title: [Bone pain in adults as the first symptom of late congenital syphilis].
abstract: A 20-year-old woman developed multifocal bone pain. Diagnostic radiology revealed thickened periosteum, and syphilis serology was positive (T. pallidum haemagglutination test 1:5120). She also had discrete signs of congenital syphilis, with retinitis pigmentosa and Hutchinson's incisors. Skeletal scintigraphy demonstrated increased uptake even in radiologically unremarkable bones. The bone pain decreased after four-week administration of 1 M units of penicillin G daily. Scintigraphy one year later showed regression of the increased uptake, skeletal radiology did not reveal significant changes. This case shows that late manifestations of congenital syphilis still occur today. The stigmata of such an infection can be minute and easily missed. Skeletal scintigraphy is better for demonstrating active bone involvement than conventional radiology.
authors.affiliation: Medizinische Poliklinik, Universität München.
authors.forename: G
authors.initials: G
authors.lastname: Rauh
authors.forename: B
authors.initials: B
authors.lastname: Stiefenhofer
authors.forename: H
authors.initials: H
authors.lastname: Dörfler
authors.forename: G
authors.initials: G
authors.lastname: Lohmöller
authors.forename: D
authors.initials: D
authors.lastname: Hahn
authors.forename: N
authors.initials: N
authors.lastname: Zöllner
mesh_terms: D000328:Adult; D001847:Bone Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D001842:Bone and Bones / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D010146:Pain / Q000209:etiology*; D010406:Penicillins / Q000627:therapeutic use; D010521:Periosteum / Q000000981:diagnostic imaging / Q000473:pathology; D011859:Radiography; D011877:Radionuclide Imaging; D013588:Syphilis Serodiagnosis; D013590:Syphilis, Congenital / Q000150:complications* / Q000188:drug therapy; D013592:Syphilis, Latent / Q000150:complications*
chemical_list: D010406:Penicillins
vernacular_title: Knochenschmerzen im Erwachsenenalter als Erstsymptom einer Syphilis connata tarda.