Radiological spectrum of endemic fluorosis: relationship with calcium intake

Mithal, Ambrish; Trivedi, Nitin; Gupta, Sushil K.; Kumar, Sheo; Rk, Gupta

doi:10.1007/bf00197670

Cited by 56 publications

(24 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Radiologic features of SF include increased bone density (osteosclerosis); osteopenia/osteoporosis; trabecular blurring or haziness; ossification of the attachments of tendons, ligaments, and muscles; interosseous membrane calcification 8 ; and ossification of the posterior longitudinal ligament. 9 Urinary fluoride levels are the best indicators of fluoride intake.…”

Section: Discussionmentioning

confidence: 99%

Image Diagnosis: Dental and Skeletal Fluorosis

Gupta

Chhabra

2016

TPJ

View full text Add to dashboard Cite

A 45-year-old man presented to the Department of Medicine at our institution with 1 year of noninflammatory pain in multiple joints. The pain had begun in both knee joints, followed by low-back ache and neck, wrist, and foot pain. There was no associated fever or swelling of any joint. The patient did not report any history of addiction or illness but did report using fluoridated toothpaste. The patient also lived in a region of India where the problem of fluorosis is endemic. On examination, we found his teeth had brown strains and rough, pitted enamel ( Figure 1). There was diffuse tenderness at the cervical spine, the lumbosacral spine, and elbow, wrist, knee, and ankle joints. There was no swelling or restriction of movement in any of these areas. There were no neurologic deficits, and the rest of the physical examination was normal. X-ray scans showed osteosclerosis of the knee (Figure 2), ankle, wrist, pelvis, and vertebral column, and calcification of the sacrotuberous ligament (Figure 3) and the posterior longitudinal ligament (Figure 4). Twenty-four-hour urinary fluoride levels were elevated (18 ppm). The patient was advised to avoid fluoridated water, fluoridated toothpaste, and foods containing fluoride. He was kept under close follow-up and was educated about the potential development of neurologic symptoms and signs.Nishtha Gupta, MDS, is a Student in the

show abstract

Section: Discussionmentioning

confidence: 99%

Image Diagnosis: Dental and Skeletal Fluorosis

Gupta

Chhabra

2016

TPJ

View full text Add to dashboard Cite

show abstract

“…Osteosclerosis has been associated with a more aggressive disease course [15]. Findings can be similar to those of idiopathic myelofibrosis [38], fluorosis [39], sickle cell anemia [29], Paget's disease [40][41][42][43], and renal osteodystrophy [44].…”

Section: Pathophysiology and Patterns Of Skeletal Abnormalitiesmentioning

confidence: 89%

Advanced imaging of skeletal manifestations of systemic mastocytosis

et al. 2012

View full text Add to dashboard Cite

“…The absorbed fluoride also stimulates the formation of new irregular bone at the sites of tendon and ligament insertions, resulting in gradual ossification of soft tissues. In the presence of adequate dietary calcium, the main picture is of osteosclerosis; however, in cases where dietary calcium is inadequate, the absorbed fluoride may result in secondary hyperparathyroidism, leading to bone loss, so that bone density may include areas of both sclerosis and porosis (Teotia and Teotia, 1988;Mithal et al, 1993). This osteoporotic type of skeletal fluorosis occurs in children and younger adults, particularly in areas with extremely high levels of fluoride in the water (Christie, 1980;Krishnamachari, 1986).…”

Section: Background: Skeletal Fluorosismentioning

confidence: 99%

“…Calcium and magnesium in water tend to inhibit fluoride ingestion, while high sodium levels and alkalinity promote fluoride ingestion (Pinet and Pinet, 1968). Similarly, a low dietary intake of calcium and phosphorus is implicated in elevated levels of skeletal fluorosis (Mithal et al, 1993). General nutritional status also plays a role, since malnourished individuals appear to be more prone to develop dental and skeletal fluorosis (Massler and Schour, 1952).…”

Section: Predisposing Factors To Skeletal Fluorosismentioning

confidence: 99%

Paleopathology of skeletal fluorosis

Littleton

1999

Am. J. Phys. Anthropol.

View full text Add to dashboard Cite

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. 250 BC-AD 250. Approximately 4% of 255 adult skeletons in the sample have hyperostosic lesions resulting in joint ankylosis primarily of the lumbar vertebrae, as well as the major joints. These lesions most frequently occur among males in the 50+ age group. Chemical analysis on a small series of bone and dental samples confirmed the presence of high levels of fluoride, while staining of the teeth is evidence of dental fluorosis. The level of dental fluorosis is comparable with a naturally occurring fluoride level in water of between 1-2 ppm. The prevalence of hyperostosic lesions, however, appears higher than expected, and two possible reasons are suggested: confusion between a diagnosis of diffuse idiopathic skeletal hyperostosis and skeletal fluorosis on partial or less severely affected skeletons; and the presence of predisposing factors for skeletal fluorosis on the island in the past.

show abstract

Radiological spectrum of endemic fluorosis: relationship with calcium intake

Cited by 56 publications

References 10 publications

Image Diagnosis: Dental and Skeletal Fluorosis

Image Diagnosis: Dental and Skeletal Fluorosis

Advanced imaging of skeletal manifestations of systemic mastocytosis

Paleopathology of skeletal fluorosis

Contact Info

Product

Resources

About