Although skeletal fluorosis has been studied intensely in other
countries for more than 40 years, virtually no research has been
done in the U.S. to determine how many people are afflicted with
the earlier stages of the disease, particularly the preclinical stages.
Because some of the clinical symptoms mimic arthritis, the first
two clinical phases of skeletal fluorosis could be easily
misdiagnosed... Even if a doctor is aware of the disease, the early stages are difficult to
diagnose