Congenital syphilis, the great mimicker, confused with non-accidental trauma

Area of Science:

• Pediatrics
• Radiology
• Infectious Diseases

Background:

• Congenital syphilis (CS) is a global health concern with diverse clinical presentations in infants.
• Skeletal manifestations of CS can be mistaken for non-accidental trauma (NAT).

Purpose of the Study:

• To highlight the diagnostic challenges in differentiating congenital syphilis from non-accidental trauma in infants.
• To emphasize the importance of comprehensive skeletal surveys in diagnosing CS.

Main Methods:

• Case report of a 4-month-old infant presenting with wrist swelling and fracture.
• Radiographic evaluation including an osseous survey.

Main Results:

• The infant's presentation mimicked non-accidental trauma.
• Osseous survey revealed findings suggestive of congenital syphilis, including bilateral symmetrical skeletal involvement and metaphyseal destruction.

Conclusions:

• Radiographic features of congenital syphilis can overlap with non-accidental trauma.
• Specific findings like bilateral symmetrical involvement and metaphyseal destruction aid in distinguishing CS from NAT.