Published online Jan 6, 2023. doi: 10.12998/wjcc.v11.i1.210
Peer-review started: October 10, 2022
First decision: November 11, 2022
Revised: November 25, 2022
Accepted: December 21, 2022
Article in press: December 21, 2022
Published online: January 6, 2023
Processing time: 86 Days and 14.6 Hours
Ochronosis, also known as alkaptonuria, is a rare autosomal recessive self-metabolic disease arising from deficiency of homogentisate 1,2 dioxygenase enzyme. It affects several organs and muscoskeletal structures. We herein report a case of a patient who presented with severe hip arthropathy complicated with late stage ochronosis.
A 56-year-old male patient was admitted in our department in 2019 with complaints of chronic low backache and left hip pain. After the required investigations were done, lumbar disc herniation and severe hip arthritis were the initial diagnosis. A total left hip arthroplasty was performed. Ochronotic osteoarthritis was only obtained post-surgery as confirmatory diagnosis. He was again admitted mid 2022 with the same complaints on the right hip. Subsequently, he underwent a total right hip arthroplasty. Post-operative recovery and follow-ups were deemed very satisfactory.
Ochronosis is an unusual diagnosis for a patient who presents with typical hip arthritis. Thus, unless meticulous history taking and advanced laboratory tests, the diagnosis can easily be missed by surgeons.
Core Tip: Ochronosis is not an usual diagnosis in orthopedics. Thus, unless meticulous history taking and advanced laboratory tests, the diagnosis can easily be missed by surgeons. Advanced testing should come in mind when odd physical examinations are noted and especially with peculiar radiological findings. Early diagnosis and a good communication between the two parties are primordial to obtain the best prognosis.