Early in the course of acquired syphilitic infection, spirochetes are widely disseminated throughout the body tissues, including those of the bony skeleton.1 Yet despite the fact that bone, together with its periosteum and marrow cavity, is known to harbor virulent organisms, the development of objective skeletal abnormalities during the early stages of the disease is comparatively rare. When the skeletal structures do become involved during early syphilis, the involvement is usually proliferative periostitis. More rarely destructive osteitis and osteomyelitis occur. It is with the latter lesions that this study is concerned.
In a series of approximately 10,000 cases of early syphilis observed in the Syphilis Division of the Medical Clinic and the wards of the Johns Hopkins Hospital over a twenty-two year period (1919-1940), 15 instances of destructive bone lesions (osteitis, osteomyelitis, osteoperiostitis) have been recognized. In view of the rarity of these conditions and the relative scarcity of
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