Bone pain as the presenting manifestation of secondary syphilis

Article Abstract:

Bone inflammation and pain are a recognized but rare manifestation of secondary syphilis referred to as periostitis. These symptoms usually occur in conjunction with skin and mucous membrane lesions and are rarely the only or first manifestation of the disease. A case report of a homosexual male with periostitis is described. The patient had pain in both legs and forearms, which was worse at night and felt tender to touch. Laboratory testing was positive for the organism Treponema pallidum (which causes syphilis) and the patient's Venereal Disease Research Laboratory (VDRL) test was also positive, although the he had no other signs of syphilis. A bone scan demonstrated widespread increased isotope uptake in both tibia, both ulna, and the frontal region of the skull. The patient's symptoms resolved after treatment with antibiotics. Bone scans are valuable in detecting early lesions of periostitis when X-rays are normal. Secondary syphilis should be considered a possible diagnosis when young patients complain of bone pain; in such an instance they should be questioned specifically about recent venereal infection. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Bones, Syphilis, Radionuclide imaging

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Apparent hip osteoarthritis in a 16 year old girl

Article Abstract:

Intra-articular osteoid osteoma (OO) should be considered in an adolescent or young adult with bone pain and a pelvic x-ray which appears normal or shows isolated osteoarthritis. OO is a benign bone tumor which can be difficult to diagnose when it occurs within a joint. In one case, it went undetected through physical examination, pelvic x-rays, bone scan, MRI, CT, and analysis of synovial fluid. A pinhole view of a scintigraph found the problem and the small tumor was removed, resulting in complete recovery.

Osteoma

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Sonography for hip joint effusion in adults with hip pain

Article Abstract:

Many patients with hip pain may have excess fluid in the joint. This condition, called an effusion, was present in 66% of 224 patients with hip pain who had an ultrasound scan of their hip.

Synovial fluid

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