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Skeletal fluorosis



Skeletal fluorosis
Classification & external resources
ICD-10 M85.1
ICD-9 733.9

Skeletal fluorosis is a bone disease exclusively caused by excessive consumption of fluoride.

Additional recommended knowledge

Contents

Causes

Common causes of fluorosis include inhalation of fluoride dusts/fumes by workers in industry, use of coal as an indoor fuel source (a common practice in China), consumption of fluoride from drinking water, and consumption of fluoride from the drinking of tea, particularly brick tea.[1]

In some areas, skeletal fluorosis may be endemic. In India, the most common cause of fluorosis is fluoride-laden water derived from deep bore wells.

Incidence/prevalence

While fluorosis is most severe and widespread in the two largest countries - India and China - UNICEF estimates that "fluorosis is endemic in at least 25 countries across the globe. The total number of people affected is not known, but a conservative estimate would number in the tens of millions." [2]

Skeletal fluorosis in China and India

The World Health Organization recently estimated that 2.7 million people in China have the crippling form of skeletal fluorosis.[citation needed] In India, 17 of its 32 states have been identified as "endemic" areas, with an estimated 66 million people at risk and 6 million people seriously afflicted.[citation needed]

According to scientific surveys, skeletal fluorosis in India and China occurs when the fluoride concentration in water exceeds 1 part per million (ppm), and has been found to occur in communities with only 0.7 part per million.[3]

The Chinese government now considers any water supply containing over 1 ppm fluoride a risk for skeletal fluorosis.[3]

Skeletal fluorosis in the United States

In the United States, an average of 1 ppm of fluoride is intentionally added to water supplies for water fluoridation. The Maximum Contaminant Level (as established by the US Environmental Protection Agency) is 4 ppm.[4]

Skeletal fluorosis phases

Osteosclerotic phase Ash concentration (mgF/kg) Symptoms and signs
Normal Bone 500 to 1,000 Normal
Preclinical Phase 3,500 to 5,500 Asymptomatic; slight radiographically-detectable increases in bone mass
Clinical Phase I 6,000 to 7,000 Sporadic pain; stiffness of joints; osteosclerosis of pelvis and vertebral spine
Clinical Phase II 7,500 to 9,000 Chronic joint pain; arthritic symptoms; slight calcification of ligaments' increased osteosclerosis and cancellous bones; with/without osteoporosis of long bones
Phase III: Crippling Fluorosis 8,400 Limitation of joint movement; calcification of ligaments of neck vertebral column; crippling deformities of the spine and major joints; muscle wasting; neurological defects/compression of spinal cord

References

  1. ^ http://www.tzuchi.org/GLOBAL/news/articles/20020700.html
  2. ^ UNICEF - Water, environment and sanitation - Common water and sanitation-related diseases. Retrieved on 2007-09-17.
  3. ^ a b Bo Z, Mei H, Yongsheng Z, Xueyu L, Xuelin Z, Jun D (2003). "Distribution and risk assessment of fluoride in drinking water in the west plain region of Jilin province, China". Environmental geochemistry and health 25 (4): 421-31. PMID 14740986.
  4. ^ U.S.P.H.S. "Review of Fluoride, Benefits and Risks", 1991. Retrieved on 2007-09-17.

acquired deformities of fingers and toes (Boutonniere deformity, Bunion, Hallux rigidus, Hallux varus, Hammer toe) - other acquired deformities of limbs (Valgus deformity, Varus deformity, Wrist drop, Foot drop, Flat feet, Club foot, Unequal leg length, Winged scapula)

patella (Luxating patella, Chondromalacia patellae)

Protrusio acetabuli - Hemarthrosis - Arthralgia - Osteophyte
Systemic connective
tissue
disorders
Polyarteritis nodosa - Churg-Strauss syndrome - Kawasaki disease - Hypersensitivity vasculitis - Goodpasture's syndrome - Wegener's granulomatosis - Arteritis (Takayasu's arteritis, Temporal arteritis) - Microscopic polyangiitis - Systemic lupus erythematosus (Drug-induced) - Dermatomyositis (Juvenile dermatomyositis) - Polymyositis - Scleroderma - Sjögren's syndrome - Behçet's disease - Polymyalgia rheumatica - Eosinophilic fasciitis - Hypermobility
DorsopathiesKyphosis - Lordosis - Scoliosis - Scheuermann's disease - Spondylolysis - Torticollis - Spondylolisthesis - Spondylopathies (Ankylosing spondylitis, Spondylosis, Spinal stenosis) - Schmorl's nodes - Degenerative disc disease - Coccydynia - Back pain (Radiculopathy, Neck pain, Sciatica, Low back pain)
Soft tissue disordersmuscle: Myositis - Myositis ossificans (Fibrodysplasia ossificans progressiva)

synovium and tendon: Synovitis - Tenosynovitis (Stenosing tenosynovitis, Trigger finger, DeQuervain's syndrome)

bursitis (Olecranon, Prepatellar, Trochanteric)

fibroblastic (Dupuytren's contracture, Plantar fasciitis, Nodular fasciitis, Necrotizing fasciitis, Fasciitis, Fibromatosis)

enthesopathies (Iliotibial band syndrome, Achilles tendinitis, Patellar tendinitis, Golfer's elbow, Tennis elbow, Metatarsalgia, Bone spur, Tendinitis)

other, NEC: Muscle weakness - Rheumatism - Myalgia - Neuralgia - Neuritis - Panniculitis - Fibromyalgia
Osteopathiesdisorders of bone density and structure: Osteoporosis - Osteomalacia - continuity of bone (Pseudarthrosis, Stress fracture) - Monostotic fibrous dysplasia - Skeletal fluorosis - Aneurysmal bone cyst - Hyperostosis - Osteosclerosis
Osteomyelitis - Avascular necrosis - Paget's disease of bone - Algoneurodystrophy - Osteolysis - Infantile cortical hyperostosis
ChondropathiesJuvenile osteochondrosis (Legg-Calvé-Perthes syndrome, Osgood-Schlatter disease, Köhler disease, Sever's disease) - Osteochondritis - Tietze's syndrome
See also congenital conditions (Q65-Q79, 754-756)
  This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Skeletal_fluorosis". A list of authors is available in Wikipedia.
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