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D., Non ASSR Member Excerpta Extraordinaire Mentor Award: No Institution where work was conducted William Beaumont Hospital Affiliation and Department Diagnostic Radiology, William Beaumont Hospital 100 RO Address 3601 W. Royal Oak, Michigan 48073 Phone: 2488980648, Fax: 2488985490 Email: [email protected] Excerpta Alkaptonuria (Ochronosis) is a rare metabolic disorder characterized by deficiency of homogentisic acid oxidase. Increased signal intensity on T1 weighted images in connective tissue elsewhere in the body has been described due to the paramagnetic effects of the deposited metabolites. We present a case of a 49 year old man who presented with acute radiculopathy superimposed on chronic back pain who did not have an established diagnosis of alkaptonuria. MRI demonstrated a hyperintense disc on T1 weighted images. The imaging findings and the nature of the disc led to a diagnostic evaluation that confirmed the diagnosis of alkaptonuria. 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