Turkish Journal of Physical Medicine and Rehabilitation 2009 , Vol 55 , Num 3

Bilateral Hip Resorption in a Case with Ochronosis

Banu Aydeniz 1 ,Aylin Saltekin 1 ,Selcen Şenol 1 ,Derya Çırakoğlu 1 ,Feyza Ünlü Özkan 2 ,Turan Uslu 1
1 Fatih Sultan Mehmet ve Araştırma Hastanesi, Fizik Tedavi ve Rehabilitasyon Klinği, İstanbul
2 Fatih Sultan Mehmet Eğitim ve Araştırma Hastanesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, İstanbul, Türkiye

A 72-year-old female patient with complaints of back pain, bilateral hip pain and walking difficulty referred to our clinic. Physical examination revealed excessive limitation of lumbar and hip range of motion bilaterally. Radiological examination showed diffuse intervertebral disc calcification and degenerative changes in lumbar and dorsal vertebrae. Lytic, sclerotic areas and resorption in both femoral heads were observed, being more prominent on the left side. According to the physical examination and radiological findings ochronosis was suspected. Urine analysis was positive for homogentisic acid and the patient was diagnosed as ochronosis. Ochronosis is a rarely seen inborn error of metabolism. In cases with spine involvement and excessive degenerative and resorptive articular changes in the hip joint ochronosis must be considered in the differential diagnosis. 

Keywords : Ochronosis, bone resorptio