Rauh G, Stiefenhofer B, Dörfler H, Lohmöller G, Hahn D, Zöllner N
Medizinische Poliklinik, Universität München.
Dtsch Med Wochenschr. 1990 Apr 6;115(14):534-8. doi: 10.1055/s-2008-1065043.
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.
一名20岁女性出现多灶性骨痛。诊断性放射学检查显示骨膜增厚，梅毒血清学检查呈阳性（梅毒螺旋体血凝试验1:5120）。她还具有先天性梅毒的离散体征，包括色素性视网膜炎和哈钦森氏切牙。骨闪烁扫描显示即使在放射学上无异常的骨骼中摄取也增加。每日给予100万单位青霉素G治疗四周后，骨痛减轻。一年后的闪烁扫描显示摄取增加有所消退，骨骼放射学检查未发现明显变化。该病例表明，先天性梅毒的晚期表现如今仍会出现。这种感染的体征可能很细微，容易被忽视。与传统放射学相比，骨闪烁扫描更有助于显示活跃的骨受累情况。
