Abstract：
BACKGROUND: Bone and periarticular tissue discoloration can be an unexpected finding that is often disconcerting for surgeons and may alter surgical plans and overall patient management. Common causes of bone discoloration include infection, avascular necrosis, and bone inflammation. Minocycline-induced black bone disease is a rare and relatively benign abnormality encountered in foot and ankle surgery that can cause significant black, blue, and gray discoloration of bone.
METHODS: Unanticipated intraoperative findings of diffuse black, blue, and gray bone discoloration during an elective forefoot operation raised concern for a metabolically malignant process and prompted the conversion of plans for a first metatarsophalangeal joint implant arthroplasty to a Keller arthroplasty. The plan for proximal interphalangeal joint arthroplasties of the lesser digits were continued as planned. Bone specimens were sent for pathologic analysis.
RESULTS: Postoperative analysis identified chronic use of a minocycline for acne vulgaris. Pathologic analysis of the specimens ruled out malignant processes. Altogether, the data available led to the diagnosis of minocycline-induced black bone disease. Since the last follow-up, the patient has healed well without complications.
CONCLUSIONS: Our case report underscores the importance of including the chronic use of tetracyclines in medical history intake during preoperative visits to assist the surgeon in intraoperative decision-making.
METHODS: Unanticipated intraoperative findings of diffuse black, blue, and gray bone discoloration during an elective forefoot operation raised concern for a metabolically malignant process and prompted the conversion of plans for a first metatarsophalangeal joint implant arthroplasty to a Keller arthroplasty. The plan for proximal interphalangeal joint arthroplasties of the lesser digits were continued as planned. Bone specimens were sent for pathologic analysis.
RESULTS: Postoperative analysis identified chronic use of a minocycline for acne vulgaris. Pathologic analysis of the specimens ruled out malignant processes. Altogether, the data available led to the diagnosis of minocycline-induced black bone disease. Since the last follow-up, the patient has healed well without complications.
CONCLUSIONS: Our case report underscores the importance of including the chronic use of tetracyclines in medical history intake during preoperative visits to assist the surgeon in intraoperative decision-making.
摘要：
背景：骨和关节周围组织的变色可能是一个意想不到的发现，通常会使外科医生感到不安，并可能改变手术计划和整体患者管理。骨变色的常见原因包括感染，缺血性坏死,骨炎症。米诺环素诱发的黑骨病是在足踝手术中遇到的一种罕见且相对良性的异常，可导致明显的黑,蓝色,和骨头的灰色变色。
方法：术中意外发现弥漫性黑色，蓝色,选择性前足手术中的灰骨变色引起了对代谢恶性过程的关注，并促使将首次meta趾关节植入物置换术的计划转换为Keller置换术。按计划继续进行小指的近端指间关节置换术的计划。送骨标本进行病理分析。
结果：术后分析确定慢性使用米诺环素治疗寻常痤疮。标本的病理分析排除了恶性过程。总之,现有数据有助于诊断米诺环素诱导的黑骨病.自从上次随访以来，病人愈合良好，没有并发症。
结论：我们的病例报告强调了在术前访视期间将长期使用四环素类药物纳入病史摄入以协助外科医生进行术中决策的重要性。
方法：术中意外发现弥漫性黑色，蓝色,选择性前足手术中的灰骨变色引起了对代谢恶性过程的关注，并促使将首次meta趾关节植入物置换术的计划转换为Keller置换术。按计划继续进行小指的近端指间关节置换术的计划。送骨标本进行病理分析。
结果：术后分析确定慢性使用米诺环素治疗寻常痤疮。标本的病理分析排除了恶性过程。总之,现有数据有助于诊断米诺环素诱导的黑骨病.自从上次随访以来，病人愈合良好，没有并发症。
结论：我们的病例报告强调了在术前访视期间将长期使用四环素类药物纳入病史摄入以协助外科医生进行术中决策的重要性。
