Abstract
Radiographs of 80 patients with severe endemic fluorosis of coal-burning type [CBEF] – 49 males and 31 females aged 30 to 70 years – were analysed to examine the changes to the bone substance, peripheral structure of bone, and joints. The changes to bone substance were: 1) osteosclerosis type, 62 cases (77.5%); 2) mixed type, 16 cases (21.25%); 3) osteoporosis type, one case (1.25%); 4) osteomalacia type, one case (1.25%). The changes to the joints were: articular lesions were found in the hips and elbows in 79 cases (98.75%), and in the knees in 75 cases (93.75%). When combinations of the above three changes occur, the classification of the disease is according to the most severe one of the three. Our findings can increase the accuracy of X-ray diagnosis, making it more consistent with clinical diagnosis, thus improving prevention and treatment of CBEF.
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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.
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Industrial fluorosis [Boillat et al.]
43 potroom workers (aluminium industry) with fluorosis have been compared with 18 foundry workers of the same age, but who had never been exposed to fluorides. Clinical examination revealed a higher incidence of articular pain and limitation of motion in the exposed group. The diagnosis of fluorosis is not only
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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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Rapid-onset diffuse skeletal fluorosis from inhalant abuse
Case: A thirty-year-old man presented with severely debilitating left hip pain and stiffness. Radiographs demonstrated diffuse osteosclerosis and heterotopic bone formation with near ankylosis of the left hip. The patient underwent successful joint-preserving surgery to restore hip range of motion. After disclosing a history of inhalant abuse, which was confirmed
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Ancient and recent evidence of endemic fluorosis in the Naples area
Endemic fluorosis induced by high concentrations of natural fluoride in groundwater and soils is a major health problem in several countries, particularly in volcanic areas. The early stages of skeletal fluorosis, a chronic metabolic bone and joint disease rarely considered in palaeopathological diagnoses, are often misdiagnosed in endemic areas. In
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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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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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"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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Skeletal Fluorosis in the U.S.
Although there has been a notable absence of systematic studies on skeletal fluorosis in the U.S., the available evidence indicates that the consumption of artificially fluoridated water is likely to cause skeletal fluorosis and other forms of bone disease in people with kidney disease and other vulnerable populations.
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