Picture of Synovial Effusion in Ochronosis

Abstract

Knee changes basically have arthrotic character. They differ from genuine osteoarthrosis by earlier onset (average age of 39 years), more rapid progression and larger deformities. Hydrops occurred in 30.4 % of our patients. On the basis of series of examinations, Hüttl et al. (1966) found out that synovial effusion has non-inflammatory, irritation-degenerative character. Effusion is yellowish, and the colour does not change even if it stays in the open air for a longer time, suggesting low concentration of homogentisic acid. From the nosographic point of view, finding of histiocytes with brown-purple to blue-black cytoplasmatic inclusions that probably represent phagocyted ochronotic pigment is significant (Hüttl et al. 1966). Hüttl et al. were the first in the world literature to describe finding of histiocytes with pigment inclusions in cytoplasm as it was pointed out by P. Stiehl and K. M. Kluger from the Institute of Pathology at the Leipzig University (Stiehl and Kluger 1994).