Abstract

Fluoride excess primarily effects dental and skeletal tissues. leading to a condition known as endemic fluorosis. The radiological and clinical features of endemic fluorosis vary in different parts of the world. The aim of this study was to investigate the clinical and radiological features of endemic fluorosis in Turkish patients. Physical examination and radiological investigations were performed in 56 patients with endemic fluorosis and 40 age- and sex-matched controls. Knee osteoarthritis (OA) was the main abnormality in both groups, both clinically and radiologically. The radiological severity of knee OA was greater in the endemic fluorosis group than in controls (P=0.01). Osteophytes at the tibial condyles and superior margin of the patellar articular surface of the femur, polyp-like osteophytes on the non-weight-bearing medial side of the femoral condyle, and popliteal loose bodies were detected more frequently in the endemic fluorosis group than in controls (P=0.0001). We suggest that the presence of atypically located osteophytes in the knees may be a feature of endemic fluorosis in Turkish patients and that endemic fluorosis may increase the severity of OA in the knees.

Excerpt:

Endemic fluorosis may increase the severity of osteoarthritis in the knees. . . . Twelve patients (21.4%) with endemic fluorosis and eight control patients (20%) had grade 2 osteoarthritis, 16 patients (28.6%) with endemic fluorosis and three control patients (7.5%) had grade 3 osteoarthritis, and six patients (10.7%) with endemic fluorosis and one control patient (2.5%) had grade 4 osteoarthritis. The osteoarthritis severity was greater in the endemic fluorosis group. Osteophytes at the anterior and posterior parts of the tibial condyles, osteophytes at the superior margin of the patellar articular surface of the femur, and popliteal loose bodies were detected more frequently in the endemic fluorosis group than in controls. There was no difference between groups in the existence of osteophytes at the superior and inferior margins of the patella. However, these osteophytes were larger in endemic fluorosis patients than in controls (p = 0.001). Twenty-five (44.6%) patients with endemic fluorosis had polyp-like osteophytes at the medial non-weight-bearing margin of the femoral condyle. This kind of osteophyte was not detected in controls. . . . Further studies are needed in order to understand the exact mechanism of bone and cartilage changes in the knees of patients with endemic fluorosis.

… Fluoride mainly affects bone metabolism. However, cartilage is one of its deposition areas. In an animal study, it was shown that excessive fluoride ingestion caused necrosis of articular chrondocytes, ulcer formation, and articular calcification.

Print PDF

• Related Studies :

  • Occupational skeletal fluorosis

    Conclusion Four cases of skeletal fluorosis are described in individuals who had been working in an aluminum plant for periods up to 12 yens. Two patients exhibited radiological changes indicative of the first stage of the disease and two of the second stage. All patients exhibited backache, pains in arms and

  • [Two cases of skeletal fluorosis in the hand].

    Skeletal fluorosis is well known, particularly in the spine, pelvis and forearm. However, the hand may also be involved. The authors report two cases of this site in endemic areas in Senegal, after ingestion of large amounts of fluoride in the water. Fluorosis consisted of deforming metacarpal and phalangeal osteoperiotitis in one case

  • A roentgenologic study of a human population exposed to high-fluoride domestic water; a ten-year study

    As shown in Table 1, a limited number of participants from both Bartlett and Cameron showed some degree of roentgenographic bone change but, in general, these changes were minimal. There was a larger number with no observable change in the ten-year interval, a fact disregarded or unreported in most fluoride

  • Radiological analysis of fluorotic elbow arthritis

    This article has reported the radiological signs in 109 cases of fluorotic elbow arthritis: sclerosis, irregularity and discontinuity of the articular surfaces; coarsened bone striation below the articular surface, trabecular coarsening and rarefaction, sparseness of trabeculae or density changes along with areas of cystic radiolucency. The author first suggested osteophyte

  • The impact of fluoride in drinking water on oral health and skeletal system of school children

    Modern life styles even among people in rural areas have created an increased demand for dental cosmetology. Dental fluorosis due to its cosmetic effect gains more public health importance today. In the scenario of increasing awareness of environmental health hazards, among people, the research into the biology of fluorosis conducted

• Related FAN Content :

  • "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.

  • 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.

  • Skeletal Fluorosis: The Misdiagnosis Problem

    It is a virtual certainty that there are individuals in the general population unknowingly suffering from some form of skeletal fluorosis as a result of a doctor's failure to consider fluoride as a cause of their symptoms. Proof that this is the case can be found in the following case reports of skeletal fluorosis written by doctors in the U.S. and other western countries. As can be seen, a consistent feature of these reports is that fluorosis patients--even those with crippling skeletal fluorosis--are misdiagnosed for years by multiple teams of doctors who routinely fail to consider fluoride as a possible cause of their disease.

  • Fluoride & Spondylosis; Spondylitis

    Among individuals with skeletal fluorosis, the fluoride-induced changes to the spine, and the accompanying symptoms, can bear a close resemblance to spondylosis and spondylitis (as well as DISH). Spondylosis is a (non-inflammatory) degenerative disease of the spine marked by bony outgrowths (spurs) which can produce nerve cord compression. Spondylitis, by contrast, is an inflammatory form of arthritis that causes inflammation in the joints between the vertebrae. Whereas spondylosis is generally asymptomatic, spondylitis generally causes significant pain and stiffness in the spine.

  • Skeletal Changes in Industrial and Endemic Fluorosis

    Fluorotic changes in bones and joints were evaluated in 105 aluminum workers and 20 residents of an endemic fluorosis region in India.