How can you tell if Type 1 DCS joint pain is due to DCS or a bruise?

• A. DCS is diagnosed solely by location of pain.
• B. Any joint pain after a dive means DCS.
• C. Only pain in the shoulder indicates DCS.
• D. Pain that worsens over time after the dive suggests DCS; otherwise it may be an injury; if unsure, recompress.

Answer: (D)

The key idea is that the time course after surfacing helps distinguish DCS-related joint pain from a simple bruise. Pain from decompression illness often starts after you’ve finished the dive and can worsen as hours pass, reflecting gas coming out of solution and affecting joints. A bruise, by contrast, comes from an injury during the dive and typically follows its own healing pattern rather than progressively getting worse due to the dive itself. So, when you see pain that worsens over time after the dive, it raises concern for DCS rather than a routine injury. If there’s any doubt, the safe approach is to recompress, because early treatment improves outcomes for potential DCS. Location alone isn’t enough to diagnose DCS, and assuming all joint pain after a dive is DCS isn’t correct; the progression over time is the telltale sign.