The clinical features of bone lesions in early congenital syphilis / 中华骨科杂志

ABSTRACT

Objective To evaluate the clinical and X-ray features of bone lesion in early congenital syphilis. Methods Between 1997 and 2005, 48 cases of early congenital syphilis were diagnosed. Among those 48 cases, there were 16 cases with bone lesions detected. The clinical and radiographic features of these 16 cases of bone lesion in early congenital syphilis were retrospectively analyzed. There were 10 males and 6 females with an age between 25-57 d. All patients were confirmed with serology and radiographs of limbs. They were given Penicilin G of 15-20 WU?kg-1?d-1, 3 times a day in a total of 14 days for one course of treatment. Results Rapid plasma reagent test(RPR) of all the cases was positive and they were 3 cases with 1∶128, 2 cases with 1∶64, 6 cases with 1∶32, 3 cases with 1∶16 and 2 cases with 1∶8. All the cases were positive for TPPA. 30 parents of 16 cases were tested for RPR and TPPA. The results showed that 16 mothers were positive for RPR, 13 fathers were positive for RPR. All the parents were positive for TPPA, and negative for HIV test. The main clinical features included active disorder, swelling of involved limbs, malnutrition, light body weight and multi-organ functional lesion. The main X-ray features were metaphysitis, periostitis and osteomyelitis involving all of the long bones of the extremities. Widen of the junction between epiphysis and diaphysis was the characteristic features of early congenital syphilis. After treatment, RPR became negative and sclerotic lesion was recovered and only remain periosteum proliferation. Hutchinson teeth were seen in some patients. Conclusion Bone lesions in early congenital syphilis has its characteristic clinical and radiographic features. The bone lesion could be cured after effective treatment.