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A 65 year old patient attended our hospital because of painful degenerative arthritis of the left hip joint. Chronic low back pain was a concomitant complaint. For this she had been treated elsewhere under the diagnosis ankylosing spondylitis. Coincidentally, she mentioned that she had had unpleasant dark stains in her underwear since childhood, which became more intense after washing. Her two sisters and the youngest daughter of one of them had the same complaints. General inspection showed black pigmentation in both sclera (fig 1). The radiographs of the lumbar spine showed degeneration of the discs with narrowing of the space and dense calcification of the remaining disc material. The radiological appearance resembled a “bamboo spine” (fig 2). Routine laboratory investigations showed no abnormalities.
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Series editor: Anthony D Woolf