What could indicate an orthopedic trauma instead of DCS?

The persistence of pain despite treatment is a strong indicator of orthopedic trauma rather than decompression sickness (DCS). In cases of orthopedic injuries, such as fractures or significant soft tissue damage, pain often remains severe even after initial interventions, including medication or immobilization. This continuous pain can signal an ongoing injury that requires additional evaluation or treatment, making orthopedic trauma a more likely diagnosis.

In contrast, while swelling can occur in both orthopedic injuries and DCS, it is not specific enough to differentiate between the two. Joint rigidity can also be present in orthopedic trauma, but it is not as definitive a sign as persistent pain. Marbling on the skin is more characteristic of DCS, particularly in more advanced stages, where skin changes occur due to gas bubbles affecting the dermal blood supply. Therefore, recognizing that persistent pain is not alleviated by standard treatments directs the assessment toward orthopedic trauma as a primary consideration.