Table 1. Published cases of bone involvement in non-congenital syphilis and the two cases presented here.
| Authors (Year) | Age sex | HIV status | Radiographic examination | Localization of lesions | Symptoms and signs | Stage of syphilis | Treatment | Length of treatment | Response |
|---|---|---|---|---|---|---|---|---|---|
| Lefkovits AM, et al. (1946) | 22/M | No | Nodular lesion and erosion of the outer layer | Skull | Headache, alopecia, generalized lymphadeno-pathy | Secondary | Procaine penicillin G | Two and a half weeks | Decreased in size at three months |
| Kellock IA, et al. (1956) | 47/M | No | Mixed lytic and sclerotic lesion | Skull, tibia, humerus, femur, elbow | Bone pain, weight loss, headache | Secondary | Benzathine penicillin G | Ten days | Improvement of images at five months |
| Bauer MF, et al. (1967) | 26/W | No | Osteolytic lesion in frontal bone | Frontal bone | Headache, maculopapular rash | Secondary | Procaine penicillin G | Ten days | Partial resolution at three months |
| Parker JDJ. (1972) | 35/M | No | Periosteal reaction | Tibias | Leg pain with paraesthesia of the ankles | Secondary | Cephalori-dine | Two weeks | Almost complete resolution of images at 11 months |
| Tigh RR, et al. (1976) | 20/M | No | Multiple areas of increased uptakea | Skull, sternum, and clavicle | Headache, myalgia, maculo-papular rash, cervical lymphadenopathy | Secondary | Benzathine penicillin G | Ten days | Loss at follow-up |
| Longstreth P, et al. (1976) | 30/M | No | Bone resorption of the distal clavicle | Clavicle | Headache, shoulder pain, alopecia, splenomegaly | Secondary | Benzathine penicillin G | Three weeks | Recalcification at one month |
| Erlich R, et al. (1976) | 25/M | No | Multiple lytic lesions | Tibia, fibula, ulna, radius | Headache, myalgia, ankle pain, maculopapular rash | Secondary | Benzathine penicillin G | Two and a half weeks | Imaging resolution at three months |
| Dismukes WE, et al. (1976) | 32/M | No | Multiple osteolytic lesions | Clavicle, frontal and parietal bone | Headache, fever, weight loss, generalized lymphadenopathy, maculopapular rash | Secondary | Procaine penicillin G | Ten days | Asymptomatic |
| Shore RN, et al. (1977) | 37/M | No | Multiple lytic lesions | Tibia, fibula, radius, and ulna bilaterally | Pain in leg, ankles and arms, maculo-papular rash | Secondary | Procaine penicillin G | Ten days | -- |
| Graudal C, et al. (1981) | 42/M | No | Osteitis changesa | Tibia | Left leg pain, fever, sore throat, weight lost | Secondary | Benzathine penicillin G | Ten days | Imaging resolution after treatment |
| Petersen LR, et al. (1983) | 48/M | No | Diffuse increased activitya | Ribs, long bones, and spine | Leg and back pain, headache, papular rash | Secondary | Parenteral penicillin G | Ten days | Asymptomatic at two months |
| Hansen K, et al. (1984) | 31/M | No | Multiple areas of increased uptakea | Parietal, occipital, maxillary, mandibular, ribs, humerus, femur | Headache, fever | Secondary | Benzathine penicillin G | Five months | 50% reduction in activity at nine months |
| Veerapen K, et al. (1985) | 35/W | No | Increased uptakea | Frontal bone and tibia | Neck and leg pain | Secondary | Procaine penicillin G | Ten days | No changes in the images at six months |
| Meier JL, et al. (1986) | 37/M | No | Increased activitya | Tibias | Fever, leg pain, headache | Early syphilis | Penicillin | Ten days | Asymptomatic at one year |
| Rodriguez S, et al. (1988) | 39/M | No | Dense bony sclerosis | T10, L1 and L5 vertebral bodies | Weight loss | Tertiary | Procaine penicillin G | One month | Asymptomatic at three months |
| Ollé-Goig JE, et al. (1988) | 32/W | No | Multiple diffuse intracortical destructive lesions | Tibias, fibulas | Leg pain, weight loss, headache | Secondary | Procaine penicillin G | Ten days | Asymptomatic at six months |
| 21/M | No | Osteolytic lesión | Frontal and parietal bone | Asthenia, headache, generalized lymphadenopathy, maculopapular rash | Secondary | Benzathine penicillin G | Ten days | Asymptomatic at two months | |
| Middleton S, et al. (1990) | 31/M | No | Increased uptakea | Tibias, ulnas, and frontal bone | Leg and forearm pain | Secondary | Benetha- mine penicillin | Ten days | Imaging resolution at four months |
| Kastner RJ, et al. (1994) | 25/M | No | Increased uptakea | Ulna, skull, and radius | Maculo-papular rash, generalized lymphadenopathy | Secondary | Procaine penicillin G | Two weeks | Markedly diminished uptake at 30 days |
| Chung KY, et al. (1994) | 29/W | No | Round osteolytic lesions | Frontal, temporal, and parietal bones | Headache, maculopapular rash | Secondary | Benzathine penicillin G | Three weeks | |
| Rademacher | 27/W | No | Periosteal elevation | Tibias, calcaneus | Headache, fever, | Secondary | Intrave-nous | Two weeks | Lost at follow-up |
| SE, et al. (1996) | 34/M | Yes | with periostitis Cortical thickeninga | Tibias | ulcerative rash, and shin and heel pain Fever, chills, night sweats, weight loss, painful skin lesions | penicillin G Intrave-nous penicillin G then benzathine penicillin | One month | Asymptomatic at nine months | |
| Gurland IA, et al. (2001) | 20/M | Yes | Multiple lytic lesions | Skull | Painful nodules | Secondary | Procaine penicillin G | Three weeks | -- |
| Coyne K, et al. (2006) | 36/M | Yes | Periostitis | Humerus, femur, tibia, fibula, and skull | Headache, fever, and sweats, maculopapular rash | Secondary | Benzathine penicillin G | Two weeks | Imaging resolution at three months |
| Huang I, et al. (2007) | 40/M | Yes | Multiple lytic lesions, “worm eaten” appearance | Frontal and parietal bone | Headache | Secondary | Penicillin | One and a half months | Asymptomatic resolution at 1.5 months |
| Kandelaki G, et al. (2007) | 20/M | Yes | Destructive lesion | Sternal bone | Painful lump on chest and maculo-papular rash | Secondary | Procaine penicillin G | Two weeks | Imaging resolution at six weeks |
| Denes E. (2009) | 37/M | Yes | Increased uptakea | Tibia, radius, and skull | Leg pain, loss of appetite and weight, skin ulcerations | Secondary | Benzathine penicillin G | Six weeks | Asymptomatic at two months |
| Naraghi AM, et al. (2010) | 64/M | Yes | Hetero-geneous activitya | Tibias, fibula, femur, skull, orbit | Leg pain | Early syphilis | Benzhatine penicillin G | Three weeks | Imaging resolution at three years |
| Samarkos M, et al. (2011) | 25/M | Yes | Increased uptakea | Skull, ribs | Headache, maculopapular rash | Secondary | Intrave-nous penicillin G | - | Imaging resolution at three months |
| Liu Z-Y, et al. (2011) | 62/M | No | Focal osteolytic lesions and onionlike periosteal reaction | Tibia and fibula | Leg pain | Late latent syphilis | Penicillin G | One and a half months | Imaging resolution at 1.5 months |
| Egan KM, et al. (2012) | 41/M | No | Increased enhancementa | Skull | Headache and papular rash | Secondary | Procaine penicillin G | Two weeks | Asymptomatic at three months |
| Boix V, et al. (2013) | 40/M | Yes | Osteolytic lesions and increased uptakea | Skull, humerus, and ulna | Fever, headache, weight loss, generalized lymphadenopathy | Secondary | Doxycy-cline and azithromycin | Four months | Imaging resolution at four months |
| Alraddadi B, et al. (2013) | 32/M | - | Osteolytic lesion | Skull | Headache | Secondary | Intrave-nous penicillin G | Two weeks | Asymptomatic at two weeks |
| Park KH, et al. (2014) | 41/M | No | Bone destruction and extra-skeletal soft tissue formation | Multiple ribs and L5 vertebra | Weight loss, maculopapular rash, and generalized lymphadenopathy | Secondary | Benzathine penicillin | Three weeks | Decreased uptake at six months |
| Bezaley S, et al. (2014) | 20/M | No | Multiple osteolytic and sclerotic lesions with periosteal reaction | Tibia, 11th rib, parietal bone, acromioclavicular joint, and sacroiliac joint | Weight loss, leg, shoulder and rib pain, headache, maculopapular rash | Secondary | Penicillin | - | Asymptomatic at one month |
| Manríquez J, et al. (2014) | 50/M | No | Increased uptakea | Tibia | Leg pain, maculopapular rash, generalized lymphadenopathy | Secondary | Benzathine penicillin G | Three weeks | - |
| Bai Y, et al. (2017) | 44/M | No | Osteolytic lesion and new bone formation | Bodies of L4 and L5 vertebras | Low back pain, numbness below the knees, and inability to walk | Tertiary | Benzathine penicillin G | Three weeks | Imaging resolution at 12 months |
| Kamegai K, et al. (2022) | 30/M | Yes | Osteolytic lesion | Sternum and ribs | Chest pain | Tertiary | Ceftriax-one | 13 weeks | Magnetic resonance imaging (MRI) showed abnormal signals |
| Jankowska L, et al. (2022) | 20/W | Osteolytic lesion | Clavicule | Skin lesions, uveitis, bone pain | Tertiary | Penicillin | 14 weeks | Reduced tumor was observed |
a
Bone scintigraphy