Low back pain and ochronosis

We have examined the presentation of low back pain in three patients with ochronosis, and have reviewed the literature. Low back pain and/or stiffness is the first presenting feature and usually appears after the age of 30. Discolouration of the ear is almost always present. Characteristic radiographic changes in the lumbar spine include calcification of the intervertebral discs and lucencies in the discs. The process gradually extends to the entire spine.