Abstract
Pain and swelling of the large joints of the lower limbs occur in about 33% of patients receiving sodium fluoride, calcium, and vitamin D therapy. In a previous study we described radiographic and scintigraphic features suggesting that these symptoms are due to juxtaarticular stress fractures. We now report the histologic features of one such lesion in a calcaneum of a patient receiving fluoride, calcium, and 1 alpha-vitamin D therapy for postmenopausal osteoporosis. Bone biopsy after tetracycline double labeling showed a trabecular fissure fracture and large intratrabecular resorption cavities surrounded by microcallus. Comparison of the static and dynamic histomorphometric parameters in the calcaneum with those in the simultaneously taken iliac bone biopsy showed a marked regional acceleratory phenomenon in the calcaneum that we ascribe to the microfractures. It cannot be said with certainty whether the microfractures resulted from the osteoporosis, the vitamin D, or the sodium fluoride therapy.
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Industrial Fluorosis [Carnow et al.]
SUMMARY: In 1242 apparently healthy and actively employed workers of a Canadian aluminum facility, the history of musculoskeletal symptoms, of the incidence of fractures, of neck and back surgery, as well as the x-ray findings were reviewed. A highly significant relationship of exposure to fluoride was established with the frequency
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Long-term fluoride therapy of postmenopausal osteoporosis
The benefit of sodium fluoride (NaF) in the therapy of osteoporosis is still controversial. For 3 years we monitored patients with postmenopausal osteoporosis subjected to a continuous treatment with 80 mg NaF/day and patients without fluoride treatment. Every 3 months peripheral total and trabecular bone densities were evaluated with high-precision
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Fluoridation and bone disease in renal patients
About the Authors: William J Johnson, director of the Mayo Artificial Kidney Center and professor of medicine with the Division of Nephrology at the Mayo Clinic, has been involved in the study of calcium and phosphorus metabolism and renal osteodystrophy, potassium metabolism, and uremic neuropathy. He is past chairman of the Minnesota
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Effects of dialysate calcium and fluoride on bone disease during regular hemodialysis
A previous study indicated that, in patients maintained by hemodialysis, clinically and roentgenographically apparent bone disease appeared almost exclusively when the dialystate calcium concentration was less than 5.7 mg per 100 ml. In the present study, bone biopsy specimens from the iliac crest were studied at the beginning and end
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Supraacetabular and femoral head stress fracture during fluoride treatment
A woman treated with fluoride for corticosteroid-induced osteoporosis presented 1 year later with an unusual localized supraacetabular followed by a same-sided femoral head fracture. Fluoride was increased in serum and urine. Transiliac bone biopsy revealed typical bone fluorosis with elevated trabecular bone fluoride.
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The Relationship Between Fluoride, Bone Density, and Bone Strength
Although fluoride has generally been found to reduce the bone density of cortical bone, it is well documented that fluoride can increase the density of trabecular bone (aka cancellous bone). Trabecular bone is the primary bone of the spine, whereas cortical bone is the primary bone of the legs and arms. While increases in
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Mechanisms by which fluoride may reduce bone strength
Based on a large body of animal and human research, it is now known that fluoride ingestion can reduce bone strength and increase the rate of fracture. There are several plausible mechanisms by which fluoride can reduce bone strength. As discussed below, these mechanisms include: Reduction in Cortical Bone Density De-bonding of
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Fluoride & Osteoarthritis
While the osteoarthritic effects that occurred from fluoride exposure were once considered to be limited to those with skeletal fluorosis, recent research shows that fluoride can cause osteoarthritis in the absence of traditionally defined fluorosis. Conventional methods used for detecting skeletal fluorosis, therefore, will fail to detect the full range of people suffering from fluoride-induced osteoarthritis.
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Fluoride Content of Bone Impairs Bone Quality
Water Fluoridation Increases the Fluoride Content of Bone "Fluoride analyses of the cadaver material from Kuopio revealed that fluoridation of drinking water increases the fluoride concentration in bone. In some individual cases the amount of fluoride in trabecular bone may rise to relatively high levels, notably in patients with impaired renal
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"Pre-Skeletal" Fluorosis
As demonstrated by the studies below, skeletal fluorosis may produce adverse symptoms, including arthritic pains, clinical osteoarthritis, gastrointestinal disturbances, and bone fragility, before the classic bone change of fluorosis (i.e., osteosclerosis in the spine and pelvis) is detectable by x-ray. Relying on x-rays, therefore, to diagnosis skeletal fluorosis will invariably fail to protect those individuals who are suffering from the pre-skeletal phase of the disease. Moreover, some individuals with clinical skeletal fluorosis will not develop an increase in bone density, let alone osteosclerosis, of the spine. Thus, relying on unusual increases in spinal bone density will under-detect the rate of skeletal fluoride poisoning in a population.
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