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

Authors

  • Jalaz Jain Department of Orthopaedics, Satyawadi Raja Harishchandra Hospital, Narela, New Delhi, India
  • Shankey Dudeja Department of Paediatrics, Dr. Baba Saheb Ambedkar Hospital, New Delhi, India
  • Gaurav Nandal Trauma and Sports, Advanta Super Speciality Hospital, Rohtak, Haryana, India
  • Ravi Sihag Department of Orthopaedics, Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India
  • Vibhuti Kumar Department of Anaesthesiology and Critical Care, Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India
  • Deepika Jain Department of Radiology, Artemis Hospital, Gurgaon, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20204610

Keywords:

Osteosclerosis, Ossification, Skeletal fluorosis

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.

Author Biographies

Jalaz Jain, Department of Orthopaedics, Satyawadi Raja Harishchandra Hospital, Narela, New Delhi, India

Senior Resident, Dept of orthopaedics, Satyawadi Raja Harishchanda Hospital, Narela, New Delhi, India

Shankey Dudeja, Department of Paediatrics, Dr. Baba Saheb Ambedkar Hospital, New Delhi, India

1.   Junior Resident, Department of Paediatrics, Dr. Baba Saheb Ambedkar Hospital, New Delhi, India.

1.     Junior Resident, Dr. Baba Saheb Ambedkar Hospital, New Delhi, India.

Gaurav Nandal, Trauma and Sports, Advanta Super Speciality Hospital, Rohtak, Haryana, India

Consultant Orthopaedics, Trauma and Sports, Advanta Super Speciality Hospital, Rohtak, Haryana, India

Ravi Sihag, Department of Orthopaedics, Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India

Junior Resident, Department of Orthopaedics, Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India.r

Deepika Jain, Department of Radiology, Artemis Hospital, Gurgaon, India

Junior Resident, Department of Radiology, Artemis Hospital, Gurgaon, India.

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.

Downloads

Published

2020-10-22