Answer of April 2003

Clinical History:

M/38, low back pain.

                                     Figure 1

                                     Figure 2

Diagnosis:

Alkaptonuria (ochronosis)

Figure 1 and 2: There are extensive laminated calcification of multiple intervertebral discs with drastically narrowing of disc spaces. Multiple "vacuum phenomena" are noted. There are osteoporosis of adjoining vertebrae, massive osteophytes. Paravertebral calcifications at left L2/3 and L3/4 levels. Ankylosis of thoracolumbar vertebral bodies are seen. The sacroiliac joints are not involved.