Answer:
Dysbaric osteonecrosis( Caisson’s Disease).
Findings:
Images depicts avascular necrosis in bilateral humeral heads. In addition, multiple medullary infarcts seen in proximal shaft of both humerus, distal shafts of both femur.
Discussion:
Caisson’s disease is caused by an accumulation of nitrogen gas bubbles in blood vessels, which act as emboli and precipitate tissue infarction. This phenomenon is most frequently encountered in individuals, such as deep sea divers, who are removed too rapidly from a high pressure environment.
Less commonly, rapid removal from low pressure environments, such as in high-altitude flying, may produce a similar condition. The entire syndrome has been called decompression sickness. Descriptive terms define the physical manifestations of the acute presentation, such as the chokes (respiratory system), the staggers (nervous system), and the bends (musculoskeletal system). Specific terms applied to the associated bone and joint abnormalities include dysbaric osteonecrosis, pressure-induced osteoarthropathy, and barotraumatic osteoarthropathy.
In the acute phase, manifestations include altered neurological status; breathing difficulties; and severe muscle, joint, and bone pain. Later, changes are predominantly related to altered joint function from nitrogen bubble-induced epiphyseal necrosis.
Epiphyseal lesions are commonly visible in humeral and femoral heads in the form of avascular necrosis; lucency, sclerosis, collapse, fragmentation, secondary degenerative joint disease.
Metaphyseal-diaphyseal lesions are characterized by healed mature medullary infarcts; central, elongated, with undulating sclerotic borders; most frequent in proximal humerus, distal femur, proximal tibia.
References: Essentials of Skeletal Radiology , yochum and rowe ;3rd Edition.
Contributed By:
Dr. Karunakaran M. Kalathi MD, Dr. Arun Chelladurai MD
Consultant Radiologists, Aarthi Scans, Thirunelveli, Tamilnadu, India
Dysbaric osteonecrosis( Caisson’s Disease).
Findings:
Images depicts avascular necrosis in bilateral humeral heads. In addition, multiple medullary infarcts seen in proximal shaft of both humerus, distal shafts of both femur.
Discussion:
Caisson’s disease is caused by an accumulation of nitrogen gas bubbles in blood vessels, which act as emboli and precipitate tissue infarction. This phenomenon is most frequently encountered in individuals, such as deep sea divers, who are removed too rapidly from a high pressure environment.
Less commonly, rapid removal from low pressure environments, such as in high-altitude flying, may produce a similar condition. The entire syndrome has been called decompression sickness. Descriptive terms define the physical manifestations of the acute presentation, such as the chokes (respiratory system), the staggers (nervous system), and the bends (musculoskeletal system). Specific terms applied to the associated bone and joint abnormalities include dysbaric osteonecrosis, pressure-induced osteoarthropathy, and barotraumatic osteoarthropathy.
In the acute phase, manifestations include altered neurological status; breathing difficulties; and severe muscle, joint, and bone pain. Later, changes are predominantly related to altered joint function from nitrogen bubble-induced epiphyseal necrosis.
Epiphyseal lesions are commonly visible in humeral and femoral heads in the form of avascular necrosis; lucency, sclerosis, collapse, fragmentation, secondary degenerative joint disease.
Metaphyseal-diaphyseal lesions are characterized by healed mature medullary infarcts; central, elongated, with undulating sclerotic borders; most frequent in proximal humerus, distal femur, proximal tibia.
References: Essentials of Skeletal Radiology , yochum and rowe ;3rd Edition.
Contributed By:
Dr. Karunakaran M. Kalathi MD, Dr. Arun Chelladurai MD
Consultant Radiologists, Aarthi Scans, Thirunelveli, Tamilnadu, India