Case ReportsAn Unusual Cause of Myelopathy Ochronotic Spondyloarthropathy With Positive HLA B27Bozkurt, Sinem MD; Aktekin, Lale MD; Uğurlu, Fatma Gülçin MD; Balci, Serdar MD; Sezer, Nebahat MD; Akkus, Selami MD Author Information From the Atatürk Educational and Research Hospital, Physical Medicine and Rehabilitation Clinic (S. Bozkurt); and Physical Medicine and Rehabilitation Department (LA, FGU, NS, SA) and Pathology Department (S. Balci), Yildirim Beyazit University, Ankara, Turkey. All correspondence and requests for reprints should be addressed to: Sinem Bozkurt, MD, Atatürk Training and Research Hospital, PMR Clinic, Bilkent, Cankaya, Ankara 06800, Turkey. Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.ajpmr.com). American Journal of Physical Medicine & Rehabilitation: November 2017 - Volume 96 - Issue 11 - p e206-e209 doi: 10.1097/PHM.0000000000000727 Buy SDC Metrics Abstract Ochronosis is a late developing complication of alkaptonuria, a black brownish pigment in the fibrous and cartilaginous tissues. Although most previous studies reported alkaptonuria and back pain due to ochronosis, thoracic myelopathy is an extremely rare complication. In this report, a paraparetic patient who has ochronotic spondiloarthropathy with the presence of HLA B27 antigen is described. He had low back and leg pain and morning stiffness for 5 yrs. Last year, these were followed by tingling, numbness, and weakness the in lower extremities and he was operated on with preliminary diagnosis of prolapsed disc herniation and cord compression. Surgery is suggested for disc herniations related to ochronotic spondyloarthropathy if it is necessary or neurologic symptoms are present. However, his pain and weakness have partially recovered after the operation. After medical and physical treatment, he showed clinically significant improvements. This case report demonstrates that the management of ochronosis needs a multidisciplinary approach with physiologic, neurologic, and psychologic effects and proper treatment may significantly improve functional outcomes in these patients. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.