Abstract
Two illustrative cases of patients with skeletal fluorosis and classic radiographic changes are presented. One patient demonstrated a progressive paraparesis, while the other was diagnosed incidentally on routine radiographs. A review of the literature, treatment, and histologic findings are presented.
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Endemic fluorosis in the Madras presidency
1. Ten cases of chronic fluorine intoxication have been investigated, clinically, radiologically, and, as regards blood and urine, biochemically. 2. The clinical picture is described and relates chiefly to disabilities caused by calcification of ligaments, tendons and fasciae, the formation of osteophytic outgrowths of bone and the nervous effects of mechanical
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Neurological complications of endemic skeletal fluorosis, with special emphasis on radiculo-myelopathy
The results of surveys carried out between 1976 and 1985 in the fluorosis-endemic area of the Ethiopian Rift Valley is summarised, with emphasis on the neurological complications resulting from the crippling osteofluorosis. The neurological manifestations in the forms of myelopathy with and without radiculopathy (respectively 72% and 28%) occurred after exposure
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Radiculomyopathy in a southwestern Indian due to skeletal fluorosis
The findings of a Papago Indian with the second reported case of fluorotic radiculomyopathy in the United States are presented. Neurological deficits occurring in this entity as a manifestation of spinal cord and nerve root bony compression are described. This radiculomyopathy is rare but it is of regional importance since
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Spinal cord compression revealing fluorosis
1. Introduction Bone fluorosis due to high fluoride contents in water and soil is endemic in North Africa and India. Neurological complications are rare. They consist of nerve root or spinal cord compression by bony excrescences, which predominate at the cervical spine. We report a new case of spinal cord compression
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Intraosseous schwannoma of the cervical spine associated with skeletal fluorosis
Intraosseous Schwannoma of the cervical spine is very rare. Its association with skeletal fluorosis is also extremely rare. A case of successfully treated intraosseous neurofibroma of the cervical spine associated with skeletal fluorosis causing tetraparesis is reported. The clinical features, diagnostic aspects and the management is described and the literature
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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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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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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 & Spinal Stenosis
Spinal stenosis is a narrowing of the spaces in the spine that results in pressure being placed on the spinal cord and/or nerve roots. Although stenosis can develop without symptoms, it may produce numbness, tingling, pain and difficulty in walking, as well as a heavy/tired feeling in the legs. It is estimated that 250,000 to 500,000 Americans currently have symptoms of spinal stenosis. Skeletal fluorosis is one cause of stenosis.
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Fluoride Magnifies Impact of Repetitive Stress on Joints
Research has repeatedly found that fluoride's effect on the skeleton is most pronounced in the bones and joints that undergo the greatest strain. Indeed, both the symptoms of fluorosis (i.e., joint pain and stiffness) as well as the radiological findings (e.g., exostoses, interosseuous membrane calcification) have been found to occur earliest, and most severely, in the joints
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