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Skeletal fluorosis is rare in North America. It can present with back pain and extremity weakness. Immobilization of the spine and the extremity joints can occur. It is usually caused by abnormally increased oral fluoride intake over many years. Epidural lipomatosis is usually caused by idiopathic obesity or corticosteroid use. It has been linked to highly active antiretroviral therapy (HAART) for human immunodeficiency virus (HIV). Fluorosis and epidural lipomatosis are each rare causes of compressive myelopathy, and have never been described previously as a combined cause of spinal stenosis leading to myelopathy. We describe an unusual case of thoracic myelopathy due to coexistence of both conditions.
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Fluorosis... causing paraplegia... mutilating life...
Fluorosis is thought to be rare in Pakistan but endemic in various parts of the world, especially in India and China. In Pakistan only a few cases have been reported from Thar, Sibbi and Manga Mandi, with probability of fluorosis on MRI findings, supported by high drinking waterfluoride content. Neurological
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Endemic fluorosis with neurological complications in a Hampshire man
We describe below a case of skeletal fluorosis occurring in a Hampshire man who presented with neurological complications, and whose condition was appreciably improved by operation. We believe that this is the first case of its kind to be reported from Britain, and also the first case of skeletal fluorosis
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Fluorotic cervical compressive myelopathy, 20 years after laminectomy: A rare event
BACKGROUND: Spinal cord compression in flourosis is a common complication. These complications are mainly due to compression of the spinal cord by thickening and ossification of posterior longitudinal ligament and ligamentum flavum. Surgical decompression is the treatment of choice for fluorotic spinal cord compression. The recurrence of spinal cord compression
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Skeletal fluorosis causing high cervical myelopathy
Skeletal fluorosis is endemic in some parts of the world and is the result of life-long ingestion of high amounts of fluoride in drinking water. Its clinical presentation is characterized mostly by bone and dental changes with later ossification of many ligaments and interosseous membranes. We present a rare case of high cervical myelopathy
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Fluorosis in Nalgonda District, Hyderabad-Deccan
Details of inviestigations of 32 cases of skeletal fluorosis with neurological manifestations are described. The results of the eighth-nerve functions are reported. The probable factors responsible for early skeletal changes in patients from Kamaguda are discussed. A case is described in which excretion of previously stored fluoride continued in the
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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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"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 & 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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Industrial Fluorosis
A highly significant relationship of exposure to fluoride was established with the frequency of back and neck surgery, fractures, symptoms of musculoskeletal disease and past history of diseases of bones and joints in the absence of the typical findings of skeletal fluorosis. Monitoring exposed workers for the early manifestations of "musculoskeletal fluorosis" is recommended prior to the development of destructive and degenerative changes of the skeleton.
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