A66.6

Clinical Causes: Infection with *Treponema pallidum pertenue*, a bacterium transmitted through skin-to-skin contact with active lesions Poor hygienic conditions and living in endemic areas facilitate the spread of the disease Inadequate access to healthcare services leading to delayed diagnosis and treatment

Key Symptoms: Bone pain and swelling, especially in the long bones and nasal bones Periostitis (inflammation of the periosteum) resulting in periosteal reactions Gummatous lesions in bones leading to deformities Hydrarthrosis, which involves swelling of synovial joints with fluid accumulation Development of gummas—soft, tumor-like lesions—over bony prominences Progressive destruction of bone tissue, potentially causing deformities of affected areas Joint stiffness and restricted movement due to periosteal and joint involvement

Diagnosis Path: Diagnosis involves a combination of clinical evaluation, patient history, and laboratory tests. Clinicians look for characteristic signs like periostitis, gummatous lesions, and bone deformities. Blood tests may reveal a positive serologic response to treponemal infection, while radiographic imaging can show characteristic bone changes such as periosteal reactions and bone destruction. Histopathology of lesions and biopsy can aid in confirming the diagnosis, especially in atypical cases.

Treatment Protocols: Treatment primarily involves antibiotic therapy, with penicillin being the mainstay to eradicate the infection. Early treatment can prevent or reduce the severity of bone and joint damage. In addition to antibiotics, supportive measures may include physical therapy to maintain joint mobility and prevent deformities. Surgical intervention might be necessary for severe deformities or to correct bone destruction, but this is usually considered after medical therapy. Preventative strategies include improving hygiene, raising awareness, and controlling the disease's spread in endemic communities.