Bone Lesions in Acquired Syphilis1

TLDR: If the hypothesis, which appears to be true, that the entire process, as far as bone involvement is concerned, represents an osteomyelitis, it is possible to understand the varying roentgen manifestations.

Abstract: The statement that syphilis is a great “imitator” finds no exception in its bone lesions. Roentgenograms of bones with syphilitic involvement are by no means always characteristic, as they may simulate chronic non-specific osteomyelitis, primary bone tumor, metastatic cancer, multiple myeloma, or any other type of bone lesion. The abundant blood supply to the bone marrow and periosteum tends to make these structures a good reservoir of infection. The causative organism is borne through the blood stream to all parts of the body. The disease is thus propagated via the blood stream, and the invasion of the periosteum or bone is to be expected. If we accept the hypothesis, which appears to be true, that the entire process, as far as bone involvement is concerned, represents an osteomyelitis, it is possible to understand the varying roentgen manifestations. The end-results may be necrosis, sclerosis, osteoporosis, sequestrum formation, or spontaneous fracture. Any combination of these findings may be present s...