A Study of the Involvement of the Bones and Joints in Early Syphilis

Polyostotic Osteitis in Secondary Syphilis in an HIV-Infected Patient

“…7 In a series without radiological confirmation, the reported incidence of bone syphilis is higher, ranging from 4% in the antibiotic era 8 to 24% in 1916. 3 In recent years, more than two thirds of bone syphilis cases have been described in HIV-infected patients. 9 Skeletal involvement generally affects long bones and manifests as pain, especially on the shins; cranial involvement is less common.…”

“…2 Clinical manifestations of syphilis were described in detail in the preantibiotic era, even defining the frequency of rare events such as osseus involvement. 3 However, post-1950, these unusual manifestations became so exceptional that a clinician would rarely see any of them throughout his/her professional career. Moreover, the radiological characteristics of syphilitic lesions have only been described in detail in recent years.…”

Synovitis in secondary syphilis

“…Musculoskeletal manifestations of secondary syphilis were recognized in the United States in 1916 when Wile and Sonnear performed a clinical study on 165 patients with infectious syphilis (9). Of sixty pa- tients with musculoskeletal complaints, 27 had clinical bone involvement, 21 had joint symptoms, and in 12, bone and joints were involved together.…”

“…Of sixty pa- tients with musculoskeletal complaints, 27 had clinical bone involvement, 21 had joint symptoms, and in 12, bone and joints were involved together. Seventeen patients were considered to have only arthralgias while 5 had actual arthritis of knees, hips, and shoulders (9). Recent reports from Europe (2,3) have also shown prominent involvement of knees but also occasional synovitis of fingers and shoulders, ranging from subacute to chronic duration of symptoms.…”

Digging deeper into the limits of ancient DNA research on syphilis

“…Different studies have noted that by the tertiary stage (where the majority of bone lesions develop; however, skeletal alterations have been observed in the secondary stage as well (e.g., Bauer and Caravati, 1967;Ehrlich and Kricun, 1976;Gomez Martinez et al, 2003;Gurland et al, 2001;Jaffe, 1972;Newman and Saunders, 1938;Ollé-Goig et al, 1988;Reynolds and Wasserman, 1942;Shore et al, 1977;Squires and Weiner, 1939;Thompson and Preston, 1952;Waugh, 1976;Wile and Sinear, 1916;Wile and Welton, 1940), individuals are no longer considered infectious because the number of spirochetes has decreased dramatically (Knox et al, 1976). Many researchers believe that the observed bone lesions are actually a hyper-allergenic response (delayed hypersensitivity) (Metzger, 1976;Schell and Musher, 1983;Smith, 1976;Musher and Baughn, 1998) possibly due to the degraded remnants of the bacteria at that particular site (Jaffe, 1972;Resnick and Niwayama, 1995) or to treponemal antigens (Salazar et al, 2002).…”