Syphilis CT

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: ; Aysha Anwar, M.B.B.S[2]; Vishal Devarkonda, M.B.B.S[3]; Tarek Nafee, M.D. [4]; Nate Michalak, B.A.

Overview[edit | edit source]

CT scan is not diagnostic of syphilis. However, non-specific CT findings may demonstrate complications of syphilis including pulmonary, cardiac, neurological, gastrointestinal, and bone findings.^{[1][2][3][4][5][6]}

CT[edit | edit source]

On CT scan, syphilis may present with various non-specific findings including:

Pulmonary[edit | edit source]

• Solitary or multiple pulmonary nodules with or without infiltrates (mimicking pulmonary metastasis)^[1]
• Round, well-defined opacities^[1][7]
• Pleural effusion^[1]

Cardiac[edit | edit source]

• Double ring appearance of the aortic wall with a hyperdense outer rim and hypodense inner rim^[2][3]
• Thickening or calcification appearing as contrast enhancement of aortic wall^[2][3]

Neurological[edit | edit source]

• Areas of decreased density suggesting cerebral infarction^[8][9]
• Syphilitic gumma appear hypodense with precontrast
• Focal or diffuse extraaxial enhancement
• Non-specific white matter lesions

Bone[edit | edit source]

• Lytic bone lesions in tibia, acromion, ribs, and sacroiliac joint^[4]
• Multiple lytic lesions in the skull in early syphilis^[5]

Gastrointestinal[edit | edit source]

• Irregular rectal wall thickening (mimicking rectal carcinoma)^[6]
• Multiple peri-rectal lymph node enlargement (mimicking rectal carcinoma)^[6]

Others[edit | edit source]

• Perivascular fluid collection
• Periaortic lymph node enlargement

References[edit | edit source]

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