title: Ochronosis in differential diagnosis of patients with chronic backache: a review of the literature.
abstract: A 50-year-old man presented with a complaint of low-back pain and widespread joint pain for the previous 20 years. Conventional radiography revealed wide areas of calcification in the intervertebral discs and degenerative changes in the peripheral joints. A diagnosis of ochronosis was made by the observation of bluish-brown pigmentation in the nose and ears, dark urine colors following alkalization, and high levels of homogentisic acid in the urine. Ochronosis should be considered in the differential diagnosis of patients with chronic low-back pain regarding features of widespread calcification in the intervertebral discs at radiography and bluish-brown pigmentation in the nose and ears.
authors.affiliation: Physical Medicine and Rehabilitation Department, Yavuz Selim Bone Diseases and Rehabilitation Hospital, Trabzon, Turkey. drcapkin@yahoo.com
authors.forename: Erhan
authors.initials: E
authors.lastname: Capkin
authors.forename: Murat
authors.initials: M
authors.lastname: Karkucak
authors.forename: Savaş
authors.initials: S
authors.lastname: Yayli
authors.forename: Münevver
authors.initials: M
authors.lastname: Serdaroğlu
authors.forename: Mehmet
authors.initials: M
authors.lastname: Tosun
mesh_terms: D000474:Alkaptonuria / Q000652:urine; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D018771:Arthralgia / Q000000981:diagnostic imaging; D001205:Ascorbic Acid / Q000008:administration & dosage; D001416:Back Pain / Q000000981:diagnostic imaging*; D002114:Calcinosis / Q000000981:diagnostic imaging; D002908:Chronic Disease; D003937:Diagnosis, Differential; D004008:Diclofenac / Q000008:administration & dosage; D006713:Homogentisic Acid / Q000652:urine; D006801:Humans; D007403:Intervertebral Disc / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009794:Ochronosis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011859:Radiography; D016896:Treatment Outcome; D014815:Vitamins / Q000008:administration & dosage
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D014815:Vitamins; D004008:Diclofenac; D006713:Homogentisic Acid; D001205:Ascorbic Acid