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At least 19 recordsLinked to original sources
PubMed1986

Caisson disease of bone.

Caisson disease of bone, which may affect compressed air workers and divers, is characterized by regions of bone and marrow necrosis that may lead to secondary osteoarthrosis of the hip and shoulder joints. A review of the pathologic, radiologic, and clinical aspects demonstrated uncertainties in the exact etiology. Early diagnosis is often not possible because of the delayed appearance of radiologic abnormalities. Research into these two aspects of this condition was carried out by the Medical Research Council Decompression Sickness Research Team in Newcastle upon Tyne over a ten-year period (1972 to 1982). Because no suitable animal model exists for the study of this condition, bone and marrow necrosis was produced by embolism of bone blood vessels with glass microspheres. With this model, it was shown that the presence of bone and marrow necrosis could be detected by bone scintigraphy using 99mTc-MDP and by measuring changes in serum ferritin concentration at a much earlier stage than was possible by radiography. However, only the former method has proved useful in clinical practice. Investigations into the etiology of caisson disease of bone have shown evidence for an increase in marrow fat cell size resulting from hyperoxia. This phenomenon may play a role in the production and localization of gas bubble emboli, which are thought to be the cause of the bone and marrow necrosis.

Animals↗
PubMed1980

Scintigraphy versus radiography in the early diagnosis of experimental bone necrosis, with special reference to caisson disease of bone.

The early diagnosis of caisson disease of bone is hindered by the long delay which must elapse before an abnormality becomes apparent on a radiograph. The possible use of bone scintigraphy for this purpose was investigated. Necrosis of the bone and marrow was produced in rabbits by glass microspheres to simulate persistent gas-bubble emboli and then serial radiographs and scintigrams using 99mTc-diphosphonate were obtained. Regions of necrosis could be detected as "hot-spots" on the scintigrams as early as three weeks after the causative insult, which was many weeks before any abnormality could be detected on the radiographs. Histological examination of excised femora suggested that the scintigraphic abnormality might depend on the new bone formation during a reactive or repair process. It is suggested that scintigraphy may have clinical value in caisson disease.

Animals↗
PubMed2004

Caisson disease during the construction of the Eads and Brooklyn Bridges: A review.

The Eads Bridge (St. Louis) and the Brooklyn Bridge (New York City) were testing grounds for caisson construction. These caissons were enormous compressed air boxes used to build riverine piers and abutments anchoring the bridges. Caisson meant faster and cheaper construction, but there was a hidden cost---caisson disease (decompression sickness). Within caissons, workers labored at pressures as high as 55 psig and caisson disease was common. This discourse is a brief history of the caisson, a brief discussion of the illness as viewed in the mid 1800's, and an abbreviated history of the Eads and Brooklyn Bridges. It also provides a detailed description and evaluation of the observations, countermeasures, and recommendations of Dr. Alphonse Jaminet, the Eads Bridge physician, and Dr. Andrew Smith, the Brooklyn Bridge physician, who published reports of their experience in 1871 and 1873, respectively. These and other primary sources permit a detailed examination of early caisson disease and Jaminet's and Smith's thinking also serve as good examples from which to study and learn.

Decompression Sickness↗
PubMed1980

Caisson disease of bone: a study of the Göttingen mini-pig as an animal model.

Investigation of the exact aetiology, early diagnosis and prevention of caisson disease of bone has been hindered by the inability to produce, by the use of realistic compression/decompression exposures, truly comparable lesions in animals. Four Gottingen mini-pigs were subjected to repeated exposures to pressures of 27 p.s.i.g. for 6 h over a period of 9 months and decompressed according to standard tables. Two mini-pigs acted as controls. In one animal radiological changes were recognised in the left lower femoral shaft 19 weeks after the exposures were started and subsequent examination of that bone confirmed the presence, at that site, of a lesion which macroscopically and microscopically resembled, in every way, the appearances of those seen in the shafts of long bones in man. It is concluded therefore that, properly used, the mini-pig may be a suitable animal model for the study of this condition in man.

Animals↗
PubMed1981

A study of old lesions of caisson disease of bone by radiography and bone scintigraphy.

A group of patients were studied 10 years after stopping work in a high-pressure environment. Radiographs of their long bones showed little change during the period, but only two of 12 scintigrams were normal. The 10 abnormal scintigrams contained 18 "hot-spots" which were not always associated with an abnormal radiographic appearance; the findings suggest that some lesions may never become visible on a radiograph. A reactive or repair process associated with these lesions may be prolonged and may not be beneficial, as structural failure of the joint may subsequently occur. Prognosis should therefore be guarded.

Adult↗