Name : Morteza
Family :Sanei Taheri
Affiliation :Radiology Department,Shohada Tajrish Hospital,SBMU
Academic Degree: Associate Professor of Radiology
Resident : Ramin Pourghorban,ashraf-o-sadat hoseini
Gender : Male
Age : 60
60 y/o man with back pain
Imaging Procedures and Findings
MRI images shows advanced degenerative changes with decreased intervertebral disk height, ankylosis and endplate degenerative change. CT images demonstrates severe DJD,anterior osteophytic changes and suspected intervertebral disk calcification in coronal images. AP and lateral thoracic plain films reveal intervertebral disk calcification and concomitant advanced degenerative changes consistent with Ochronosis.
Ochronosis is caused by an inherent metabolic flaw resulting in the absence of the enzyme homogentisic acid oxidase. In the second and third decade the most distinctive finding is the laminated calcirication of multiple intervertebral disks. Commonly,all the interspaces are affected and dramatically emphasized by the osteoporosis in the adjoining vertebrae. Universal calcified disks and osteoporosis in the young individual are pathognomonic of ochronosis. The intervertebral disk space is drastically narrowed, but little or no osteophytic lipping appears in the early stages. In older individuals, osteophytic changes occur. In the older patients, massive lipping and ankylosis of the spine result in a severe dorsal kyphosis with a decrease in the lumbar lordosis.
Edeiken J: roentgen diagnosis of diseases of bone, 2nd ed. Baltimore,: Mosby, 1978.