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Age / Sex : /
Age / Sex : 9 days/female
Chief complaint : Prematurity, persistent pulmonary hypertension
1) What is your impression?
Two weeks later, you can see the final diagnosis with a brief discussion of this case.
* Send Application Answers to Ja-Young Choi, MD (drchoi01@radiol.snu.ac.kr)
Courtesy : In Sup Song, MD. Chung-Ang University Hospital
Diagnosis: congenital syphillis (metaphyseal radiolucent band)
Discussion
Findings:
Metaphyseal radiolucent band and radiopaque transverse band in proximal and distal both femur, both tibia, both humerus, both ulna and radius. Dense diaphysis of involved bones.
Diagnosis: Congenital syphilis
Discussion:
Typical radiographic abnormalities included growth arrest lines, metaphyseal destruction, periostitis, and, rarely, osteitis, with abnormalities most frequently being found in infants with florid congenital syphilis. The bony abnormalities were originally thought to be due to direct infection by spirochetes, but the symmetrical nature of the changes and their consistent appearance in the metaphyses suggest that the lesions represent not local invasion and inflammatory response but rather alterations in osseous development in rapidly growing long bones, with the development of bone findings being proportionate to the rate of growth.
References:
Imaging of the Newborn, Infant and Young Child (Swischuk) 4th Edit. Pp 736-738
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