Abstract
This paper presents X-ray manifestations of industrial fluorosis in 100 cases. It is recognized that increasing density, bony structure changes and periosseous hyperplasia with calcification or ossification, especially the process of hyperplastic calcification of the posterior margin of tibia and interosseous membrane of radius and ulna, constitute the main criteria for the diagnosis of this clinical entity. Often all the above-mentioned processes make their appearance in the early stage of the disease but they may be delayed until the later stages. Preliminary analysis of the causes of this manifestation and classification of the stages of this disease with its various types are herein discussed.
-
-
Recovery from skeletal fluorosis
Kurland et al.(1) reported a fascinating case of skeletal fluorosis in a man who probably ingested significant quantities of fluoride from toothpaste. They report that after withdrawal of fluoride, there was a short initial period of rapid bone loss, followed by a prolonged period of slow BMD loss from the
-
Further observations on radiological changes of endemic food borne skeletal fluorosis
Among radiological changes in 396 cases of foodborne skeletal fluorosis, from 4 endemic areas in Guizhou, China, osteoporosis, osteomalacia and impaired bone growth were seen in addition to previously recorded findings of osteosclerosis, bone prominences, joint changes and calcification of peripheral arteries. The deformity of genu valgum, a manifestation of
-
Endemic skeletal fluorosis in children: hypocalcemia and the presence of renal resistance to parathyroid hormone
Although endemic skeletal fluorosis has been reported in children, hypocalcemia has not been previously noted. In a prevalence study of 260 schoolchildren living in an endemic fluorosis area in South Africa (water fluoride content 8-12 ppm), hypocalcemia was documented in 23%. Furthermore in a separate study of nine children with skeletal symptoms due to
-
Changes in basic metabolic elements associated with the degeneration and ossification of ligamenta flava
OBJECTIVE: To determine the association between levels of basic metabolic elements and degeneration and ossification of the ligamentum flavum (LF). SUBJECTS: Fourteen consecutive patients with degenerative lumbar stenosis, 11 with ossification of the thoracic ligamenta flava, and 11 control subjects. METHODS: The basic elements of calcium (Ca), phosphorus (P), magnesium (Mg), zinc
-
Relations between environment and endemic fluorosis in Hohhot region, Inner Mongolia
Results are reported of a comprehensive investigation into fluoride levels in drinking water and other environmental characteristics, and their relation to endemic fluorosis, in Hohhot Region, Inner Mongolia.
Related Studies :
-
-
-
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.
-
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.
-
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.
-
"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.
-
X-Ray Diagnosis of Skeletal Fluorosis
In 1937, Kaj Roholm published his seminal study Fluorine Intoxication in which he described three phases of bone changes that occur in skeletal fluorosis. (See below). These three phases, which are detectable by x-ray, have been widely used as a diagnostic guide for detecting the disease. They describe an osteosclerotic bone disease that develops first in the axial skeleton (the spine, pelvis, and ribs), and ultimately results in extensive calcification of ligaments and cartilage, as well as bony outgrowths such as osteophytes and exostoses. Subsequent research has found, however, that x-rays provide a very crude measure for diagnosing fluorosis since the disease can cause symptoms and effects (e.g., osteoarthritis) before, and in the absence of, radiologicaly detectable osteosclerosis in the spine.
Related FAN Content :
-