One of the most common radiological findings in skeletal fluorosis is osteosclerosis – a hardening of bones with a blurring of the trabecular structure. In advanced cases, the osteosclerotic form of fluorosis may closely resemble the appearance of osteopetrosis, a “marble bone” disease in which the bones are dense, but fragile and prone to fracture.

Fluoride & Osteopetrosis:

“In the differential diagnosis (of skeletal fluorosis) one must think of osteopetrosis (marble bones), metastatic cancer, and Paget’s disease.”
SOURCE: Linsman JF, McMurray CA. (1943). Fluoride osteosclerosis from drinking water. Radiology 40: 474-484.

“Other diseases simulating radiographic features of fluorosis are Paget’s disease, parathyroid hormone disorders, osteopetrosis, chronic renal failure, myelofibrosis, hypophosphatemic osteomalacia, and diffuse blastic metastases.”
SOURCE: Fisher RL, et al. (1989). Endemic fluorosis with spinal cord compression. A case report and review. Archives of Internal Medicine 149: 697-700.

“In addition to osteopetrosis and osteoblastic metastases, the differential diagnosis (of skeletal fluorosis) includes Paget’s disease…”
SOURCE: Morris JW. (1965). Skeletal fluorosis among indians of the American Southwest. American Journal of Roentgenology, Radium Therapy & Nuclear Medicine 94: 608-615.

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