Summation - Fluoride & Spondylosis/Spondylitis:

Among individuals with skeletal fluorosis, the fluoride-induced changes to the spine, and the accompanying symptoms, can bear a close resemblance to spondylosis; spondylitis; and DISH.

Differentiating between clinical skeletal fluorosis and spondylosis/spondylitis may be difficult, particularly for doctors unfamiliar with the disease.

Excerpts from the Scientific Literature - Fluoride & Spondylosis/Spondylitis:

"Ankylosing spondylitis and osteofluorosis had a remarkable similarity in their clinical and radiological features..."
SOURCE: Susheela AK, et al. (1988). Circulating levels of sialic acid and glycosaminoglycans: a diagnostic test for ankylosing spondylitis. Annals of Rheumatic Diseases 47:833-837.

"In the aluminum workers, the most frequent changes in the spine were exostoses and ossification of the ligaments. These changes did not differ in appearance from those seen in spondylarthritis or vertebral ankylosing hyperostosis."
SOURCE: Czerwinski E, Lankosz W. (1978). Skeletal changes in industrial and endemic fluorosis. Fluoride 11:29-32.

"fluorosis is usually associated only with stiffness, backache, and joint pains which may suggest the diagnosis of rheumatism, rheumatoid arthritis, ankylosing spondylitis and osteomalacia."
SOURCE: Teotia SPS, et al. (1976). Symposium on the Non-Skeletal Phase of Chronic Fluorosis: The Joints. Fluoride 9: 19-24.

"a 50 year old male appeared in our out-patient department complaining of pains in bones and joints, back pains, stiffness, immobility of the neck and spine, and inability to walk for the past four years. He had spent his entire life in an endemic fluorosis area. He had been treated for ankylosing spondylitis elsewhere for several months but without benefit."
SOURCE: Teotia SPS, Teotia M. (1972). Calcification of the Vas Deferens in a patient with endemic fluorosis. Fluoride 5: 86-88.

"The vertebrae are fused at many places which explains the marked limitation of movements and the resemblance of the disease to spondylitis ankylopoietica."
SOURCE: Jolly SS. (1970). Hydric fluorosis in Punjab. In: TL Vischer, ed. (1970). Fluoride in Medicine. Hans Huber, Bern. pp. 106-121.

"[The early cases of the disease] are usually young adults whose only complaints are vague pains most frequently in the small joints of the hands and feet, the joints of knee and spine. Such cases are common in an endemic area. They are misdiagnosed as rheumatoid arthritis or ankylosing spondylitis."
SOURCE: Jolly SS. (1968). An epidemiological, clinical and biochemical study of endemic, dental and skeletal fluorosis in Punjab. Fluoride 1: 65-75.

"Backache: This is a common complaint and is usually proportional to the degree of calcification of the spinous, ilio-lumbar and sacro-iliac ligaments and can closely simulate ankylosing spondylitis."
SOURCE: Kumar SP, Harper RA. (1963). Fluorosis in Aden. British Journal of Radiology 36: 497-502.

"The vertebrae were fused at many places which explained the marked limitation of movement and the resemblance of the disease to spondylitis ankylopoietica."
SOURCE: Singh A, et al. (1963). Endemic fluorosis. Epidemiological, clinical and biochemical study of chronic fluoride intoxication in Punjab. Medicine 42: 229-246.

"The interspinous and other spinal ligaments were calcified, simulating spondylitis ankylopoietica."
SOURCE: Singh A, et al. (1961). Skeletal fluorosis and its neurological complications. Lancet 1: 197-200.

"It has long been known that intake of fluorine in large amounts - either added to drinking water or by inhalation of fluoride-containing dust - induces a characteristic disease entity which is readily diagnosed clinically and resembles spondylosis."
SOURCE: Rockert H, Sunzel H. (1960). Skeletal lesions following ingestion of fluoridated water. Experientia 15: 155-156.

"Crippling fluorosis and rheumatoid (anklyosing) spondylitis present a confusing similarity..."
SOURCE: Steinberg CL, et al. (1955). Comparison of rheumatoid (ankylosing) spondylitis and crippling fluorosis. Annals of the Rheumatic Diseases 14: 378-384.

"During our anthropological studies we were puzzled by the high incidence of a peculiar type of 'arthritis' and joint ankylosis that seemed to afflict a majority of the adult inhabitants of a number of small Miao villages in the neighbourhood. In fact, in many of the older people the disease had advanced to such an extent that they appeared to be 'set' in semi-sitting positions, with almost complete loss of movement in the limbs... Later a copy of Roholm's mongraph on fluorine intoxication came to hand and we were struck by the similarity in appearance between the photographs of the Danish workers in cryolite and the crippled Miao peasants in China... It is quite possible that endemic centres [of skeletal fluorosis] exist but that the cause of the disabling spondylitis or other joint affections has not been determined, and a diagnosis of chronic arthritis has resulted. Few cases in Canada or the United States will be found to be as dramatic as that recorded here from Southwest China, but by calling attention to the advanced stage of this condition help may be afforded to the diagnosis of early cases."
SOURCE: Kilborn LG, et al. (1950). Fluorosis with report of an advanced case. Canadian Medical Association Journal 62: 135-141.

"SUMMARY: A brief account is given of the discovery of endemic fluorosis in the province of Kweichow in China. A clinical description of 4 cases of spondylitis is given..."
SOURCE: Lyth O. (1946). Endemic fluorosis in Kweichow, China. The Lancet 1: 233-235.

"In this short series of cases we have found that disturbances in the natural ossification of the spines of children are very common. Though some of these defects probably heal or improve, we found many young adults with similar deformities and with early signs of spondylosis deformans (spondylitis osteo-arthritica). We notice that dental fluorosis is commonly associated with such changes but we have no evidence to prove that fluorine is solely responsible: changes of a similar nature, though less definite, were demonstrated in children showing no signs of dental fluorosis, and not all children with severe dental fluorosis had changes in the spine, whereas some with only slighly mottling showed significantg deformities. These results are put forward as a preliminary investigation... We believe that fluorine in the water-supply may influence the development of such defects especially when it is associated with defective nutrition."
SOURCE: Kemp FH, et al. (1942). Spondylosis deformans in relation to fluorine and general nutrition. The Lancet 93-97.

"In the X-ray examination of the columna of the former cryolite workers a surprisingly large number of cases of spondylitis deformans of ordinary type was observed, but often of a pronounced character."
SOURCE: Roholm K. (1937). Fluoride intoxication: a clinical-hygienic study with a review of the literature and some experimental investigations. London: H.K. Lewis Ltd.

"The ligaments on the anterior and lateral aspects of the vertebral bodies form, with their calcifications, actual bridges between the latter, in the same way as in severe cases of spondylitis deformans; and in some places the picture resulting from these calcifications exactly resembles that of a spondylitis ankylopoietica."
SOURCE: Moller P, Gudjonsson SV. (1932). Massive fluorosis of bones and ligaments. Acta Radiologica 12: 269-294.

General Info - SPONDYLOSIS (non-inflammatory): (back to top)

“a type of degenerative disease of the spine whose most obvious pathologic and radiographic finding is the presence of osteophytes (e.g. bone spurs), especially along the anterior and lateral aspects of the vertebral column."
SOURCE: AmerhshamHealth.com

"Spondylosis (spinal osteoarthritis) is a degenerative disorder that may cause loss of normal spinal structure and function. Although aging is the primary cause, the location and rate of degeneration is individual."
SOURCE: SpineUniverse.com

"Osteophytes (e.g. bone spurs) may form adjacent to the end plates, which may compromise blood supply to the vertebra. Further, the end plates may stiffen due to sclerosis; a thickening/hardening of the bone under the end plates."
SOURCE: SpineUniverse.com

Symptoms - SPONDYLOSIS (non-inflammatory): (back to top)

"The course of cervical spondylosis may be slow and prolonged, and patients may either remain asymptomatic or have mild cervical pain."
SOURCE: eMedicine.com

"When a bone spur (osteophyte) causes nerve root compression, extremity (e.g. arm) weakness may result. In rare cases, bone spurs that form at the front of the cervical spine, may cause difficult swallowing (dysphagia)."
SOURCE: SpineUniverse.com

"Morbidity ranges from chronic neck pain, radicular pain, diminished cervical range of motion (ROM), headache, myelopathy leading to weakness, and impaired fine motor coordination to quadriparesis and/or sphincteric dysfunction (eg, difficulty with bowel or bladder control) in advanced cases. The patient may be eventually chair-bound or bedridden."
SOURCE: eMedicine.com

"Lumbar spondylosis usually is asymptomatic, with no diagnostic or prognostic significance."
SOURCE: eMedicine.com

Frequency - SPONDYLOSIS (non-inflammatory): (back to top)

"In the US: Cervical spondylosis is a common condition that is estimated to account for 2% of all hospital admissions. It is the most common cause of spinal cord dysfunction in patients older than 55 years. On the basis of radiologic findings, 90% of men older than 50 years and 90% of women older than 60 years have evidence of degenerative changes in the cervical spine."
SOURCE: eMedicine.com

"Symptoms of cervical spondylosis may appear in those as young as 30 years and are most commonly in those aged 40-60 years. Radiologic spondylotic changes increase with patient age..."
SOURCE: eMedicine.com

"In the United States, more than 80% of individuals older than 40 years have lumbar spondylosis, increasing from 3% of individuals aged 20-29 years."
SOURCE: eMedicine.com

Synonyms/Key Words - SPONDYLOSIS (non-inflammatory): (back to top)

"spondylosis deformans, bony overgrowths, osteophytes, degenerative joint disease, osteoarthritis, hypertrophic arthritis"
SOURCE: eMedicine.com

"Throughout the literature, the alternate use of the terms spondylitis and spondylosis was obvious. Hansen appeared to be the first in the veterinary literature to correctly use the term spondylosis. implying a non-inflammatory disease.”
SOURCE: International Veterinary Information Service

General Info - SPONDYLITIS (inflammatory):(back to top)

"a form of inflammatory arthritis. The most common form of inflammatory arthritis is Rheumatoid arthritis."
SOURCE: Mayo Clinic

"Starts at a relatively young age (e.g. Avg age = 24)."
SOURCE: National Anklyosing Spondylitis Society (UK)

"Onset is usually under 35 years of age."
SOURCE: Spondylitis Association of America

"Commonly misdiagnosed for other types of back problems"
SOURCE: Mayo Clinic

“The condition primarily causes inflammation of the joints between the vertebrae of your spine and the joints between your spine and pelvis (sacroiliac joints). However, ankylosing spondylitis may also affect joints in your arms and legs, tendons and ligaments where they attach to your bones, and the joints in your ribs where they attach to your spine.”
SOURCE: Mayo Clinic

Symptoms - SPONDYLITIS (inflammatory):(back to top)

"Early signs and symptoms may include: Low back pain., Pain and stiffness in any part of your spine, or your entire spine, and perhaps other joints; often worse in the morning and after periods of inactivity.”
SOURCE: Mayo Clinic

"The back pain and stiffness worsen with immobility, especially at night and early morning. The back pain and stiffness tend to ease with physical activity and exercise."
SOURCE: Spondylitis Association of America

Frequency - SPONDYLITIS (inflammatory):(back to top)

"AS afflicts an estimated 129 out of 100,000 people in the United States. AS typically strikes adolescents and young adult males. The prevalence of AS varies by ethnic group and is most common in Native Americans."
SOURCE: American College of Rheumatology

Genetic Predisposition - SPONDYLITIS (inflammatory):(back to top)

"Is believed to have a genetic link (a genetic marker has been identified: HLA-B27."
SOURCE: National Anklyosing Spondylitis Society (UK)

"It is important to note that the HLA-B27 test is not a diagnostic test for AS (Ankylosing Spondylitis). It is a very strong indicator in that over 95% of people with AS test HLA-B27 positive, but generally speaking, no more than 2% of people born with this gene will eventually get spondylitis. HLA-B27 is a perfectly normal gene found in 8% of the caucasian population."
SOURCE: Spondylitis Association of America

“HLA-B27 is a perfectly normal gene found in 8% of the general population. Generally speaking, no more than 2% of people born with this gene will eventually get spondylitis. The gene itself does not cause spondylitis, but people with HLA-B27 are more susceptible to getting spondylitis. To date, 15 subtypes of HLA-B27 have been identified. The most common in the US being B27.05 and then after that B27.02. The way in which HLA-B27 interacts with some other proteins seems to be very important in the cause of AS, but this needs further research to find out just how. Other genetic factors seem to determine how the AS will manifest -- such as inflammation of the eye or other complications of the disease. Recent studies seem to indicate that genes also impact the severity of the disease.”
SOURCE: Spondylitis Association of America

Synonyms - SPONDYLITIS (inflammatory):(back to top)

AS; Bechterew Syndrome; Marie-Strumpell disease; Rheumatoid spondylitis.