Case 208: Alkaptonuria

History A 76-year-old woman presented after a fall with a history of progressively worsening mobility due to lower back and generalized joint pain. She had a longstanding history of arthritis since early adulthood that predominantly affected her weight-bearing joints. The small joints of her hands and feet were spared. Physical examination findings were notable for the presence of slate gray pigmented areas on the patient’s sclerae, ears, and...