• Sabine Fraberger, Martin Dockner, Eduard Winter, Michael Pretterklieber, Gerhard W Weber, Maria Teschler-Nicola, and Peter Pietschmann.
• Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University Vienna (MUV), Vienna, Austria.
• Wien. Klin. Wochenschr. 2021 Jun 1; 133 (11-12): 602-609.

BackgroundIn tertiary syphilis, Treponema pallidum triggers the formation of granulomatous nodules in various organs of the human body. Within the skeleton, predominantly in the skull and long bones, these characteristic syphilitic lesions cause typical patterns of bone damage. In this study, micro-computed tomography (µ-CT) was used to assess the microarchitecture of these osseous defects in untreated syphilitic skull bones.Material And MethodsBone structure of 30 macerated human skulls was noninvasively examined by means of µ-CT images (Viscom X8060 NDT). A total of 20 specimens showing typical morphological signs of syphilis were provided by the Collection of Anatomical Pathology of the Museum of Natural History in Vienna. They were compared to 10 macerated control skulls provided by the Division of Anatomy of the Medical University of Vienna.ResultsAll samples affected by syphilis showed perforating defects and increased porosity. Furthermore, we observed sclerotic reorganization and complete loss of the cortical bone in 80% of infected cases. Cortical thinning occurred in 75%.ConclusionOur findings revealed extensive micromorphological bone destruction and a broad variability of osseous manifestations of (tertiary) syphilis.

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