BMJ 2009; 339 doi: http://dx.doi.org/10.1136/bmj.b4042 (Published 07 October 2009) Cite this as: BMJ 2009;339:b4042
  1. Teng-Teng Chung, MRC clinical research fellow1,
  2. Norbert Avril, consultant2,
  3. Shern L Chew, consultant1
  1. 1Department of Endocrinology, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London EC1A 7BE
  2. 2Department of Nuclear Medicine, Barts and the London School of Medicine and Dentistry
  1. t.t.chung{at}qmul.ac.uk

    A 74 year old man had pain in his large joints, including his shoulders and knees, over a period of 20 years. He was thought to have osteoarthritis, but plain radiology of the joints showed diffuse sclerosis. An isotope bone scan showed dense tracer uptake symmetrically in his humerus bones, shoulders, knees, pelvis, and spine. He was referred on with suspected metabolic bone disease, but the relevant investigations were negative. Instead, he was found to have positive syphilis serology. His symptoms completely resolved after antibiotic treatment for syphilis.


    Cite this as: BMJ 2009;339:b4042


    • Patient consent obtained.

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