Abstract
Joint pain and swelling in patients on fluoride therapy are generally attributed to rheumatic phenomena; however, their occurrence exclusively in the lower limbs suggests a mechanical cause. Eight patients receiving daily doses of sodium fluoride 1.09 mg/kg, elemental calcium 1 gm, and vitamin D 1000–2800 units for osteoporosis spontaneously developed 17 episodes of periarticular pain and swelling in the lower limbs. Radiographs taken within two weeks of the onset of pain were negative, but when repeated 4–6 weeks later showed features of healing stress fractures in the periarticular cancellous bone at the following sites: distal femur (2) proximal tibia (3), distal tibia (6), calcaneum (6). Bone scintigraphy was positive on five occasions, two before radiographic signs had appeared.
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Dambacher MA, Ittner J, Ruegsegger P (1984) Fluoride therapy of postmenopausal osteoporosis and its complications. In: Christiansen C, Arnaud D, Nordin BEC, Parfitt AM, Peck WA, Riggs BL (eds) Osteoporosis. Proceedings of the Copenhagen International Symposium on Osteoporosis June 3–8, 1984. Department of Clinical Chemistry, Glostrup Hospital, Denmark. p 603
Glimet T, Kuntz D, de Vernejoul MC, Ryckewaert A (1980) Fissurations osseuses multiples au cours d'un traitement de l'osteóporose par le fluorure de sodium. Rev Rhum Mal Osteoartic 47:581
Kleerekoper M, Frame B, Villanueva AR, Oliver I, Rao DS, Matkovic V, Parfitt AM, Chir B (1981) Treatment of osteoporosis with sodium fluoride alternating with calcium and vitamin D. In: De Luca HF, Frost HM, Jee WSS, Johnston CC Jr, Parfitt AM (eds) Osteoporosis. Recent advances in pathogenesis and treatment. University Park Press, Baltimore, p 441
Leroux JL, Blotman F, Claustre J, Simon L (1983) Fractures du calcanéum au cours du traitement de l'ostéoporose par le fluor. Sem Hôp Paris 45:3140
Murray RO, Jacobson HG (1971) The radiology of skeletal disorders. Churchill Livingstone, Edinburgh London, p 133
Riggs BL (1984) Treatment of osteoporosis with sodium fluoride: An appraisal. In: Peck WA (ed) Bone and mineral research. Annual 2. A yearly survey of developments in the field of bone and mineral metabolism. Elsevier, Amsterdam, p 366
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Schnitzler, C.M., Solomon, L. Trabecular stress fractures during fluoride therapy for osteoporosis. Skeletal Radiol 14, 276–279 (1985). https://doi.org/10.1007/BF00352619
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DOI: https://doi.org/10.1007/BF00352619