Version May 2024
| Affected organ system and manifestations | % of DCS cases | Description |
| Musculoskeletal: pain | 50-65 | Often described as a deep, boring ache in shoulder, elbow, hip, or knee area, unaffected by joint movement, usually without local tenderness; may be multifocal and poorly localized |
| Cutaneous | ||
| Rash and itch | 5-10 | An erythematous, poorly demarcated patch, often itchy, or a more clearly circumscribed, reticular rash with cyanotic discoloration (cutis marmorata or livedo racemosa); usually a truncal or proximal distribution |
| Patchy paresthesia | 40-50 | Nondermatomal distribution; often described as tingling |
| Lymphatic: subcutaneous swelling | 1-5 | Truncal distribution, similar to that of rash, particularly involving upper chest and shoulders |
| Spinal cord | ||
| Motor weakness | 20-25 | Typically, paraplegia or quadriplegia with upper motor neuron signs; severity ranges from subtle to dense |
| Numbness or dense paresthesia | 20-30 | Dorsal columns appear to be vulnerable; proprioception may be affected |
| Bladder and sphincter dystonia | 1 | Bladder also becomes insensate; urinary retention |
| Girdle, chest, back, or abdominal pain | 1-5 | Typically, a premonitory symptom that precedes other spinal symptoms |
| Inner ear | ||
| Vestibular: vertigo, ataxia | 10-20 | Usually accompanied by nausea and nystagmus; 75% of inner ear DCS cases have no other symptoms |
| Cochlear: hearing loss, tinnitus | 1-5 | Cochlear manifestations are less common than vestibular manifestations in DCS |
| Brain (cerebral): cognitive impairment, scotomata, visual field changes, focal weakness, ataxia | 5-10 | Typically, mild executive dysfunction (eg, impaired concentration or memory); gross focal lesions considered to be less common in DCS than in AGE |
| Cardiopulmonary: dyspnea, cough, chest pain ("the chokes") | 1-5 | Typically associated with provocative events such as rapid ascent or omitted decompression after deep dives |
| Cardiovascular: hemoconcentration, shock, coagulopathy | <1 | Rare; typically associated with provocative events such as rapid ascent or omitted decompression after deep dives |
| Constitutional, including fatigue, malaise, headache | 20-40 | Often described as similar to a viral infection |
AGE: arterial gas embolism.
* Approximate proportions of divers affected are based on data from various sources.[1-3]From: Mitchell SJ, Bennett MH, Moon RE. Decompression sickness and arterial gas embolism. N Engl J Med 2022; 386:1254. Copyright © 2022 Massachusetts Medical Society. Reprinted with permission from Massachusetts Medical Society.
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