Key Findings - Diagnosis of Skeletal Fluorosis: (Click for more detail)

Skeletal fluorosis is a difficult disease to diagnose, and can be readily confused with various forms of arthritis.

The joint pains of fluorosis can occur before the onset of detectable bone changes, thereby making the early stages of fluorosis difficult to differentiate from arthritis.

In the advanced stages of skeletal fluorosis, the spine may closely resemble the appearance of spondylosis and DISH.

Skeletal fluorosis produces a wide variety of radiological manifestations, including osteosclerosis, osteomalacia, osteoporosis, and secondary hyperparathyroidism, thus a potential for misdiangosis exists between skeletal fluorosis and these disorders.

In individuals with kidney disease, fluoride exposure can exacerbate, and mimic, renal osteodystrophy.

Notable Quotes - Diagnosis of Skeletal Fluorosis:

"In areas where fluorosis is endemic, skeletal fluorosis is a common mimic of seronegative arthritis and should be pursued with investigations for diagnosis of fluorosis with measurement of fluoride levels, wherever applicable."
SOURCE: Gupta R, Kumar AN, Bandhu S, Gupta S. (2007) Skeletal fluorosis mimicking seronegative arthritis. Scandanavian Journal of Rheumatology 36(2):154-5.

"Our case report illustrates dramatically that fluorosis can lead to severe disability while closely mimicking a wide variety of other disorders... We believe increased awareness of this unusual disease is needed to enable physicians to make the proper diagnosis."
SOURCE: Fisher RL, et al. (1989). Endemic fluorosis with spinal cord compression. A case report and review. Archives of Internal Medicine 149: 697-700.

"Although skeletal fluorosis has been studied intensely in other countries for more than 40 years, virtually no research has been done in the U.S. to determine how many people are afflicted with the earlier stages of the disease, particularly the preclinical stages. Because some of the clinical symptoms mimic arthritis, the first two clinical phases of skeletal fluorosis could be easily misdiagnosed [as arthritis]... Even if a doctor is aware of the disease, the early stages are difficult to diagnose. "
SOURCE: Hileman B. (1988). Fluoridation of water.Questions about health risks and benefits remain after more than 40 years. Chemical and Engineering News August 1, 1988, 26-42.

"It should also be noted that chronic fluorosis is not easily diagnosed, and that few physicians have ever seen a case. Three of the cases reported in the U.S. literature were not diagnosed until post-mortem examination revealed excessive fluoride content in the bone. It is possible that the disease may be occurring to some extent without having been recognized."
SOURCE: Groth, E. (1973), Two Issues of Science and Public Policy: Air Pollution Control in the San Francisco Bay Area, and Fluoridation of Community Water Supplies. Ph.D. Dissertation, Department of Biological Sciences, Stanford University, May 1973.

"It is quite possible that many cases of (skeletal fluorosis) have gone misdiagnosed and unreported over the years... The state of knowledge among practicing physicians, even those in non-fluoride areas, concerning the diagnosis of skeletal fluorosis seems to be deficient and should be more carefully assessed."
SOURCE: Prival MJ. (1972). Fluorides and human health. Center for Science in the Public Interest, Washington D.C.

"Symptoms of fluoride poisoning are actually common in this country. The question is not at all whether they occur, but when and how often they are produced by fluoride... It is true that reports (of skeletal fluorosis in the U.S.) are few. This is both the cause and the effect of the fact that physicians, by and large, are unaware that such a thing exists. It is hardly mentioned in the textbooks or in the medical literature. "
SOURCE: Exner FB. (1957). Fallacies of the fluoridation thesis. In: J Rorty, ed. (1957). The American Fluoridation Experiment. Delvin-Adair Co, New York. pp. 29-153.

"One common feature of the three manifestations of chronic fluorine intoxication is that isolated cases may be difficult to diagnose."
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.