign) in the humerus (Figure 4), femur ( Figure 5), and the proximal tibia.…”