Fig 3 Fig 4 Plain radiographs of the spine show marked increased bone density with a large osteophyte involving the L5 vertebral body. The MRI shows reduced signal intensity on the T1W and T2W images, suggesting increased bone density or marrow fibrosis. In an otherwise asymptomatic patient, fluorosis is the most likely possibility. Rajasthan is a state in which fluorosis is endemic. The plain radiographs show increased bone density with a large osteophyte at L5.
Fluorosis occurs due to ingestion of fluoride in abnormal quantities.
Over a period of time, this replaces calcium in the bone leading to increased bone density. This bone however is brittle and prone to fracture. An underlying osteomalacia therefore is always present. The interossseous membrane between the radius and ulna also often ossifies. On MRI, there is marked reduction in signal from the bone due to the increased bone sclerosis.