Pictorial CME

Fig. 1 : Blackish discoloration of Sclera.

Fig. 2 : Intervertebral disc calcification.

A 50 year lady presented with low back pain and pain in both knees for one year.

Clinically she had severe limitation of spinal movements in all directions and had Positive Schoeber’s test mimicking ankylosing spondylitis. In addition blackish pigmentation in sclera, ears and hands was observed (Fig. 1).

X-rays of lumbar spine shows intervertebral disk calcification with no sacroiliitis (Fig. 2). Urine examination was positive for homocystinuria by addition of alkali, on reduction reaction by Benedicts test and on exposure to sunlight.

K Shanmuganandan*; CP Rajendran**

*Resident; **Reader and Head, Department of Rheumatology, Madras Medical College, Govt. General Hospital, Chennai 600 003.

Received :  6.7.2000; Accepted : 8.8.2000