Syphilis x-ray

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

Overview[edit | edit source]

Chest x-ray is not routinely used to detect syphilis. However, complications associated with syphilis may be detected incidentally on x-ray. Cardiovascular manifestations of syphilis may be seen as a non-specific widening of the aortic or mediastinal silhouettes on PA and lateral chest x-ray.^[1][2] Linear calcification of the ascending aorta is an almost pathognomonic finding of syphlitic aortitis.^[3] This may prompt the clinician to order further imaging studies for confirmation. Additionally, on chest x-ray, secondary pulmonary syphilis may be characterized by the bilateral infiltrates, pleural effusion, subpleural nodules, and lymphadenopathy.^{[4][5][6][7][8]} X ray findings may also include osteolytic bone lesions.^[9]

X-ray[edit | edit source]

X-ray findings in syphilis are largely non-specific and may be found incidentally. Common incidental x-ray findings of syphilis may include:

Pulmonary[edit | edit source]

On chest x-ray, secondary pulmonary syphilis may be characterized by the following:^{[4][5][6][7][8]}

• Bilateral infiltrates
• Pleural effusion
• Subpleural nodules
• Lymphadenopathy

Cardiac[edit | edit source]

Chest x-ray is not routinely used to detect thoracic manifestations of syphilis. However, thoracic aortic aneurysms associated with syphilis may be detected incidentally as a widening of the aortic or mediastinal silhouettes on PA and lateral chest x-ray. Accurate assessment of the exact size is difficult and further imaging studies are required to do so.^[1][2] Linear calcification of the ascending aorta is an almost pathognomonic finding of syphlitic aortitis.^[3]

Bone[edit | edit source]

X-ray findings may also include osteolytic bone lesions.^[9]

References[edit | edit source]

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