Although peripheral articular symptoms of ochronotic arthritis
may resemble those of rheumatoid arthritis (RA) with chronic painful swollen joints, in contrast to RA, the smaller joints of the hands and feet are often spared.
However, pathological tissue pigmentation is occasionally induced under several specific conditions, including ochronotic arthritis accompanied by alkaptonuria [1-3], haemosiderosis , and the use of drugs for Parkinson's disease [5, 6] or antibiotics [7-9].
In this case, we conclude that the severe pigmentation and destruction of the articular cartilage (similar to that observed in ochronotic arthritis due to haemosiderosis) occurred after chronic haemarthrosis, despite the patient having no underlying disease, drug usage, or traumatic episode, which ultimately required total knee arthroplasty.
Weight-bearing joints are usually affected in ochronotic arthritis. The knees are most frequently affected, while hip and shoulder joints can also be affected.
There is no specific treatment for ochronotic arthritis. Joint manifestations might be mitigable if homogentisic acid accumulation and deposition could be diminished by dietary limitation of phenylalanine and tyrosine.
Ochronotic arthritis is a very uncommon disease that can be potentially misdiagnosed with osteoarthritis in patients with knee pain and radiographic evidence of joint space narrowing.
Arthroplasty for ochronotic arthritis: no failure of 11 replacements in 3 patients followed 6-12 years.