Heavy metal intoxication
Objectives- Discuss the public health aspects of lead poisoning in developed and developing countries
- Describe symptoms of lead toxicity
- Describe the radiographic features of lead toxicity
Discussion
By far the most common variety of heavy metal intoxication in children is lead poisoning. Symptomatology related to lead poisoning is primarily neurologic and gastrointestinal, so it is unlikely that the orthopaedist will often be in a position to make the primary diagnosis. In the United States, a somewhat coordinated program has been underway for over 10 years to reduce the exposure of children to lead, lead-free gas being one outcome of this effort. The socioeconomic stratification of exposure to lead has been well documented, and in parts of the world, dust contains significant quantities of lead. Behavioral disorders and developmental delays have been attributed to even low levels of lead intoxication. Dense metaphyseal lines are a cardinal radiographic feature of lead intoxication.
References
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- Mendelsohn AL, Dreyer BP, Fierman AH, Rosen CM, Legano LA, Kruger HA, et al. Low-level lead exposure and cognitive development in early childhood. Journal of Developmental & Behavioral Pediatrics 1999; 20( 6): 425-31.
- Raber SA. The dense metaphyseal band sign. Radiology 1999; 211( 3): 773-4.
- Liggans GL, Nriagu JO. Lead poisoning of children in Africa, IV: Exposure to dust lead in primary schools in south-central Durban, South Africa. Science of the Total Environment 1998; 221( 2-3): 117-26.
- Mendelsohn AL, Dreyer BP, Fierman AH, Rosen CM, Legano LA, Kruger HA, et al. Low-level lead exposure and behavior in early childhood. Pediatrics 1998; 101( 3): E10.
- Silbergeld EK. Preventing lead poisoning in children. Annual Review of Public Health 1997; 18: 187-210.
- Zaleske DJ. Metabolic and endocrine abnormalities. In: Morrissy RT, Weinstein SL, editors. Pediatric Orthopaedics. Philadelphia: Lippincott-Raven; 1996. p. 137-201.
May 16-19, 2012 in Denver, CO
