Dysbaric osteonecrosis associated with decompression sickness in a fishing diver

Abstract

Diving as a method of fishing is used worldwide in small-scale fisheries. However, one of the main causes of morbidity and mortality among fishermen is decompression sickness (DCS). We report the case of a 46-year-old male fisherman diver who presented with chronic inguinal pain that radiated to the lower left limb. Living and working in a fishing port in Yucatan, he had a prior history of DCS. A diagnosis of avascular necrosis in the left femoral head secondary to DCS was made via analysis of clinical and radiological findings. The necrosis was surgically resolved by a total hip arthroplasty. Dysbaric osteonecrosis is a more probable diagnosis. In this region fishermen undergo significant decompression stress in their daily fishing efforts. Further studies regarding prevalence of dysbaric osteonecrosis among small-scale fisheries divers are needed. In a community where DCS is endemic and has become an epidemic, as of late, the perception of this health risk remains low. Furthermore, training and decompression technique are lacking among the fishing communities.

Femoral Head Necrosis Due to Brucella Infection in China: Case Series and Literature Review

“…Trauma, corticosteroid, alcohol, hip dysplasia, decompression sickness, homeopathy, Gaucher's disease, and human immunodeficiency virus (HIV) are some pathogens responsible for femoral head necrosis, among which trauma, corticosteroid, and alcohol are the most common. [1][2][3][4][5] Brucella primarily infects humans' bone and joint system, resulting in spondylitis, sacroiliitis, and so on; pyogenic hip arthritis is relatively rare, and osteonecrosis of the femoral head is even more unusual. 6 There have been only three cases of osteonecrosis of the femoral head caused by Brucella, mainly speculated due to the absence of a conclusive basis of bacterial culture or pathological diagnosis.…”