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Updated: June 21, 2025
In the later stages of acquired syphilis, gummatous periostitis and osteomyelitis occur, and are characterised by the formation in the periosteum and marrow of circumscribed gummata or of a diffuse gummatous infiltration. The framework of the bone is rarefied in the area immediately involved, and sclerosed in the parts beyond.
They are usually multiple, develop slowly, and are rarely sensitive or painful. One or more of the gummata may break down and give rise to tertiary ulcers. The co-existence of indolent swellings, ulcers, and depressed scars in the vicinity of the knee is characteristic of tertiary syphilis.
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