Safety Tip:  Diving and Risk Factors for Arthritis
Age and sex are two of the most important risk factors for the rheumatic diseases. Most of the major joint conditions show a remarkable sex difference in incidence; eg, systemic lupus erythematosus (SLE) occurs primarily in women, whereas ankylosing spondylitis (Spine) is both more frequent and more severe in males. The reasons for this are unclear. Divers of all ages will need to be aware of the few but important relationships to this widespread condition.

The musculoskeletal system does not "wear out"; it thrives on usage and, unlike most mechanical systems, "lasts a lifetime." The underwater 'weightlessness' lends itself nicely toward allowing this great sport of scuba to be enjoyed by many people who would otherwise not be able to participate in athletics. However, like gender, age very strongly affects the incidence, expression, and impact of musculoskeletal diseases. Some conditions only occur in childhood; others, like SLE and ankylosing spondylitis, usually start in young adults, while polymyalgia rheumatica and giant cell arteritis rarely begin in those less than 55 yr. Rheumatoid arthritis (RA), SLE, gout, and other major inflammatory rheumatic diseases are expressed differently if they begin in older patients. With minimal assistance with entrances and exits, the arthritic diver can usually manage a moderately difficult dive with ease.

Diagnosis and Assessment Important to the Diver
Rheumatology is mainly a clinical specialty, still depending more on the skills of history-taking and examination than on special investigations. There are 2 main aspects to diagnosis: (1) differentiating the type of rheumatic disorder present and (2) assessing its impact on daily life. Diagnosis is based largely on pattern recognition --the chronology, distribution, and associated features of the disorder. The assessment of pain, disability, and handicap is often more difficult, involving investigation of patients' functional abilities, as well as their hopes, fears, needs, and aspirations. This assessment requires careful documentation in prospective divers for comparison in the case of a possible bout with decompression sickness. Most musculoskeletal disorders cause chronic pain and disability without having a great effect on life expectancy; the prevalence is therefore highest in older people. Some arthritic divers have described significant relief from pain at depth.

Enjoy the weekend and the super bowl, even if your team is not there.  Stay safe and look out for one another.  This is Ed Dunn with Kadena Marina and we will see ya down under.