Diagnostic Images for Ochronosis: One history clinches the diagnosis

S. Chockalingam

Senior Consultant Orthopaedic Surgeon, 1win, Cantonment, Trichy

Case Presentation

A 62 old female had Back pain, walks with kyphotic spine. She was not able to straighten up. She had hip replacement surgery with interesting intra op findings.

One history clinches the diagnosis.

Diagnosis

Ochronosis

The Key History

Alkaptonuria in which urine turns brown or black on settling

Key Points

  • Ochronosis is one of the cause of intervertebral calcification (Fig 1).
  • Black pigmentation of tissues noted at surgery are characteristic (Fig 2)
  • One of the causes of Discoloration of sclera in the eyes (Fig 3)

Fig (1): X-ray shows Intervertebral Calcification

Fig (2):  Tissue discoloration during hip replacement surgery

Fig (3): Discoloration of sclera

Note from Author

Patients usually do not take a photo of urine discoloration, as they do not reveal it routinely.

“That is the point of this publication; we have to ask the history”

Sometimes it takes time for the color to reveal and hence it may get missed in modern toilet use as opposed to passing urine outside.

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Applied Medical Statistics

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