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This is traversed by numerous vessels which supply the blood to the bone cells embedded in the bone. The bone cells permit the repair of fractures and allow the bone to change its structure to accommodate stresses which may vary during the person's life. If the blood vessels supplying the bone cells are blocked by gas bubbles or any other cause, the bone cells die and the self-repairing ability of the bone stops.

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It becomes unable to fix the Chapter 17 — 2 repeated minor trauma which is common around joints and eventually the bone structure collapses causing permanent damage to the major load bearing joints, such as the hips or shoulders. This variance is probably due to factors such as different diagnostic criteria and differing ages, dive patterns, deco procedures and dive frequency.

Predisposing factors which are commonly associated with osteonecrosis include: When joint involvement does occur, the onset of symptoms is usually delayed for many years, reflecting the time required for joint destruction. Fortunately, in most cases the disease does not cause any serious damage to the joints and so produces no symptoms. Occasionally bone pain may increase during recompression treatment, or may persist after treatment.

Some of these progress to dysbaric osteonecrosis over the following months. Chapter 17 — 3 Classification of Bone Necrosis The lesions are classified into two groups: With these, the joints may become involved as the under-lying bone is destroyed and the joint surface collapses. This may produce symptoms which are potentially crippling. Hips and shoulders are more frequently affected.

These rarely cause symptoms and are generally of little clinical importance, except to suggest more conservative diving procedures. The most common areas affected are the long bones of the thigh, leg and upper arm. Some games will have additional options too — you can make selections or just leave everything on its default setting. Every game has a Spin button.

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