[Tarsometatarsal syphilitic osteoarthropathy]

Bone lesions that develop in the course of tertiary syphilis in the tarsus and the metatarsus are considered by most of the authors as being exceptionaly rare. In the author's statistics the tarso-metatarsal localizations are just as frequent as the tibial ones--generally recognized as elective localizations. A total of 10 cases are presented, of patients with tarso-metatarsal luetic osteoarthropathy, characterized by a mosaic of destructive lesions (osteoporosis, osteonecrosis, osteolysis, bone goma, spontaneous amputations of bone segments), coexisting with bone-constructive lesions (osteophitosis, compact layer condensation, osteosclerosis, peridiaphisal-epiphiseal muff), with periostal and articular reactions. The general clinical signs, the neurological symptoms, the local clinical signs and the specific serologic reactions fill in the nosological frame of the tarso-metatarsal luetic osteoarthropathy, a clinical entity clearly defined by the author. The fact is stressed that, as a rule, cutaneous lesions on the soles of the feet are wrongly taken for simple callosities, while, in fact, these are perforating lesions of the sole, a revealing peripheral sign, which, correctly interpreted, allows for making the diagnosis of tertiary syphilis with tarso-metatarsal osteoarthropathy.