Fluorose

Skeletal fluorosis is a chronic metabolic bone disease caused by ingestion of large amounts of fluoride through either water or food in geographic areas where high levels of fluoride occur naturally.

Radiographic features

Plain radiograph/CT

Described features include:

• increased bone density: osteosclerosis
• osteopenia or osteoporosis 
• trabecular blurring or haziness
• compact bone thickening
• periosteal bone formation
• ossification of the attachments of tendons, ligaments, and muscles
• interosseous membrane calcification
• ossification of the posterior longitudinal ligament

Involvement of the axial skeleton is characteristic, and changes are most marked in the spine, pelvis, and ribs.

In early fluorosis, the first changes are bone deposition and thickening at the junctions of trabeculae. This is seen as sand-like, granular, or particle-like bone structure on radiographs.

In more advanced fluorosis, the trabeculae are more generally thickened because of new bone formation on the trabecular surface. At this stage, radiographs show thickening and condensation of trabeculae, with coarse reticulum or woven bone striations.

If the trabeculae are fused, focal round densities are seen in the medullary bone.

Osteopenia (less common) also may occur in fluorosis, especially in younger patients at an earlier stage .

Calcification of the sacrotuberous ligament is considered a characteristic feature.

Differential diagnosis

For diffuse skeletal sclerosis on imaging, consider:

• differential diagnosis of diffuse bony sclerosis

Siehe auch:

• Syndesmophyten
• Ossifikation Ligamentum longitudinale posterius
• Osteopetrose
• Osteoporose
• Ossifikation der Ligamenta flava
• diffuse skelettale Sklerosierung
• Dentalfluorose
• fluoride toxicity

und weiter:

• diffuse bony sclerosis (mnemonic)
• juvenile maligne Osteopetrose
• generalized increased bone density in paediatrics