Fluoride excess primarily effects dental and skeletal tissues. leading to a condition known as endemic fluorosis. The radiological and clinical features of endemic fluorosis vary in different parts of the world. The aim of this study was to investigate the clinical and radiological features of endemic fluorosis in Turkish patients. Physical examination and radiological investigations were performed in 56 patients with endemic fluorosis and 40 age- and sex-matched controls. Knee osteoarthritis (OA) was the main abnormality in both groups, both clinically and radiologically. The radiological severity of knee OA was greater in the endemic fluorosis group than in controls (P=0.01). Osteophytes at the tibial condyles and superior margin of the patellar articular surface of the femur, polyp-like osteophytes on the non-weight-bearing medial side of the femoral condyle, and popliteal loose bodies were detected more frequently in the endemic fluorosis group than in controls (P=0.0001). We suggest that the presence of atypically located osteophytes in the knees may be a feature of endemic fluorosis in Turkish patients and that endemic fluorosis may increase the severity of OA in the knees.
Endemic fluorosis may increase the severity of osteoarthritis in the knees. . . . Twelve patients (21.4%) with endemic fluorosis and eight control patients (20%) had grade 2 osteoarthritis, 16 patients (28.6%) with endemic fluorosis and three control patients (7.5%) had grade 3 osteoarthritis, and six patients (10.7%) with endemic fluorosis and one control patient (2.5%) had grade 4 osteoarthritis. The osteoarthritis severity was greater in the endemic fluorosis group. Osteophytes at the anterior and posterior parts of the tibial condyles, osteophytes at the superior margin of the patellar articular surface of the femur, and popliteal loose bodies were detected more frequently in the endemic fluorosis group than in controls. There was no difference between groups in the existence of osteophytes at the superior and inferior margins of the patella. However, these osteophytes were larger in endemic fluorosis patients than in controls (p = 0.001). Twenty-five (44.6%) patients with endemic fluorosis had polyp-like osteophytes at the medial non-weight-bearing margin of the femoral condyle. This kind of osteophyte was not detected in controls. . . . Further studies are needed in order to understand the exact mechanism of bone and cartilage changes in the knees of patients with endemic fluorosis.
… Fluoride mainly affects bone metabolism. However, cartilage is one of its deposition areas. In an animal study, it was shown that excessive fluoride ingestion caused necrosis of articular chrondocytes, ulcer formation, and articular calcification.