Schnitzler C M, Solomon L
Skeletal Radiol. 1985;14(4):276-9. doi: 10.1007/BF00352619.
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.
接受氟化物治疗的患者出现关节疼痛和肿胀通常被归因于风湿性现象；然而，这些症状仅出现在下肢提示存在机械性原因。八名因骨质疏松症每日接受1.09毫克/千克氟化钠、1克元素钙和1000 - 2800单位维生素D治疗的患者自发出现了17次下肢关节周围疼痛和肿胀发作。疼痛发作两周内拍摄的X光片为阴性，但在4 - 6周后复查时，显示以下部位关节周围松质骨出现愈合性应力性骨折的特征：股骨远端（2例）、胫骨近端（3例）、胫骨远端（6例）、跟骨（6例）。骨闪烁扫描有5次呈阳性，其中两次在X光片出现征象之前。
