Purpose or Case Report: Syphilis left untreated, or inadequately treated during pregnancy, can result in congenital syphilis. Congenital syphilis can lead to severe sequelae or at worst, death. Worldwide congenital syphilis has recently seen a resurgence, with the United States alone having 9.2 cases of congenital syphilis per 100,000 live births in 2013, the first increase since 2008. Since then, it has been increasing in prevalence yearly, with most recent preliminary data showing up to 2100 cases of congenital syphilis in 2020. In addition, the number of syphilitic stillbirths in the United States has increased as well, most recently to 94 still births in 2019. Radiology plays an important role in early diagnosis of this condition which results in early treatment and prevention of long term sequelae.

This electronic exhibit of a case series will review the osseous manifestations of congenital syphilis on radiographs, as well as instruct on the clinical diagnosis, treatment and expected response to therapy, with post treatment radiographic examples. Illustrative cases from our radiology department will be used to demonstrate musculoskeletal changes of congenital syphilis, ranging from nonspecific metaphyseal lucent bands and diaphyseal periostitis to more pathognomonic presentations such as “celery stalk sign” and “Wimberger sign”.
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