AccScience Publishing / ARNM / Volume 2 / Issue 1 / DOI: 10.36922/arnm.2204
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Secondary syphilis: An unusual cause of osteolytic lesion diagnosed by 99mTc-MDP SPECT and presenting features

Xia Lu1* Chifeng Xu1 Haizhong Zhou1 Qin Xiao2 Huiying He3*
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1 Department of Nuclear Medicine, Northern Jiangsu People’s Hospital, Yangzhou, China
2 Department of Pathology, Northern Jiangsu People’s Hospital, Yangzhou, China
3 Department of Pathology, School of Basic Medical Sciences, Peking University Third Hospital, Peking University Health Science Center, Beijing, China
Revised: 8 November 2023 | Accepted: 26 January 2024 | Published: 26 March 2024
© 2024 by the Author (s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( )

Herein, we present the case of a 68-year-old woman complaining of pain of the right knee, which was initially misdiagnosed by plain radiography as fracture on inner right tibia plateau but was finally clarified as osteolytic lesion secondary to syphilis affecting the whole right knee. The final diagnosis was made based on the valuable findings from bone scanning, which allows for imaging of abnormalities with much larger extent, a scale that is out of the examination capacity of plain radiography. Bone scanning was employed in this case, coupled with the use of 99mTc-MDP, to assess abnormal bone metabolism at the whole right knee next to the tibia plateau. The imaging results illustrated the diverse features of bone involvement of secondary syphilis, including periostitis, osteolysis as well as osteomyelitis, occurring together or in isolation.

Secondary syphilis
Right knee
This work was supported by the foundation of “Lvyang Jinfeng” talents attracting plan (LYJF00040) and Jiangsu Provincial Health Commission General Project (H2023055).
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Conflict of interest
The authors declare that they have no competing interests.
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Advances in Radiotherapy & Nuclear Medicine, Electronic ISSN: 2972-4392 Published by AccScience Publishing