Syphilitic Arthritis

Juvenile hypertrophic osteoarthropathy associated with primary sclerosing cholangitis

“…The striking symmetry of the periostitis and absence of radiographic bone changes suggestive of bone infarcts, along with normal hemoglobin electrophoresis, failed to support the possibility of sickle cell disease or other hemoglobinopathy (6). Congenital deafness, along with periostitis and large effusion of both knees, suggested a late form of congenital syphilis, but this possibility was ruled out by the negative VDRL and absence of keratitis or Hutchinson's teeth (7).…”

“…Congenital deafness, along with periostitis and large effusion of both knees, suggested a late form of congenital syphilis, but this possibility was ruled out by the negative VDRL and absence of keratitis or Hutchinson's teeth (7).…”

The Great Impostor Did It Again: Syphilitic Arthritis

“…There are four stages of syphilis with different clinical presentations in each stage: primary (local), secondary (generalized), latent (asymptomatic), and tertiary (cardiovascular, neuro, gummatous) syphilis. Rheumatic clinics reported a fresh increase in the number of cases of syphilitic arthritis in 1963, a few years after the Second World War, when syphilis was not adequately treated and resulted in an increased number of congenital syphilis cases [ 4 ].…”

“…On the other hand, the osseous form, which is commonly seen in young patients, presents as epiphysitis; eroded and irregular articular surface, and cavitation in the interior of the bone, along with bony outgrowths. In adults, one whole large joint might get affected with osteoarthritic features [ 4 ]. Less frequently, migratory polyarthralgia or arthritis can occur in secondary syphilis, which might resemble the presentation of rheumatic fever.…”

“…Gummatous synovitis does not have bone involvement; however, they can develop disuse osteoporosis as a result of the patient's pain. The Von Gie joint has reduced joint space and well-demarcated bone erosions towards the central areas of the joint that are evidenced radiologically [ 4 ]. Synovial fluid analysis in the affected patients has revealed polymorphonuclear neutrophils and phagocytic mononuclear cells with large vacuoles when visualized under electron microscopy.…”