Abstract

Objective: To compare the diagnosis of endemic skeletal fluorosis by means of clinical examination to diagnosis by x-ray, in order to provide a foundation for revising standards of clinical diagnosis for endemic osteofluorosis.

Method: The study was carried out using existing data. The fluoride levels of 15 villages in the Qianan and Nongan counties of Jilin, where residents continue to drink from naturally fluoridated sources, were divided into 11 categories based on the fluoride content of the water: 0.5, 1.0, 1.5, 2.0, 2.2, 2.4, 3.0, 3.5, 4.0, 6.0, and 7.0 mg/L.  675 residents between the ages of 16 and 60 who had lived in the area for at least 10 years were selected as subjects; the results of their diagnosis by either clinical examination or x-ray examination were analyzed and compared.

Results: For subjects drinking water with fluoride concentrations of 2.0, 2.2, 2.4, 3.0, and 4.0 mg/L, clinical detection rates (21.43%, 22.45%, 21.28%, 19.05%, 38.89%) were markedly higher than x-ray detection rates (0, 2.04%, 9%, 4.76%, 12.96%; ?2 = 7.96, 9.49, 11.19, 4.08, 9.45, p < 0.05). The detection rate for x-rays were zero at fluoride concentrations of 2.0 and 2.4 mg/L, and still relatively low at 3.0 and 4.0 mg/L.  At fluoride concentrations of 0.5, 1.0, 1.5, 3.5, 6.0, 7.0 mg/L, the difference between the clinical detection rates (1.00%, 4.44%, 7.23%, 18.00%, 54.39%, 49.18%) and x-ray detection rates (0, 2.22%, 3.61%, 8.00%, 36.84%, 52.46%) was not statistically significant ( ?2  = 1.00, 0.17, 0.47, 2.21, 3.54, 0.13, p > 0.05)

Conclusion: With both the clinical and x-ray method, the detection rate increases with the concentration of fluoride in the local water, and the clinical detection rate increases more reliably with concentration than the x-ray detection rate.

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