Skeletal Fluorosis: A Case Report of Rare Diagnosis of Computer-cleaner Toxicosis.

Abstract

Original study online at
https://escholarship.org/uc/item/2fp1z08h

Introduction: Skeletal fluorosis is a complication of excess fluoride, which may be associated with
chronic inhalation or “huffing” of compressed air cleaners for keyboards and electronics. The rare
presentation of this condition can lead to a missed diagnosis and lack of appropriate intervention.
Clinicians should be aware of the potential development of fluorosis in patients reporting a history of
inhalant abuse.

Case Report: We present a case of skeletal fluorosis in a 46-year-old female patient with a four-
month history of daily inhalant use of computer cleaner containing difluoroethane (DFE). She
presented to the emergency department after developing myalgias for approximately four months.
The pain was alleviated by rest, heat therapy, and pain medication. She was noted to have diffuse
bilateral swelling to upper and lower extremities, as well as interphalangeal joint swelling and non-
mobile lesions to bilateral hands and left forearm on physical exam. Radiography revealed diffuse
periosteal reaction throughout the hand and forearm suggestive of fluorosis. She was counseled to
cease inhalant use.

Conclusion: Skeletal fluorosis is a rare and painful condition that can have prolonged adverse
effects and a lasting impact on quality of life. Patients who report regular inhalant use should be
counseled on the potential toxicities of these products and encouraged to discontinue use of DFE.
Those presenting with diffuse skeletal findings and reported DFE use should be evaluated for
skeletal fluorosis.