DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20204610

Diagnosis and management of skeletal fluorosis in current scenario: a case report

Jalaz Jain, Shankey Dudeja, Gaurav Nandal, Ravi Sihag, Vibhuti Kumar, Deepika Jain

Abstract


Skeletal fluorosis is a rare form of toxic metabolic disease of bone characterised by increased incorporation of fluoride in bone. Skeletal fluorosis generally occurs in endemic regions where there is increased ingestion of fluorine in water and or food over a long period of time. Fluorosis is a spectrum of disease ranging from dental, non-skeletal fluorosis to skeletal fluorosis. The disease is characterised by typical clinical and radiological features that raise the suspicion towards diagnosis of the disease. Radiographic features are characterized by generalised osteosclerosis and later ossification of ligaments, tendons and interosseous membranes. Skeletal fluorosis can be easily confused with other rheumatologic disorders. People exposed to large amounts of fluoride show dental changes much earlier than the skeletal effects. Management of fluorosis generally focuses on symptomatic treatment.


Keywords


Osteosclerosis, Ossification, Skeletal fluorosis

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References


Datta P, Datta PP. Prevalence, etiology and clinical features of skeletal fluorosis: a critical review. Innovare J Med Sci. 2013;1:5-6.

Arlappa N, Aatif IQ, Srinivas R. Fluorosis in India: an overview. Int J Res Dev Health. 2013;1:97-102.

Chen J, Liu G, Kang Y, Wu B, Sun R, Zhou C et al. Coal utilization in China: environmental impacts and human health. Environ Geochem Health. 2014;36(4):735-53.

Majumdar KK. Health impact of supplying safe drinking water containing fluoride below permissible level on flourosis patients in a fluoride-endemic rural area of West Bengal. Indian J Public Health. 2011;55:303-8.

Gupta N, Gupta N, Chhabra P. Image diagnosis: dental and skeletal fluorosis. Perm J. 2016;20:105-6.

Izuora K, Twombly JG, Whitford GM, Demertzis J, Pacifici R, Whyte MP. Skeletal fluorosis from brewed tea. J Clin Endocrinol Metab. 2011;96:2318-24.

Laatar A, Mrabet D, Zakraoui L. Fluorosis in sub-Saharan Africa. Rev Rhum. 2003;70:178-82.

Kumar H, Boban M, Tiwari M. Skeletal fluorosis causing high cervical myelopathy. J Clin Neurosci. 2009;16:828-30.

Wang W, Kong L, Zhao H, Dong R, Li J, Jia Z et al. Thoracic ossification of ligamentum flavum caused by skeletal fluorosis. Eur Spine J. 2007;16(8):1119-28.

Pei J, Li B, Gao Y, Wei Y, Zhou L, Yao H et al. Fluoride decreased osteoclastic bone resorption through the inhibition of NFATc1 gene expression. Environ Toxicol. 2014;29(5):588-95.

del Carmen Aguilar-Diaz F, Federico Morales-Corona F, Cintra- Viveiro AC, Fuente-Hernández J. Prevalence of dental fluorosis in Mexico 2005-2015: a literature review. Salud Publica Mex. 2017;59:306-13.