Document Detail

The distribution of limb pain in decompression sickness.
MedLine Citation:
PMID:  8929209     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: For many years there has been a widely held but largely unsubstantiated belief that pain in the upper limb in decompression sickness (DCS) is associated with bounce diving, whereas compressed air workers, saturation divers and high altitude aviators are more susceptible to involvement of the lower limbs. HYPOTHESIS: The hypothesis of counter current exchange of inert gas, modulated by changes in tissue temperature, has been evaluated as a possible mechanism to explain the reported distribution of limb pain in DCS. METHODS: An extensive review of over 19,000 cases of limb pain decompression illness has been undertaken from case reports stored in the diving accident database at the Institute of Naval Medicine, in the published literature, and from unpublished clinical and experimental reports. RESULTS: There was a predominance of upper limb involvement in bounce divers and, in contrast to traditional teaching, in aviators. By contrast, the lower limbs were more commonly involved in compressed air workers and saturation divers. CONCLUSION: Each of the occupational exposures has been discussed individually with reference to counter-current exchange and other factors as potential influences on the distribution of disease. We conclude that counter-current exchange of inert gas may be implicated in the distribution of limb pain in DCS.
L M Sowden; E P Kindwall; T J Francis
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Aviation, space, and environmental medicine     Volume:  67     ISSN:  0095-6562     ISO Abbreviation:  Aviat Space Environ Med     Publication Date:  1996 Jan 
Date Detail:
Created Date:  1996-11-08     Completed Date:  1996-11-08     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7501714     Medline TA:  Aviat Space Environ Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  74-80     Citation Subset:  IM; S    
Institute of Naval Medicine, Hants, UK.
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MeSH Terms
Acid-Base Equilibrium
Arm* / blood supply
Decompression Sickness / complications,  physiopathology*
Diving / adverse effects*
Leg* / blood supply
Noble Gases
Occupational Diseases / complications,  physiopathology*
Pain / etiology*
Partial Pressure
Retrospective Studies
Reg. No./Substance:
0/Noble Gases

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