GENERALIZED OSTEOPATHY WITH PATHOLOGICAL FRACTURES IN A PATIENT WITH LONG-TERM EXPOSURE TO FLUORINE-CONTAINING PLASTICS

In a 68-year-old man with a painful syndrome of the lower extremities which began at the age of 64 years, workup revealed a generalized oste opathy with sclerosis of the axial skeleton and osteopenia at the extr emities associated with pathologic fractures. The occupational history showed exposure to several synthetics such as vinyl chloride, polyeth ylene, delrine and polyamides over 30 years. However, a presumptive co nnection between the skeletal disorder and the occupational exposure c ould not initially be substantiated. In a later analysis of the bone b iopsies from 1991, a significant increase of fluorine in the tibia and fibula of the patient was detected and thus the diagnosis of industri al fluorosis established. The fluorine presumably originated from the workup of polytetrafluorethylene plates. A detailed analysis of the wo rkplace is ongoing. The fluorosis may obviously appear as a variable s keletal disease. The clinical picture of fluorosis is incompletely des cribed in most of the German textbooks. It-calls for an extended descr iption of the X-ray findings associated with fluorosis and a new defin ition of the disease.