Periostitis in secondary syphilis: a place for bone scintigraphy

Area of Science:

• Medical imaging
• Infectious diseases
• Rheumatology

Background:

• Secondary syphilis is a systemic infection with diverse clinical manifestations.
• Periostitis, inflammation of the bone membrane, can be a presenting feature of secondary syphilis.
• Diagnostic imaging plays a crucial role in evaluating skeletal involvement.

Observation:

• Two cases of secondary syphilis are presented where periostitis was the primary clinical sign.
• Radiographic imaging was performed to assess the bone involvement.
• Technetium-99m bone scintigraphy was also utilized for evaluation.

Findings:

• Technetium-99m bone scintigraphy demonstrated superiority over conventional radiography.
• Bone scintigraphy effectively defined the extent of periosteal involvement.
• Early syphilitic bone lesions were more readily identified by scintigraphy.

Implications:

• Technetium-99m bone scintigraphy should be considered in the diagnostic workup of secondary syphilis presenting with periostitis.
• This imaging modality offers enhanced sensitivity for early detection and comprehensive assessment of osseous lesions.
• Improved diagnostic accuracy can lead to timely treatment and better patient outcomes in syphilis management.