Abstract
In a 68-year-old man with a painful syndrome of the lower extremities which began at the age of 64 years, workup revealed a generalized osteopathy with sclerosis of the axial skeleton and osteopenia at the extremities associated with pathologic fractures. The occupational history showed exposure to several synthetics such as vinyl chloride, polyethylene, delrine and polyamides over 30 years. However, a presumptive connection between the skeletal disorder and the occupational exposure could not initially be substantiated. In a later analysis of the bone biopsies from 1991, a significant increase of fluorine in the tibia and fibula of the patient was detected and thus the diagnosis of industrial fluorosis established. The fluorine presumably originated from the workup of polytetrafluorethylene plates. A detailed analysis of the workplace is ongoing. The fluorosis may obviously appear as a variable skeletal disease. The clinical picture of fluorosis is incompletely described in most of the German textbooks. It calls for an extended description of the X-ray findings associated with fluorosis and a new definition of the disease.
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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
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Total knee arthroplasty in a patient with skeletal fluorosis
Published reports on patients with skeletal fluorosis undergoing total knee arthroplasty are rare. Skeletal fluorosis is a chronic condition that occurs secondary to the ingestion of food and water that contain high levels of fluoride. Although fluorosis may be described as osteosclerotic and marble-like in appearance, features may also include
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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
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Back pain in chronic renal failure.
Article w/o Photos (see pdf attached) Patient SK, a 40-yr-old female, resident of Bhagalpur village in Bihar, India, was operated for gallstones 3 years previously. On pre-operative checkup, mild renal dysfunction was detected. She was asymptomatic for renal disease with serum creatinine of 159 mmol/l (1.8mg/dl), bland urinary sediment and small echo-genic kidneys on ultrasound. She was
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X-ray diagnosis of fluorine-associated arthropathy
I. Pathological basis and X-ray signs of fluorine-associated arthropathy Long-term uptake of excessive fluorine may cause pathological changes of bone structure and bone periphery; furthermore, animal experiments and epidemiological investigations demonstrate that fluorosis may cause necrosis, degeneration and ulceration of articular cartilage, and also cause necrosis of subchondral bones, leading to
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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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Skeletal Fluorosis Causes Bones to be Brittle & Prone to Fracture
It has been known since as the early as the 1930s that patients with skeletal fluorosis have bone that is more brittle and prone to fracture. More recently, however, researchers have found that fluoride can reduce bone strength before the onset of skeletal fluorosis. Included below are some of the
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