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__NOTOC__
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{{CMG}}; {{AE}}{{MMJ}}
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{{Neurosyphilis}}
{{Neurosyphilis}}
==Overview==
==Overview==
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.<ref name="radiop"> https://radiopaedia.org/articles/thoracic-aortic-aneurysm. Accessed on September 28th, 2016. </ref><ref name="radiop1"> https://radiopaedia.org/articles/ascending-aortic-aneurysm. Accessed on September 28th, 2016. </ref> Linear calcification of the ascending aorta is an almost pathognomonic finding of syphlitic [[aortitis]].<ref name="pmid21427433">{{cite journal| author=Dabis R, Radcliffe K| title=Is it useful to perform a chest X-ray in asymptomatic patients with late latent syphilis? | journal=Int J STD AIDS | year= 2011 | volume= 22 | issue= 2 | pages= 105-6 | pmid=21427433 | doi=10.1258/ijsa.2010.010248 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21427433  }} </ref> This may prompt the clinician to order further imaging studies for confirmation. Additionally, on [[Chest X-ray|chest x-ray]], secondary pulmonary syphilis may be characterized by the bilateral infiltrates, [[pleural effusion]], subpleural nodules, and [[lymphadenopathy]].<ref name="pmid4175712">{{cite journal| author=Biro L, Hill AC, Kuflik EG| title=Secondary syphilis with unusual clinical and laboratory findings. | journal=JAMA | year= 1968 | volume= 206 | issue= 4 | pages= 889-91 | pmid=4175712 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4175712  }} </ref><ref name="pmid16392072">{{cite journal| author=David G, Perpoint T, Boibieux A, Pialat JB, Salord H, Devouassoux M et al.| title=Secondary pulmonary syphilis: report of a likely case and literature review. | journal=Clin Infect Dis | year= 2006 | volume= 42 | issue= 3 | pages= e11-5 | pmid=16392072 | doi=10.1086/499104 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16392072  }} </ref><ref name="pmid: PMC3056368">{{cite journal| author=Burger HG, Baker HW, Buckler HM, Healy DL, Kovacs GT| title=Advances in reproductive medicine: Australian contributions. | journal=Aust N Z J Med | year= 1988 | volume= 18 | issue= 3 | pages= 263-77 | pmid=: PMC3056368 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3056368  }} </ref><ref name="pmid6613117">{{cite journal| author=Coleman DL, McPhee SJ, Ross TF, Naughton JL| title=Secondary syphilis with pulmonary involvement. | journal=West J Med | year= 1983 | volume= 138 | issue= 6 | pages= 875-8 | pmid=6613117 | doi= | pmc=1010855 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6613117  }} </ref><ref name="pmid4074225">{{cite journal| author=Geer LL, Warshauer DM, Delany DJ| title=Pulmonary nodule in secondary syphilis. | journal=Australas Radiol | year= 1985 | volume= 29 | issue= 3 | pages= 240-2 | pmid=4074225 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4074225  }} </ref> X ray findings may also include osteolytic bone lesions.<ref name="pmid921426">{{cite journal| author=Shore RN, Kiesel HA, Bennett HD| title=Osteolytic lesions in secondary syphilis. | journal=Arch Intern Med | year= 1977 | volume= 137 | issue= 10 | pages= 1465-7 | pmid=921426 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=921426  }} </ref>
 
X-rays are not routinely recommended to detect neurosyphilis. 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|chest x-ray]]. Linear calcification of the ascending aorta is an almost [[pathognomonic]] finding of syphlitic [[aortitis]]. This may prompt the clinician to order further imaging studies for confirmation. Additionally, on [[Chest X-ray|chest x-ray]], secondary pulmonary syphilis may be characterized by the bilateral infiltrates, [[pleural effusion]], subpleural nodules, and [[lymphadenopathy]]. X-ray findings may also include osteolytic bone lesions.


==X-ray==
==X-ray==
X-ray findings in syphilis are largely non-specific and may be found incidentally. Common incidental x-ray findings of syphilis may include:
X-rays are not routinely recommended to detect neurosyphilis. However, complications associated with [[syphilis]] may be detected incidentally on x-ray. [[X-rays|X-ray]] findings in [[syphilis]] are largely non-specific. Common incidental x-ray findings of [[syphilis]] may include:
===Pulmonary===
===Pulmonary===
On chest x-ray, secondary pulmonary syphilis may be characterized by the following:<ref name="pmid4175712">{{cite journal| author=Biro L, Hill AC, Kuflik EG| title=Secondary syphilis with unusual clinical and laboratory findings. | journal=JAMA | year= 1968 | volume= 206 | issue= 4 | pages= 889-91 | pmid=4175712 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4175712  }} </ref><ref name="pmid16392072">{{cite journal| author=David G, Perpoint T, Boibieux A, Pialat JB, Salord H, Devouassoux M et al.| title=Secondary pulmonary syphilis: report of a likely case and literature review. | journal=Clin Infect Dis | year= 2006 | volume= 42 | issue= 3 | pages= e11-5 | pmid=16392072 | doi=10.1086/499104 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16392072  }} </ref><ref name="pmid: PMC3056368">{{cite journal| author=Burger HG, Baker HW, Buckler HM, Healy DL, Kovacs GT| title=Advances in reproductive medicine: Australian contributions. | journal=Aust N Z J Med | year= 1988 | volume= 18 | issue= 3 | pages= 263-77 | pmid=: PMC3056368 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3056368  }} </ref><ref name="pmid6613117">{{cite journal| author=Coleman DL, McPhee SJ, Ross TF, Naughton JL| title=Secondary syphilis with pulmonary involvement. | journal=West J Med | year= 1983 | volume= 138 | issue= 6 | pages= 875-8 | pmid=6613117 | doi= | pmc=1010855 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6613117  }} </ref><ref name="pmid4074225">{{cite journal| author=Geer LL, Warshauer DM, Delany DJ| title=Pulmonary nodule in secondary syphilis. | journal=Australas Radiol | year= 1985 | volume= 29 | issue= 3 | pages= 240-2 | pmid=4074225 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4074225  }} </ref>
On chest x-ray, secondary pulmonary syphilis may be characterized by the following:<ref name="pmid4175712">{{cite journal| author=Biro L, Hill AC, Kuflik EG| title=Secondary syphilis with unusual clinical and laboratory findings. | journal=JAMA | year= 1968 | volume= 206 | issue= 4 | pages= 889-91 | pmid=4175712 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4175712  }} </ref><ref name="pmid16392072">{{cite journal| author=David G, Perpoint T, Boibieux A, Pialat JB, Salord H, Devouassoux M et al.| title=Secondary pulmonary syphilis: report of a likely case and literature review. | journal=Clin Infect Dis | year= 2006 | volume= 42 | issue= 3 | pages= e11-5 | pmid=16392072 | doi=10.1086/499104 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16392072  }} </ref><ref name="pmid: PMC3056368">{{cite journal| author=Burger HG, Baker HW, Buckler HM, Healy DL, Kovacs GT| title=Advances in reproductive medicine: Australian contributions. | journal=Aust N Z J Med | year= 1988 | volume= 18 | issue= 3 | pages= 263-77 | pmid=: PMC3056368 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3056368  }} </ref><ref name="pmid6613117">{{cite journal| author=Coleman DL, McPhee SJ, Ross TF, Naughton JL| title=Secondary syphilis with pulmonary involvement. | journal=West J Med | year= 1983 | volume= 138 | issue= 6 | pages= 875-8 | pmid=6613117 | doi= | pmc=1010855 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6613117  }} </ref><ref name="pmid4074225">{{cite journal| author=Geer LL, Warshauer DM, Delany DJ| title=Pulmonary nodule in secondary syphilis. | journal=Australas Radiol | year= 1985 | volume= 29 | issue= 3 | pages= 240-2 | pmid=4074225 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4074225  }} </ref>
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===Cardiac===
===Cardiac===
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 [[Mediastinum|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.<ref name="radiop"> https://radiopaedia.org/articles/thoracic-aortic-aneurysm. Accessed on September 28th, 2016. </ref><ref name="radiop1"> https://radiopaedia.org/articles/ascending-aortic-aneurysm. Accessed on September 28th, 2016. </ref> Linear calcification of the ascending [[aorta]] is an almost pathognomonic finding of syphlitic aortitis.<ref name="pmid21427433">{{cite journal| author=Dabis R, Radcliffe K| title=Is it useful to perform a chest X-ray in asymptomatic patients with late latent syphilis? | journal=Int J STD AIDS | year= 2011 | volume= 22 | issue= 2 | pages= 105-6 | pmid=21427433 | doi=10.1258/ijsa.2010.010248 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21427433  }} </ref>
[[Chest X-ray|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  
* Widening of the aortic or [[Mediastinum|mediastinal]] silhouettes on PA and lateral chest x-ray. <ref name="radiop">https://radiopaedia.org/articles/thoracic-aortic-aneurysm. Accessed on September 28th, 2016. </ref><ref name="radiop1">https://radiopaedia.org/articles/ascending-aortic-aneurysm. Accessed on September 28th, 2016. </ref>  
* Linear [[calcification]] of the ascending [[aorta]] is an almost [[pathognomonic]] finding of syphlitic [[aortitis]].<ref name="pmid21427433">{{cite journal| author=Dabis R, Radcliffe K| title=Is it useful to perform a chest X-ray in asymptomatic patients with late latent syphilis? | journal=Int J STD AIDS | year= 2011 | volume= 22 | issue= 2 | pages= 105-6 | pmid=21427433 | doi=10.1258/ijsa.2010.010248 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21427433  }} </ref>
 
===Bone===
===Bone===
X-ray findings may also include osteolytic bone lesions.<ref name="pmid921426">{{cite journal| author=Shore RN, Kiesel HA, Bennett HD| title=Osteolytic lesions in secondary syphilis. | journal=Arch Intern Med | year= 1977 | volume= 137 | issue= 10 | pages= 1465-7 | pmid=921426 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=921426  }} </ref>
[[X-ray]] findings of syphilis include osteolytic bone lesions.<ref name="pmid921426">{{cite journal| author=Shore RN, Kiesel HA, Bennett HD| title=Osteolytic lesions in secondary syphilis. | journal=Arch Intern Med | year= 1977 | volume= 137 | issue= 10 | pages= 1465-7 | pmid=921426 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=921426  }} </ref>
==References==
==References==
{{reflist|2}}
{{reflist|2}}
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Overview

X-rays are not routinely recommended to detect neurosyphilis. 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. Linear calcification of the ascending aorta is an almost pathognomonic finding of syphlitic aortitis. 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. X-ray findings may also include osteolytic bone lesions.

X-ray

X-rays are not routinely recommended to detect neurosyphilis. However, complications associated with syphilis may be detected incidentally on x-ray. X-ray findings in syphilis are largely non-specific. Common incidental x-ray findings of syphilis may include:

Pulmonary

On chest x-ray, secondary pulmonary syphilis may be characterized by the following:[1][2][3][4][5]

Cardiac

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

Bone

X-ray findings of syphilis include osteolytic bone lesions.[9]

References

  1. Biro L, Hill AC, Kuflik EG (1968). "Secondary syphilis with unusual clinical and laboratory findings". JAMA. 206 (4): 889–91. PMID 4175712.
  2. David G, Perpoint T, Boibieux A, Pialat JB, Salord H, Devouassoux M; et al. (2006). "Secondary pulmonary syphilis: report of a likely case and literature review". Clin Infect Dis. 42 (3): e11–5. doi:10.1086/499104. PMID 16392072.
  3. Burger HG, Baker HW, Buckler HM, Healy DL, Kovacs GT (1988). "Advances in reproductive medicine: Australian contributions". Aust N Z J Med. 18 (3): 263–77. PMID PMC3056368 : PMC3056368 Check |pmid= value (help).
  4. Coleman DL, McPhee SJ, Ross TF, Naughton JL (1983). "Secondary syphilis with pulmonary involvement". West J Med. 138 (6): 875–8. PMC 1010855. PMID 6613117.
  5. Geer LL, Warshauer DM, Delany DJ (1985). "Pulmonary nodule in secondary syphilis". Australas Radiol. 29 (3): 240–2. PMID 4074225.
  6. https://radiopaedia.org/articles/thoracic-aortic-aneurysm. Accessed on September 28th, 2016.
  7. https://radiopaedia.org/articles/ascending-aortic-aneurysm. Accessed on September 28th, 2016.
  8. Dabis R, Radcliffe K (2011). "Is it useful to perform a chest X-ray in asymptomatic patients with late latent syphilis?". Int J STD AIDS. 22 (2): 105–6. doi:10.1258/ijsa.2010.010248. PMID 21427433.
  9. Shore RN, Kiesel HA, Bennett HD (1977). "Osteolytic lesions in secondary syphilis". Arch Intern Med. 137 (10): 1465–7. PMID 921426.


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