Abstract
Clinical and radiological investigations were performed for 2,258 aluminum workers exposed to fluoride for an average of 17.6 yr (standard deviation = 7.6). Changes in bone and joints were presented in detail in three groups: (1) exposed up to 5 yr (135 cases), (2) exposed from 6-32 yr (1,463 cases), and (3) retired workers (660 cases). A semiquantitative assessment of early fluorosis was introduced. A 20.2% incidence of fluorosis was found, but, according to Roholm, only 1.05% was in stage I. The disease was mainly in the pre-stages of O and OI. A close relationship between the occurrence of fluorosis and the time and degree of fluoride exposure was found. The difficulties in diagnosing skeletal fluorosis result from the questionable sensitivity of the x-ray techniques and from the nonspecificity of the associated symptoms. A quantitative method to assess osteosclerosis and bone structure alteration is needed.
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Alert on long-term lumbago and skelalgia not responsive to anti-rheumatic pharmacotherapy
In our work we have often dealt with patients who were diagnosed with “rheumatic or rheumatoid arthritis” in rural basic medical units or certain hospitals. A minority of those patients did have rheumatoid arthritis, but most of them did not improve with anti-rheumatic pharmacotherapy for multiple years; instead, their conditions
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Paleopathology of skeletal fluorosis
Skeletal fluorosis is one of a range of conditions causing excessive ossification and joint ankylosis in skeletons. It is rarely considered, however, in differential diagnoses of palaeopathological lesions. This paper considers the identification of skeletal fluorosis in a skeletal sample from the island of Bahrain, Arabian Gulf, dating to ca.
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X-ray changes in the forearm and crus of residents of areas in Jilin Province with varying drinking water fluoride concentrations
GOAL: To understand the characteristics of forearm and crus X-rays of residents from areas with varying concentrations of fluoride in their drinking water, providing evidence for diagnosis of osteofluorosis. METHOD: Using quantificational epidemiological methods, a total of 15 villages from Qianan and Nonan Counties of Jilin Province were selected as the
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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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Comparison of rheumatoid (ankylosing) spondylitis and crippling fluorosis
(1) Fluoride concentrations were determined for autopsy samples of rib, sacrum, ilium, vertebra, adhering soft tissue, and rib marrow from a patient suffering from rheumatoid (ankylosing) spondylitis of 10 years’ duration. The fluoride concentrations were not increased above normal levels. In this case, the increased bone density seen in this
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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 & Rheumatoid Arthritis
The symptoms of skeletal fluorosis can closely resemble rheumatoid arthritis (RA), and thus individuals with fluorosis can "easily be mistaken" as having RA. In addition, clinical research on fluoride-treated osteoporosis patients has found that fluoride exposure can exacerbate pre-existing RA, and recent research shows that the levels of fluoride found in the blood of the general population (19-57 ppb) are sufficient to effect an enzyme (15-lipoxygenase) implicated in the inflammatory process of RA.
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Factors which increase the risk for skeletal fluorosis
The risk for developing skeletal fluorosis, and the course the disease will take, is not solely dependent on the dose of fluoride ingested. Indeed, people exposed to similar doses of fluoride may experience markedly different effects. While the wide range in individual response to fluoride is not yet fully understood, the following are some of the factors that are believed to play a role.
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