M85.10

Clinical Causes: Consuming drinking water with naturally high fluoride levels over many years Occupational exposure to fluoride dust or gases in industries such as aluminum, phosphate fertilizers, or glass manufacturing Use of fluoride-containing dental products or supplements in excessive amounts Use of fluoride-based medications or treatments for certain medical conditions in high doses

Key Symptoms: Joint stiffness and pain, especially in the neck, back, and hips Bone deformities and thickening of bones Muscle weakness Reduced mobility and stiffness in affected joints Nerve compression symptoms if bones impinge on nerves Potential dental fluorosis, manifesting as discoloration and mottling of teeth (though primarily related to dental fluorosis rather than skeletal fluorosis)

Diagnosis Path: Diagnosing skeletal fluorosis involves a combination of medical history review, physical examination, and imaging studies. Healthcare providers may inquire about fluoride exposure sources and duration. Imaging tests such as X-rays can reveal characteristic changes in bones, including increased bone density or deformities. Blood and urine tests may be conducted to assess fluoride levels, although these are more useful in confirming ongoing exposure rather than diagnosing the damage. Differential diagnosis is important to distinguish skeletal fluorosis from similar bone diseases such as osteoarthritis or other metabolic bone disorders.

Treatment Protocols: The primary approach to managing skeletal fluorosis involves reducing fluoride intake, which may include switching to alternative water sources with lower fluoride levels, and avoiding fluoride-containing products. Symptomatic treatments can include pain relievers and physical therapy to improve joint mobility. In some cases, chelation therapy has been explored, but evidence for its efficacy is limited. Over time, reducing fluoride exposure may halt progression and, in some cases, lead to partial recovery of bone health, but existing deformities may not be reversible. Prevention through safe water practices and occupational safety measures is essential in high-risk regions.