PMC9124898_01
Dark brown pigmentation in physical examination shows characteristic of Ochronosis in bilateral sclera; dark pigmentation observed on bilateral ear auricle (A). A urine sample at different times: (A) fresh urine; (B) fresh urine exposed to air for 4 h. Urine darkening can be observed (B).
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F1
The subsequent clinical examination revealed dark pigmentation of the sclera of bilateral eyes and on the ear auricle. (Figure 1A) Her urine appeared normal in color (buff), but when exposed to air for about 4 to 6 h, it gradually turned brown (Figure 1B).
Preoperative X-rays of hip joints showed the density of the right femoral head was increased unevenly with rough joint surface and narrow joint space, the upper acetabulum edge was slightly hyperosteogenic, and the joint was in position after left artificial hip implantation. These features resemble as osteoarthritis (A). Some scattered calcifications in the left kidney (B) and multilevel narrowing of the intervertebral spaces (C).
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F2
In addition, the density of the right femoral head was increased unevenly with rough joint surface and narrow joint space, the upper acetabulum edge was slightly hyperosteogenic, and the joint was in position after left artificial hip implantation (Figure 2A). Another slide of the spine illustrated multilevel narrowing of the intervertebral spaces and some scattered calcifications in the left kidney, which contributed to the diagnosis and made ochronotic arthritis distinct from other degenerative joint disease (Figures 2B,C).