Black pigmentation of both forearm bones after chronic minocycline antibiotic therapy for septic nonunion. A case report and literature review

Minocycline black bone disease in arthroplasty: a systematic review

“…Minocycline black bone disease is a rare condition that may be encountered unexpectedly during arthroplasty. Based on the findings of this study, surgeons can be reassured that good clinical outcomes can be achieved with routine arthroplasty, and there is no need to alter the operative plan [2]. Other causes of bone discolouration need to be excluded, but sparing of the cartilage and peri-articular soft tissues appears to be indicative of minocycline bone disease [1].…”

“…Author details 1 Department of Orthopaedics, Toowoomba Hospital, Pechey Street, Toowoomba, Queensland 4350, Australia. 2 University of Queensland, Toowoomba, Queensland, Australia. 3 School of Medicine, Rural Clinical School, University of Queensland, Toowoomba, Queensland, Australia.…”

“…Discolouration of bone encountered intra-operatively during arthroplasty can be unexpected for the surgeon and raise concerns regarding bone integrity, prosthesis stability and risk of post-operative complications [1]. Despite increasing recognition of minocycline causing bony discolouration, orthopaedic reports remain sparse [2]. Discolouration has been reported as grey, greyishblack, brown, blue-green and black [1,3].…”

“…The latter gives it therapeutic properties in rheumatoid arthritis and dermatological conditions such as acne vulgaris and rosacea. Hyperpigmentation can occur in different body tissues, and minocycline is well-recognised as a cause of bony pigmentation in oral and maxillofacial surgery [2]. Differentials for bony discolouration include ochronosis, metabolic bone diseases, metal deposition including titanium, iron and copper, haemophilic arthropathy, sequestra, metastases and long-term minocycline use [1,3].…”