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Monday, May 2, 2011

FLUROSIS

Skeletal flurosis occurs endemically in some tropical and sub-tropical areas with high fluoride concentrations in soil and water.
In non-endemic areas it may occur as a result of occupational exposure in aluminium production, magnesium foundries, fluorspar processing and super phosphate manufacture. The bones become sclerotic, and calcification occurs in other organs.
Clinical features
In children the more severe effects include genu valgus and varum, lateral bowing of the femora, sabre shins, deformities of ribs, thorax, vertebral bodies, pelvis and joints. Milder forms include mottling of the teeth. In adults, occupational exposure may lead to increased bone density and thickening of long bones, the development of exostoses and osteophytes calcification in the ligaments, tendons and muscle insertions, polyarthralgia and arthoses. The spine mat become rigid and contracture of hips and knees may occur. Occupational exposure to leaks of fluorides or hydrofluoric acid may cause severe acute illness, with skin and eye burns, acute tracheobronchitis and pulmonary oedema, and hypocalcaemia due to consumption of calcium converted to calcium fluoride.
Management
No treatment is effective for flurosis. The effects of leaks of fluoride should be treated with calcium gluconate (gel locally , and by injection).

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