PMC6803722_01
Pre-operative X-rays of the knees.
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fig1
Intraoperative images of the right knee. Black discoloration is noted on the patella and trochlea (a), tibia (d), and menisci (c). The cancellous bone appears normal after preparation (b).
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fig2
Upon everting the patella, it was noted that the patella tendon, menisci, cruciate ligaments, and cartilage over femur, patella, and trochlea were black in colour (Figure 2).
Dark pigmentation at the sclera of the left (a) and right (b) eyes. In panel (c), the normal appearance of urine on the left turned dark on the right upon addition of sodium hydroxide.
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fig3
Subsequent physical examination revealed dark pigmentation of his sclerae (Figures 3(a) and 3(b)). His urine appeared normal, until the addition of sodium hydroxide turned it dark (Figure 3(c)).
Postoperative X-rays of the knees.
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fig4
The X-rays showed satisfactory position and alignment (Figure 4).