Syphilis other imaging findings

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]

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## Overview

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Other imaging findings of syphilis include novel PET/CT technology, multimodal ophthalmologic imaging, bone scintigraphy, and angiography. PET/CT is a novel imaging study which portrays 18F-Fluorodeoxyglucose (FDG) uptake enhanced regions superimposed on cross sectional CT images. Multimodal ophthalmologic imaging combines ophthalmoscopy with spectral domain optical coherence tomography (SD-OCT) to produce high definition imaging of the posterior chamber of the eye. Bone scintigraphy allows clinicians to visualize bone uptake of Technetium-99 (T-99m) using x-ray technology. These imaging findings allow clinicians to detect syphilitic manifestations involving the bone, retina, heart, lungs, and lymph nodes.[1][2][2][3][4][5][6]

## Other imaging studies

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Other imaging findings of syphilis include novel PET/CT technology, multimodal ophthalmologic imaging, bone scintigraphy, and angiography. These imaging findings allow clinicians to detect syphilitic manifestations involving the bone, retina, heart, lungs, and lymph nodes.

### PET/CT (FDG Uptake)

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Bone

* Increased 18F-Fluorodeoxyglucose (FDG) uptake and osseous destruction[1]

Pulmonary

* Increased FDG uptake in multiple pulmonary nodules (mimicking pulmonary metastasis)[2]

Other

* Increased FDG uptake in lymph nodes (generalized lymphadenopathy in secondary syphilis)[3]

### Bone Scintigraphy

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* Heterogenous uptake of T-99m[4]

### Multimodal Ophthalmologic Imaging

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* Multifocal lesions [5][6]
* Retinal precipitates[5]
* Unilateral yellow lesions[5]
* Nodular elevations of the choroid[6]

## References

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1. ↑ 1.0 1.1 Wang X, Yin J, Chen X (2011). "Syphilitic bone destruction on FDG PET/CT". Clin Nucl Med. 36 (7): 616–8. doi:10.1097/RLU.0b013e318219ac62. PMID 21637078.CS1 maint: Multiple names: authors list (link)
2. ↑ 2.0 2.1 2.2 Kim HJ, Seon HJ, Shin HH, Choi YD (2011). "Case report: Pulmonary syphilis mimicking pulmonary hematogenous metastases on chest CT and integrated PET/CT". Indian J Radiol Imaging. 21 (1): 34–7. doi:10.4103/0971-3026.76052. PMC 3056368. PMID 21431031.CS1 maint: Multiple names: authors list (link)
3. ↑ 3.0 3.1 Kim JM, Lee SM, Bae SB, Lee JS, Kim SY (2016). "The role of PET/CT in diagnosing generalized lymphadenopathy in asymptomatic secondary syphilis". Hell J Nucl Med. 19 (1): 60–2. doi:10.1967/s002449910340. PMID 26929943.CS1 maint: Multiple names: authors list (link)
4. ↑ 4.0 4.1 Naraghi AM, Salonen DC, Bloom JA, Becker EJ (2010). "Magnetic resonance imaging features of osseous manifestations of early acquired syphilis". Skeletal Radiol. 39 (3): 305–9. doi:10.1007/s00256-009-0806-7. PMID 19795120.CS1 maint: Multiple names: authors list (link)
5. ↑ 5.0 5.1 5.2 5.3 Curi AL, Sarraf D, Cunningham ET (2015). "MULTIMODAL IMAGING OF SYPHILITIC MULTIFOCAL RETINITIS". Retin Cases Brief Rep. 9 (4): 277–80. doi:10.1097/ICB.0000000000000186. PMID 26237137.CS1 maint: Multiple names: authors list (link)
6. ↑ 6.0 6.1 6.2 Sekine Y, Yashiro S, O'hira A, Yoshida N, Morinaga M, Nagashima N; et al. (2015). "[Multimodal imaging of a case of acute syphilitic posterior placoid chorioretinitis]". Nippon Ganka Gakkai Zasshi. 119 (4): 266–72. PMID 25980046.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)

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