Magnetic resonance imaging of brain and the neuromotor disorder in endemic cretinism.

Neurological endemic cretinism, resulting from severe iodine deficiency, is characterized by mental deficiency, deafmutism, and a spastic-rigid motor disorder. Its neuropathology and pathophysiology have been investigated very little. We report the clinical and magnetic resonance imaging brain scan findings of 3 adult Chinese cretins. All show an apparent magnetic resonance imaging abnormality in the globus pallidus and substantia nigra, with hyperintensity on T1-weighted images and hypointensity on T2-weighted images. The motor abnormality, characterized by truncal and proximal limb-girdle rigidity and spasticity, with relative sparing of the hands and feet, is analogous to other extrapyramidal disorders. Endemic cretinism is a unique form of cerebral palsy of potential interest for students of human neuromotor development.

Osteoporosis--an early radiographic sign of endemic fluorosis.

Radiological investigation of skeletal fluorosis was carried out among the inhabitants from two areas where the fluoride content of water was high, using both conventional radiography and radiographic measurements of bone mineral content (BMC). Of 139 cases in the first group, 68 presented bone abnormalities while 21 of 54 cases in the second group showed a similar change. Four essential types of bony lesion were classified. Osteoporosis, especially in the long bones, was the earliest change to be observed. The results of measurements at the distal end of the ulna indicated the presence of a low BMC even among inhabitants with a good nutritional status. It is concluded that osteoporosis towards the ends of long bones is an early radiographic sign of endemic fluorosis especially in an individual under the age of 40 years.