Pediatric Syphilis

  • Etiology: Treponema pallidum causing symmetrical involvement of enchondral ossification sites
  • Imaging: periosteal reaction of long bones is bilateral / symmetrical / diffuse, metaphyseal lucency / notch on proximal medial tibial metaphysis due to destruction (Wimberger’s corner sign), metaphyseal zone of provisional calcification mineralization
  • Clinical: 66% present at 1-2 months and 100% present by 3 months, see hepatomegaly / splenomegaly, petechiae, jaundice, hemolytic anemia, thrombocytopenia, chorioretinitis, rhinitis, lymphadenopathy, vesiculobullous or maculopapular rash

Radiology Cases of Syphilis

Radiograph of osteomyelitis due to syphilis
AP radiograph of the lower extremities shows bilateral diffuse periostitis of the tibiae and some destructive changes on the medial proximal metaphysis of the left tibia (Wimberger’s sign).