{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T12:26:11Z","timestamp":1789993571529,"version":"4.0.1"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"S1","license":[{"start":{"date-parts":[[1990,3,1]],"date-time":"1990-03-01T00:00:00Z","timestamp":636249600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1990,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>We report clinical and bone morphometric findings in 18 osteoporotic patients who experienced stress fractures during fluoride therapy. Patients were treated with either sodium fluoride (n = 15), or sodium monofluorophosphate (n = 3). Oral calcium supplementation was given in 11 patients, and vitamin D in 13. Stress fractures occurred after 17.1 \u00b1 10.3 months of therapy (range: 5\u201341 months). Atraumatic sudden pain in a lower limb bone extremity, normal initial roentgenogram, high 99technetium uptake on early bone scan, and a 3 to 4 week delay in linear bone condensation area at the same site were characteristics of stress fracture. The most frequent sites were the tibial metaphysis (n = 13), femoral neck (n = 10), and calcaneus (n = 4). Biochemical data showed increased plasma alkaline phosphatase levels in 11 patients, and mild renal failure in 2. Bone histomorphometry was performed on an iliac crest specimen in 10 patients at the time of the stress fracture. Trabecular bone volume was normal, and formation parameters were increased. Features of osteomalacia were encountered in only 2 patients with decreased renal function. Trabecular resorption was increased, as assessed by the osteoclastic surface (1.01 \u00b1 1.15% bone surface), and the number of osteoclasts (0.44 \u00b1 0.49 per mm2 bone section). The clinical course was favorable in all patients who stopped fluoride, although 5 patients who continued the treatment had either completion of femoral neck stress fractures to hip fractures (n = 2), or recurrent stress fractures (n = 2), or both (n = 1). Fluoride appears to be a key factor in the pathogenesis of stress fractures, and may be associated with increased trabecular resorption in some treated patients.<\/jats:p>","DOI":"10.1002\/jbmr.5650051392","type":"journal-article","created":{"date-parts":[[2010,2,25]],"date-time":"2010-02-25T21:52:14Z","timestamp":1267134734000},"page":"S191-S194","source":"Crossref","is-referenced-by-count":17,"title":["Journal of Bone and Mineral Research"],"prefix":"10.1093","volume":"5","author":[{"given":"PH.","family":"Orcel","sequence":"first","affiliation":[{"name":"Service de Rhumatologie, H\u00f4pital Saint-Antoine, 184 Faubourg Saint-Antoine, 75012 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. C.","family":"De Vernejoul","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, H\u00f4pital Saint-Antoine, 184 Faubourg Saint-Antoine, 75012 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Miravet","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, H\u00f4pital Saint-Antoine, 184 Faubourg Saint-Antoine, 75012 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Kuntz","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, H\u00f4pital Saint-Antoine, 184 Faubourg Saint-Antoine, 75012 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Prier","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, H\u00f4pital Saint-Antoine, 184 Faubourg Saint-Antoine, 75012 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Kaplan","sequence":"additional","affiliation":[{"name":"Service de Rhumatologie, H\u00f4pital Saint-Antoine, 184 Faubourg Saint-Antoine, 75012 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[1990,3,1]]},"reference":[{"key":"2024012712362722700_bib1","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/S0140-6736(88)92834-6","article-title":"Risk-benefits ratio of sodium fluoride treatment in primary vertebral osteoporosis","volume":"ii","author":"Mamelle","year":"1988","journal-title":"Lancet"},{"key":"2024012712362722700_bib2","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/8756-3282(86)90018-9","article-title":"Long-term fluoride therapy of post menopausal osteoporosis","volume":"7","author":"Dambacher","year":"1986","journal-title":"Bone"},{"key":"2024012712362722700_bib3","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1007\/BF00352619","article-title":"Trabecular stress fractures during fluoride therapy for osteoporosis","volume":"14","author":"Schnitzler","year":"1985","journal-title":"Skeletal Radiol"},{"key":"2024012712362722700_bib4","first-page":"857","volume-title":"Calcium Regulation and Bone Metabolism, Basic and Clinical Aspects","author":"Devogelaer","year":"1987"},{"key":"2024012712362722700_bib5","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1007\/BF02556560","article-title":"Decreased bone formation in osteoporotic patients compared with age-matched controls","volume":"44","author":"Garcia-Carrasco","year":"1987","journal-title":"Calcif Tis Int"},{"key":"2024012712362722700_bib6","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1002\/jbmr.5650030504","article-title":"Fluoride content in human iliac bone: results in controls, patients with fluorosis, and osteoporotic patients treated with fluoride","volume":"3","author":"Boivin","year":"1988","journal-title":"J Bone Min Res"},{"key":"2024012712362722700_bib7","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/8756-3282(86)90017-7","article-title":"Histomorphometric analysis of a calcaneal stress fracture: a possible complication of fluoride therapy for osteoporosis","volume":"7","author":"Schnitzler","year":"1986","journal-title":"Bone"},{"key":"2024012712362722700_bib8","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1007\/BF02030747","article-title":"Extended treatment of primary osteoporosis by sodium fluoride combined with 25 hydroxycholecalciferol","volume":"3","author":"Kuntz","year":"1984","journal-title":"Clin Rheumatol"},{"key":"2024012712362722700_bib9","first-page":"679","article-title":"Int\u00e9r\u00eat du dosage du fluor osseux chez l'ost\u00e9oporotique trait\u00e9 par le fluorure de sodium","volume":"18","author":"Laurent","year":"1989","journal-title":"Presse Med"},{"key":"2024012712362722700_bib10","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1136\/bmj.287.6394.723","article-title":"Bilateral fractures of the femoral neck in patients with moderate renal failure receiving fluoride for spinal osteoporosis","volume":"287","author":"Gerster","year":"1983","journal-title":"Br Med J"}],"container-title":["Journal of Bone and Mineral 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