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2018 ; 19
(1
): 251
Nephropedia Template TP
gab.com Text
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English Wikipedia
The disappearance of femoral head and neck resulting from extensive bone defect
caused by secondary syphilis: a case report and literature review
#MMPMID30045704
Liang X
; Liu T
; Yuan C
; Wang W
; Liang P
BMC Musculoskelet Disord
2018[Jul]; 19
(1
): 251
PMID30045704
show ga
BACKGROUND: Treponema Pallidum (TP), the pathogen of syphilis, commonly infects
bones in cases of congenital and tertiary syphilis, but it is rare in the primary
and secondary stages. With its mild symptoms and rare clinical findings, it might
be easy to dismiss the diagnosis of early syphilis. Usually, effective results
can be achieved after the conventional strategy of antibiotic treatments, mainly
penicillin. To our knowledge, our case is so far the most serious reported case
of destructive bone lesion in secondary syphilis, and our treatment for the case
is the first strategy using total hip arthroplasty in secondary syphilis. CASE
PRESENTATION: We present the case of a 71-year-old man with local repeated pain
and dysfunction in the right hip. Radiologic examinations showed the
disappearance of the ipsilateral femoral head and neck. After excluding the
aetiologies of cancer metastasis and tuberculosis, we confirmed the diagnosis of
syphilitic arthritis. The patient received the medical treatment of antibiotics
and the surgical treatment of total hip arthroplasty. At the follow-up of 1, 3,
and 5.5 years after the operation, the patient presented with a pain-free and
functional hip prosthesis without local signs of infection and loosening.
CONCLUSIONS: This report highlights the difficulties of early diagnosis of
secondary syphilis with bone involvement. Bone defect of the femur with secondary
syphilis, especially at the proximal femur, was an extremely rare complication in
the previous reports. Our case was the first case of a patient who experienced
the disappearance of femoral head and neck caused by secondary syphilis.
Follow-up after the operation proved the successful treatment of the extensive
bone defect of femur by total hip arthroplasty.