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Our patient emphasizes the importance of considering fluoride as an explanation for osteosclerosis, and in diagnosing skeletal fluorosis especially in those who are at high risk from environmental or occupational exposure. Skeletal fluorosis, whether from current or remote exposure, is readily detected using axial DXA and diagnosed using urinary fluoride measurements. Eliminating the source of fluoride toxicity leads to a reversible disorder, albeit one that will likely linger and perhaps impact
