Eponymous Osseous Signs in Congenital Syphilis: A Narrative Historical Review

Area of Science:

• Medical History
• Pediatric Pathology
• Radiology

Background:

• The early origins of syphilis and its bone involvement are debated.
• Eponymous labels for osseous signs of congenital syphilis have not been systematically reviewed.
• Clinical and radiographic descriptions of bone involvement in syphilis evolved in the late 19th and early 20th centuries.

Purpose of the Study:

• To review the origins and early clinical descriptions of six eponymous osseous signs of congenital syphilis (1871-1928).
• To outline the present-day relevance of these historical diagnostic signs.
• To demonstrate how clinicians identified skeletal syphilis before widespread serologic testing.

Main Methods:

• Documentary review of PubMed/MEDLINE and major digitized archives (Gallica, HathiTrust, Internet Archive, Wellcome Collection).
• Searches in English, French, and German, supplemented by citation tracing.
• Analysis of primary sources for clinical features, anatomic site, date, and biographical context of six selected eponyms.

Main Results:

• Six eponymous signs met inclusion criteria: Parrot (1871), Fournier (1887), Fraenkel (1897), Wimberger (1925), Du Bois (1926), and Higoumenakis (1928).
• These signs, primarily described in infants and young children, illustrate cranial/clavicular hyperostosis, metaphyseal lucencies, and digital anomalies.
• Collectively, they represent a historical record of recognizing skeletal syphilis before serologic tests.

Conclusions:

• While no longer primary diagnostic tools, these eponymous signs offer historical insight into early syphilis recognition.
• They retain value in prompting consideration of congenital syphilis with unexpected bone changes in infants.
• The review highlights the evolution of understanding skeletal manifestations of congenital syphilis.