title: MRI features of spinal Fluorosis: Results of an endemic community screening.
abstract: OBJECTIVE
  Fluorosis is endemic in many parts of the world. However community studies on MRI features of fluorosis are lacking. The aim of this study was to determine MRI features of spinal changes in a community with endemic fluorosis in the Thar Desert Pakistan.
  
  
  METHODS
  Randomly selected adults from the Village Samorindh, district Tharparker, Sindh, Pakistan, with spinal fluorosis diagnosed on plain x-rays and raised serum fluoride levels were studied from June 2008 to January 2009. MRI was carried out on 0.5 T open magnet MRI system. Features of vertebral body, spinal ligaments, intervertebral disc, facet joints, iliac wings and other incidental findings were noted. Sclerosis was defined as low signal intensity on both T1 and T2 weighted images. RESULTS were described as mean and percentage values.
  
  
  RESULTS
  All the studied 27 subjects complained of back ache without neurological signs. The average age was 43.33 ± 10.45 years; 21 being male (77.8%). The most frequent findings included generalized vertebral sclerosis (24, 88.8%), ligamentum flavum hypertrophy (23, 85%), anterior (20, 74%) and lateral (17, 62.9%) disc herniation, thickened longitudinal ligaments, and narrowing of spinal foramina. Hemangioma was seen in 04(14.8%). The most commonly involved level was L1-2, L4-5 and lower dorsal spine.
  
  
  CONCLUSIONS
  Vertebral sclerosis, a combination of premature degeneration with anterior disc herniation and an unusually high frequency of vertebral hemangioma formed the spectrum of MRI findings in subjects with spinal fluorosis having back ache but no neurological findings.
authors.affiliation: Iftekhar Ahmed, MBBS, MCPS, FCPS, Professor of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
authors.forename: Iftekhar
authors.initials: I
authors.lastname: Ahmed
authors.affiliation: Saba Sohail, MBBS, MCPS, FCPS, Professor Radiology, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.
authors.forename: Saba
authors.initials: S
authors.lastname: Sohail
authors.affiliation: Munawwar Hussain, MBBS, FCPS, Assistant Professor of Radiology,Dow International Medical College, Dow University of Health Sciences, Karachi, Pakistan.
authors.forename: Munawwar
authors.initials: M
authors.lastname: Hussain
authors.affiliation: Nazeer Khan, MSC, MS, PhD (Canada), Director of Research & Professor of Biostatistics, Dow University of Health Sciences, Karachi, Pakistan.
authors.forename: Nazeer
authors.initials: N
authors.lastname: Khan
authors.affiliation: Masood Hameed Khan, MCPS, FCPS, FRCP, PhD, Professor of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
authors.forename: Masood
authors.initials: M
authors.lastname: Hameed Khan
keywords: Endemic fluorosis; MRI; Screening; Spine; Thar Desert