A patient presented with chronic low back pain and hyperpigmented nose and ears. Schober’s test is positive. On spinal X-ray, the following appearance is seen. What is the most likely diagnosis?
B. Ankylosing spondylitis
Answer- C. Ochronosis
Positive Schober’s test and Diffuse skeletal hyperostosis (DISH) and intemertebral disk calcification as seen in the set of X-rays here can be seen in varioas spondyloarthropathies like ankylosing spondylitis (AS) as well as other less commonmetabolic, infectious, and malignant causes of btack pain. It includes infectious spondylitis, spondylodiscitis, and sacroileitis, and primary or metastatic tumon Ochronosis can produce a phenofirye that is clinically and radiographically similar to AS. Along with low back pain, presence of hyperpigmented nose and ears point towards ochronosis.