[Not a fall--not abuse--not a rare finding?]

Area of Science:

• Pediatrics
• Radiology
• Infectious Diseases

Background:

• Congenital syphilis is a serious infection transmitted from mother to child.
• Skeletal manifestations in congenital syphilis can be mistaken for traumatic injuries.
• Accurate diagnosis is crucial for appropriate treatment and preventing long-term complications.

Observation:

• An infant presented with right arm pain, X-rays revealed epiphyseal destruction and double periosteal contours.
• Similar bone alterations were noted in all long bones.
• The clinical and radiological findings were consistent with florid congenital syphilis.

Findings:

• Congenital syphilis was confirmed through patient history and laboratory tests.
• The infant and both parents received successful treatment with penicillin G.
• Orthopedic intervention was unnecessary, and the plaster cast was removed after diagnosis.

Implications:

• Recognizing specific radiological signs of congenital syphilis is key to avoiding misdiagnosis of trauma.
• Prompt antibiotic treatment can lead to complete resolution of skeletal abnormalities.
• Screening and treating pregnant mothers for syphilis prevents congenital infections and their skeletal sequelae.