Fluorosis continues to be prevalent in the southern regions of China. The endemic fluorosis caused by inhalation of fluoride-containing coal dust etiologically contrasts with the common occurrence of endemic fluorosis due to the intake of fluoride-containing water. We investigated the radiologic findings in 49 affected individuals in a district of this region. More than 80% of patients exhibited radiologic evidence of skeletal fluorosis, and most patients belonged to stage 3 of Singh and Jolly's classification. The most common skeletal abnormality was ossification of the interosseous ligaments in the extremities, which warranted radiographic examination of the limbs as a tool for screening.