Diagnosis
The differential diagnosis based on the imaging findings included ossification of subperiosteal hematomas, ectopic calcification in the setting of a connective tissue disorder, and periostitis deformans secondary to fluoride intoxication. Laboratory assays were requested by the patient’s rheumatologist, which were notable for a mildly elevated alkaline phosphatase level (216 U/L, reference range=40–115 U/L) and a markedly elevated serum fluoride level (3.9 mg/L, normal range <0.2 mg/L), confirming the diagnosis of fluoride intoxication. The findings were discussed with the patient, who admitted to chronically “huffing” Freon, or inhaling the chlorofluorocarbon gas from a plastic bag.
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Skeletal fluorosis from instant tea
INTRODUCTION: Skeletal fluorosis (SF) can result from prolonged consumption of well water with >4 ppm fluoride ion (F(-); i.e., >4 mg/liter). Black and green teas can contain significant amounts of F(-). In 2005, SF caused by drinking 1-2 gallons of double-strength instant tea daily throughout adult life was reported in
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Fluoride-related bone disease associated with habitual tea consumption
Acquired osteosclerosis is a rare disorder of bone formation but an important consideration in adults with sclerotic bones or elevated bone density results. In such patients, malignancy, hepatitis C, and fluorosis should all be considered when making a diagnosis. We describe 4 patients evaluated at our Metabolic Bone Disease Clinic
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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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Rapid-onset diffuse skeletal fluorosis from inhalant abuse
Case: A thirty-year-old man presented with severely debilitating left hip pain and stiffness. Radiographs demonstrated diffuse osteosclerosis and heterotopic bone formation with near ankylosis of the left hip. The patient underwent successful joint-preserving surgery to restore hip range of motion. After disclosing a history of inhalant abuse, which was confirmed
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Industrial fluorosis [Boillat et al.]
43 potroom workers (aluminium industry) with fluorosis have been compared with 18 foundry workers of the same age, but who had never been exposed to fluorides. Clinical examination revealed a higher incidence of articular pain and limitation of motion in the exposed group. The diagnosis of fluorosis is not only
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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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"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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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 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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Gastrointestinal Problems Among Individuals with Skeletal Fluorosis
Humans suffering from skeletal fluorosis are known to suffer from an increased occurrence of gastrointestinal disorders. When fluoride intake is reduced, these gastrointestinal problems are among the first symptoms to disappear. The following are some of the studies that have examined this issue: "It is clear from the observations presented in this article
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