Severe hemochromatosis arthropathy in the absence of iron overload

Abstract

An 18 year old man presented with bilateral knee pains. He had first developed symptoms at age 15 in 1991. Physical examination in 1995 by a senior rheumatology consultant showed patellofemoral crepitus and pain on movement of the patellae over the femur with slight loss of flexion. There were no effusions. Examination of the hands, hips and ankles were unremarkable. Radiographs were available for his hips, feet and chest which were normal. His initial knee radiographs and rheumatology assessment were interpreted as bilateral chondromalacia patellae with possible chondrocalcinosis and genetic hemochromatosis was suggested (Figure 1).

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