Summary
1. The skeletal changes in endemic fluorosis are described from an area of the Punjab where the fluorine content of water and soil is very high.
2. A detailed description of a fluorotic skeleton is given, with its various anthropometric measurements.
3. The vertebral changes demonstrated the pathogenesis of the neurological complications observed in this condition.
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 cigarettes per day, and did not drink alcohol. He was born in the Punjab region of southern Asia and had lived there until moving to the United Kingdom
