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
Although fluorinated water has benefited the population, discrepancies exist concerning the allowable concentration. Currently, the Environmental Protection Agency lists the maximum contaminant level goal at 4 mg/L and the secondary maximum contaminant level at 2 mg/L of fluoride in drinking water. It was found that even 2mg/L of fluoride in drinking water could be associated with stage 2 and 3 skeletal fluorosis. Therefore, joint stiffness and arthritis may be experienced. Reversing skeletal fl
A 47-year-old woman was referred for bone pain and abnormal findings on radiography. The patient reported that for the past 17 years, she has habitually consumed a pitcher of tea made from 100 to 150 tea bags daily (estimated fluoride intake, >20 mg per day). She reported a 5-year history of pain in the lower back, arms, legs, and hips. Because of brittleness, all her teeth had been extracted. Radiography of the forearm revealed interosseous membrane calcifications (Panel A, arrows), and radi
