Abstract
The purpose of this prospective study was to investigate the quantity and quality of bone by quantitative ultrasound (QUS) measurements and to assess bone resorption by urinary excretion measurement of C-terminal telopeptide of type I collagen (CTX) in an adult Turkish population living in an endemic fluorosis area and consuming drinking water with a high fluoride (F) concentration (mean 3.57 ppm F). Excretion of urinary CTX, heel broadband ultrasound attenuation (HBUA; dB/MHz), and speed of sound (SOS; m/s) were examined in 122 Turkish adults (37 pre- menopausal, 40 post-menopausal women, and 45 men) living in the endemic fluorosis area. For comparison, the same measurements were made on 117 controls (48 pre-menopausal women, 34 post-menopausal women, and 35 men) living in a nonendemic low F water area (mean 0.4 ppm F). In the F endemic area urinary excretion of CTX was higher in all subjects, whereas calcaneal BUA was lower in post-menopausal women. In the F endemic area SOS was significantly greater among pre-menopausal women but was not significantly different in the other two groups. Although non-trauma bone fracture rates were not significantly different among any of the groups, some of the bone marker differences indicate that exposure to prolonged high concentration of F may increase the risk of bone fracture, especially in post-menopausal women.
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Bilateral fractures of femoral neck in patients with moderate renal failure receiving fluoride for spinal osteoporosis
Two patients with moderate renal failure sustained spontaneous bilateral hip fractures during treatment with fluoride, calcium, and vitamin D for osteoporosis. They had been taking sodium fluoride (40-60 mg/day) for 11 and 21 months, respectively. Histological examination of a specimen of the bone showed severe fluorosis in the first case,
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Total knee arthroplasty in a patient with skeletal fluorosis
Published reports on patients with skeletal fluorosis undergoing total knee arthroplasty are rare. Skeletal fluorosis is a chronic condition that occurs secondary to the ingestion of food and water that contain high levels of fluoride. Although fluorosis may be described as osteosclerotic and marble-like in appearance, features may also include
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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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Mechanical properties and density of bone in a case of severe endemic fluorosis
Mechanical properties of 25 standardized specimens of compact bone from a 45-year-old man with extreme endemic fluorosis were compared with similar specimens of nonfluorotic bone. Data from dry and wet tested specimens were compared. Tensile strength, strain, energy absorbed to failure, and modulus of elasticity were reduced in fluorotic specimens
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A case of thick but brittle bones and instant tea
CASE DESCRIPTION A 45-year-old white male was found to have radiographic findings of a diffusely dense appendicular skeleton, mild trabecular thickening, and multiple thoracic compression fractures indicating structural weakness. Bone mineral density was above the expected range for his age on the lumbar spine and femoral neck. Social history was significant
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Fluoride Reduces Bone Strength Prior to Onset of Skeletal Fluorosis
The majority of animal studies investigating fluoride's impact on bone strength have found that fluoride has either no effect, or a detrimental effect, on bone strength. Importantly, several of the animal studies that have found fluoride reductes bone strength have reported that this reduction in strength occurs before signs of skeletal fluorosis
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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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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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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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