Abstract
Fluorotic changes in bones and joints were evaluated in 105 aluminum workers and 20 residents of an endemic fluorosis region in India. The age of the workers averaged 51.2 years, and the duration of their exposure 18.2 years. The skeletal changes in the aluminum workers exhibited the same characteristics as those of endemic fluorosis. In industrial fluorosis the changes were less advanced than in endemic fluorosis. Generalized sclerosis, alterations in the bone structure and periosteal reactions are the most typical features of skeletal fluorosis; ossification of the interosseous membranes and muscle attachments, are less characteristic.
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Industrial fluorosis [Vischer et al.]
Summary Chronic fluorosis alters bone structure, leads to odd exostosis, to osseous appositions, to ossification of ligaments and tendons and their insertions. This can cause pain and discomfort. Radiological examination usually leads to the correct diagnosis; the most constant changes were found in films of elbows and forearms. Such films may
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Excision of Prominent Bony Mass Due to Skeletal Fluorosis: A Case Report.
Case: A 72-year-old man presented for evaluation of bony prominences over extremities. Radiographic imaging demonstrated masses of varying sizes extending from the cortical surfaces without medullary continuity. The patient had a history of Freon inhalation abuse and was diagnosed with skeletal fluorosis due to elevated serum fluoride levels.
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Skeletal fluorosis among Indians of the American Southwest
Presented are 20 cases of Southwestern American Indians having characteristic sclerotic bone changes caused by the ingestion of drinking water containing excessively great quantities of fluoride salts. The changes of skeletal fluorosis are described, and it is pointed out that the degree of change does not seem to correlate well
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Diagnostic criteria for endemic osteofluorosis (WS 192-1999)
According to the General Administration of Quality Supervision, Inspection, and Quarantine: National Standards Committee Proclamation (2005, No. 146), GB 16396-1996 “Clinical Diagnosis and Classification of Endemic Osteofluorosis” shall be repealed as of the date of implementation of these Criteria. These Criteria combine GB 16396-1996 “Clinical Diagnosis and Classification of Endemic Osteofluorosis”
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Mus musculus bone fluoride concentration as a useful biomarker for risk assessment of skeletal fluorosis in volcanic areas.
Fluoride is often found in elevated concentrations in volcanic areas due to the release of magmatic fluorine as hydrogen fluorine through volcanic degassing. The exposure to high levels of fluoride can affect the processes of bone formation and resorption causing skeletal fluorosis, a pathology that can easily be mistaken for
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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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Variability in Radiographic Appearance of Skeletal Fluorosis
Osteosclerosis (dense bone) is the bone change typically associated with skeletal fluorosis, particularly in the axial skeleton (spine, pelvis, and ribs). Research shows, however, that skeletal fluorosis produces a spectrum of bone changes, including osteomalacia, osteoporosis, exostoses, changes resulting from secondary hyperparathyroidism, and combinations thereof. Although the reason for this radiographic variability is not yet fully understood, it is believed to relate to the dose of fluoride consumed, the individual's nutritional status, exposure to aluminum, genetic susceptibility, presence of kidney disease, and area of the skeleton examined.
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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 & Osteomalacia
One of fluoride's most well-defined effects on bone tissue is it's ability to increase the osteoid content of bone. Osteoid is unmineralized bone tissue. When bones have too much of it, they become soft and prone to fracture -- a condition known as osteomalacia. As shown below, fluoride has repeatedly been
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