eMJA: Black bones: a case of incidental discovery of ochronotic arthropathy

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Black bones: a case of incidental discovery of ochronotic arthropathy

See-Seong Chang, Eugene T Ek and Vicki Pliatsios

MJA 2009; 190 (7): 390

A 77-year-old man with no significant medical history presented to the orthopaedic clinic of a metropolitan hospital with longstanding left mechanical knee pain. Examination and x-ray revealed features consistent with degenerative arthritis (Figure, A), and he subsequently underwent total knee arthroplasty. During surgery, a bluish-black pigmentation of the bone and the cartilage of the knee joint was noted (Figure, B). The patient’s surgery and recovery were uneventful. It was later discovered that he had a previously undiagnosed rare metabolic disorder, alkaptonuria, which affects one in 250 000 to 1 000 000 people worldwide.1

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