Leg and Back Pain Caused by Excessive Tea Drinking


New in the New England Journal this week: Skeletal fluorosis from consumption of very strong tea, and a lack of proven benefit for arthroscopic partial meniscectomy.

Last week's articles on rheumatology topics in the major nonspecialty journals

Skeletal Fluorosis Due to Excessive Tea DrinkingN Engl J Med,  Mar. 21, 2013, free

A 47-year-old woman reported a five-year history of pain in the lower back, arms, legs, and hips. Radiology revealed increased density in the vertebrae. For 17 years, she had been drinking tea made from at least 100 tea bags every day, thus dosing herself daily with 20 mg fluoride.


Surgery versus physical therapy for a meniscal tear and osteoarthritisN Engl J Med 2013, online first, full text $15.

Editorial: Meniscectomy in patients with knee osteoarthritis and a meniscal tear? N Engl J Med 2012, online first, full text $15.

As previously reported here, the largest randomized controlled trial (RCT) so far has found no benefit to arthroscopic partial meniscectomy (APM), even in patients with symptomatic meniscal tears. An accompanying editorial said that APM should now be limited to the minority of cases that don’t improve after physical therapy, which it said is also unproven.

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