X-ray analysis of endemic fluorosis region in Shaanxi Province / 中华地方病学杂志

ABSTRACT

Objective To investigate the characteristics of X-ray signs of water-related and coal-burning borne endemic fluorosis in Shaanxi Province,so as to provide a theoretical basis for revising X-ray diagnostic criteria of skeletal fluorosis in the future.Methods The X-ray data of 2 525 cases of patients with endemic fluorosis from the central subsidies to local public health programs were collected from 2008 to 2011,and the X-ray signs,age,gender distribution,detection rate were analyzed statistically ; skeletal fluorosis was diagnosed on the basis of skeletal diagnostic criteria(WS 192-2008).Results The 2 525 cases observed were taken X-ray film on forearm and shank.In the X-ray signs of patients from fluorosis areas,the detection rates were higher,and these signs were mainly radial crest of increase,marginal sclerosis,surface thickening and forearm interosseous membrane ossification and forearm interosseous membrane calcification which showed bud break ground sign,which accounted for 29.91％(242/809),17.92％(145/809) and 17.69％ (143/809),respectively.Three X-ray signs occurred in the forearm,and the total detection rate based on the forearm signs was 88.12％ (721/809); 682 cases of skeletal fluorosis were detected and the detection rate was 27.01％ (682/2 525),including 401 mild cases accounting for 15.88％ (401/2 525); 236 moderate cases that accounted for 9.35％ (236/2 525); 45 severe cases accounted for 1.78％(45/2 525).With age,the prevalence increased gradually.After the age of 55 reached the peak,and the difference was significant statistically between different ages (x2 =228.58,P ＜ 0.05).The total prevalence was not significantly different between male group and female group (x2 =0.74,P ＞ 0.05).Conclusions With age,the prevalence of skeletal fluorosis is increased,and the skeletal fluorosis is not different between different sexes.The X-ray sign results have showed that the prevalence based on forearm signs is high and specific.We suggest to diagnose skeletal fluorosis by the X-ray signs of the forearm in the diagnostic standard revision,so as to reduce financial input,workload and radiation level to the patient.