Neurosyphilis X-ray
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[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-ray is not directly used to detect the neurosyphilis but it may helps to diagnose other manifestations of syphilis disease.
X-ray findings in syphilis are largely non-specific and may be found incidentally. 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]
- Bilateral infiltrates
- Pleural effusion
- Subpleural nodules
- Lymphadenopathy
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 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.[6][7] Linear calcification of the ascending aorta is an almost pathognomonic finding of syphlitic aortitis.[8]
Bone
X-ray findings may also include osteolytic bone lesions.[9]
References
- ↑ Biro L, Hill AC, Kuflik EG (1968). "Secondary syphilis with unusual clinical and laboratory findings". JAMA. 206 (4): 889–91. PMID 4175712.
- ↑ 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.
- ↑ 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). - ↑ 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.
- ↑ Geer LL, Warshauer DM, Delany DJ (1985). "Pulmonary nodule in secondary syphilis". Australas Radiol. 29 (3): 240–2. PMID 4074225.
- ↑ https://radiopaedia.org/articles/thoracic-aortic-aneurysm. Accessed on September 28th, 2016.
- ↑ https://radiopaedia.org/articles/ascending-aortic-aneurysm. Accessed on September 28th, 2016.
- ↑ 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.
- ↑ Shore RN, Kiesel HA, Bennett HD (1977). "Osteolytic lesions in secondary syphilis". Arch Intern Med. 137 (10): 1465–7. PMID 921426.