Ochronotic tendinopathy of Achilles tendon-A rare case report

Abstract

Alkaptonuria, a rare autosomal recessive genetic disorder, resulting in blackish discoloration of urine, connective tissue, sclera, heart valves, blood vessels and skin.We report, a 57 yrs old / Female presented to us with complain of chronic right ankle pain since 9-months. Patient had difficulty in weight bearing and walking. Patient had a history of twisting injury of right ankle 1 month ago, with popping sound.On Examination, palpable gap was felt on Right Tendo Achilles region. O’Brien needle test, Simmonds-Thompson test and Single heel raise test were found to be positive. Intraoperatively Blackish discoloration of Tendo Achilles was seen.Open Trans osseous Tendo Achilles repair with modified Krakow suture and Plantaris reinforcement procedure was done.Postoperatively, laboratory investigations showed an increase in homogentisic acid levels in urine (1025%; normal value