Abstract
146 patients with bone fluorosis were collected from endemic areas (100 from Yangyuan county of Hebei province and 46 from Beijing suburbs). X-rays of the chest, spinal column, pelvis, elbow, forearm, knee joint and leg bones were taken in every case. The drinking water fluorine content was also determined. All patients were followed up once a year for 3 years. Our investigation revealed that in different areas with similar drinking water fluorine content, X-ray findings of bone fluorosis were significantly different. Some cases presented mainly rarefaction whereas others had mainly malacia. For further research into this problem, we observed the principal X-ray changes of bone fluorosis and its pathologic basis.
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Endemic chronic fluoride toxicity and dietary calcium deficiency interaction syndromes of metabolic bone disease and deformities in India: year 2000
Epidemiological studies during 1963-1997 were conducted in 45,725 children exposed to high intake of endemic fluoride in the drinking water since their birth. Children with adequate (dietary calcium > 800 mg/d) and inadequate (dietary calcium < 300 mg/d) calcium nutrition and with comparable intakes of fluoride (mean 9.5 +/- 1.9
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Endemic fluorosis of the skeleton: radiographic features in 127 patients
OBJECTIVE: A wide range of radiographic appearances have been reported in skeletal fluorosis, but little has been written about the spectrum of radiographic features. We evaluated the spectrum of radiographic appearances in this disorder to help with its diagnosis and differentiation from other metabolic skeletal disorders. MATERIALS AND METHODS: One hundred
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Recovery from skeletal fluorosis (an enigmatic, American case)
A 52-year-old man presented with severe neck immobility and radiographic osteosclerosis. Elevated fluoride levels in serum, urine, and iliac crest bone revealed skeletal fluorosis. Nearly a decade of detailed follow-up documented considerable correction of the disorder after removal of the putative source of fluoride (toothpaste). INTRODUCTION: Skeletal fluorosis, a crippling bone
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Fluorosis and osteomalacia
Clinical history A 30-year-old taxicab driver presented with a 1-year history of low back pain radiating into the posterior aspect of both legs, stiffness during inactivity, and proximal upper and lower limb myalgia. Symptoms were poorly controlled with acetaminophen. The medical history was unremarkable. The patient was a vegetarian, smoked 5
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The effect of nutrition on the development of endemic osteomalacia in patients with skeletal fluorosis
The aim of the study was to study the relationship between nutrition and endemic osteomalacia, resulting in bone deformation with hump back, spinal curvature and "0" legs, in persons living in high drinking water fluoride areas with skeletal fluorosis. A dietary survey was made of 30-50 families from each of
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Variability in Radiographic Appearance of Skeletal Fluorosis
Osteosclerosis (dense bone) is the bone change typically associated with skeletal fluorosis, particularly in the axial skeleton (spine, pelvis, and ribs). Research shows, however, that skeletal fluorosis produces a spectrum of bone changes, including osteomalacia, osteoporosis, exostoses, changes resulting from secondary hyperparathyroidism, and combinations thereof. Although the reason for this radiographic variability is not yet fully understood, it is believed to relate to the dose of fluoride consumed, the individual's nutritional status, exposure to aluminum, genetic susceptibility, presence of kidney disease, and area of the skeleton examined.
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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 & Osteomalacia
One of fluoride's most well-defined effects on bone tissue is it's ability to increase the osteoid content of bone. Osteoid is unmineralized bone tissue. When bones have too much of it, they become soft and prone to fracture -- a condition known as osteomalacia. As shown below, fluoride has repeatedly been
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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.
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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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