Abstract

Skeletal fluorosis is well known, particularly in the spine, pelvis and forearm. However, the hand may also be involved. The authors report two cases of this site in endemic areas in Senegal, after ingestion of large amounts of fluoride in the water. Fluorosis consisted of deforming metacarpal and phalangeal osteoperiotitis in one case and peri-articular ossifications and calcifications of the attachments of the ligaments and capsule in the other case. They review the literature concerning skeletal fluorosis and discuss the rarity of hand involvement its clinical features and particularly its radiological features. Lastly, they emphasize the differential diagnosis with certain metabolic, infectious and neoplastic diseases.

• Related Studies :

  • An uncommon presentation of fluorosis

    A 70 years old farmer from Yemen was referred as a case of osteoarthritis of both knees for preoperative rehabilitation procedures. Six years before he developed progressive skeletal stiffness. By 70 years he became dependent for ambulation and many other self-care activities. He showed quadriparesis resulting from compression of spinal cord

  • Industrial skeletal fluorosis: preliminary report on 61 cases from aluminum smelter

    SchIegel presented data on 61 cases of skeletal f1uorosis among workers of a Swiss aluminum factory. Of 350 cases ofìndustrial fluorosis reported in the world's literature, approximately 20 occcured in the smelting area of the aluminum industry. For processing aluminum from clay, cryolite (NaAlF6) is used as a fluxing agent.

  • Radiological criteria of industrial fluorosis

    The bone radiographs of 43 potroom workers in an aluminium factory, on whom the diagnosis of industrial fluorosis had been confirmed by bone biopsy, are compared with radiographs from 18 control subjects. A higher frequency of ossification of ligament, tendon, and muscle attachments is observed among the fluoride exposed subjects.

  • Skeletal fluorosis mimicking seronegative arthritis

    Fluorosis is endemic in certain parts of the world, especially the Asian subcontinent (1). We report an unusual presentation of fluorosis mimicking seronegative spondyloarthritis. Although fluorosis is known to cause irritable bowel syndrome-like disorder and joint pain, this could be wrongly diagnosed as a case of seronegative arthritis. Case report A 35-year-old

  • Bone mineral structure after six years fluoride treatment investigated by backscattered electron imaging (BSEI) and small angle x-ray scattering (SAXS): a case report

    NaF, a bone formation stimulating agent, is used for the treatment of osteoporosis. Controversy exists concerning the quality of the newly formed bone and the antifracture effectiveness. We report about a 70 years old woman, who had received 50 mg NaF/d for about 6 years. Calcium or Vit D supplements

• Related FAN Content :

  • 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.

  • "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.

  • 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.

  • 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.

  • Skeletal Fluorosis in India & China

    In India and China, scientists have repeatedly found that skeletal fluorosis occurs in populations drinking water with just 0.7 to 1.5 ppm fluoride. Although nutritional deficiencies and hot climates make populations in India and China more susceptible to fluoride toxicity than is generally the case in western countries, this fact does not remove the relevance of the Indian and Chinese experience to the situation in fluoridating countries. This is because (a) nutritional deficiencies also exist in the western world, particularly in low-income communities, and (b) some individuals, including those with kidney disease, can be just as -- if not more -- susceptible to fluoride toxicity.