Description

ABSTRACT

Miyoshi Y, Watanabe S, Tsukazaki S, Sugiura T, Ikomi F, Tanaka T, Ogawa H, Sawamura T. Risk Factors

of Dysbaric Osteonecrosis in Saturation Diving Identified through Magnetic Resonance Imaging

Surveillance. Undersea Hyperb Med. 2026 First Quarter; 53(1):35-46.

Introduction: Only a few cohort studies have investigated dysbaric osteonecrosis (DON) in saturation

diving (SD) divers using magnetic resonance imaging (MRI) to detect early-stage DON. We aimed to

investigate DON in the Japan Maritime Self-Defense Force (JMSDF) deep SD divers using MRI and

examined the relationship between DON and the risk factors.

Methods: This study included 62 JMSDF SD divers. DON was diagnosed in the subjects’ shoulders, hips,

and knee joints using MRI and their clinical information. We analyzed subjects’ diving records, including

pre- and post-diving medical check information such as decompression sickness (DCS) and pain +/–.

Data from the annual JMSDF health checks were analyzed to identify risk factors for DON based on divers’

predispositions, lifestyles, and diving profiles.

Results: Of the 62 saturation divers (mean age: 40.61±6.93 years), three (4.8%) showed evidence of DON.

MRI showed a geographic lesion with symptoms or a history of DCS. Two divers with DON had knee pain

and a history of DCS. Furthermore, one asymptomatic diver and another diver with pain were heavy

drinkers. Regarding physical and biochemical examination, diastolic blood pressure and high-density

lipoprotein-cholesterol were identified as significant risk factors in an unpaired t-test (DON+ vs. DON-).

Discussion: Our findings suggest that SD is associated with a higher risk of DON, the early stage of which

can be detected using MRI. The possible risk factors for DON were a previous history of DCS, diastolic BP,

and HDL cholesterol, suggesting that ischemia could be involved in DON pathogenesis.

Keywords: Dysbaric osteonecrosis; early detection; hyperbaric conditions; hyperbaric medicine

DOI: 10.22464/831