On Bone Changes Observed in Residents of High Fluorine Zone

Abstract

1) In 25 inhabitants of Odani village, Sanyo town, Okayama prefecture, who displayed considerable degrees of limitation of motion in various joints, roentgenographic evidence of bone changes identical to those seen in chronic fluorine poisoning was established. 2) The bone changes involved the entire skeleton, being most marked in the vertebrae and to decreasing extent the pelvis, ribs and the long bones of the extremities. Only slight involvement was observed in the distal portions of the limbs. 3) The nature of the bone changes could be divided into two kinds. First, extensive sclerotic changes occurred in the inner structures of the bone, and marked increase in density caused obliteration of structure and produced a uniformly opaque appearance resembling “marble disease”. Secondly, calcifications extended from the metaphyses into the intervertebral fibrocartilages, various ligaments and muscular attachments, forming characteristic exostosis. 4) The patients with difficulty of movement finally became unable to move about unaided. Except for periodic mild rheumatic pains, general complaints were usually absent. 5) The circumstances under which the cases occurred seemed closely related to the content of fluorine in the well-water used by the people. The fluorine content of these water proved to be generally high ranging from 6 to 13 p.p.m. Most of the patients had used this water for more than 10 years. 6) In the urine from these cases, the excretion of 17-ketosteroid was decreased. 7) Differentiation from ]Kaschin-Bech's disease was discussed. This investigation was carried out with research grants obtained from the Ministry of Education for the purpose of performing a medicodental study on fluorine.