Quotation from: Manual of Surgery

Written by: Alexander Miles and Alexis Thomson


A _central gumma_ in a long bone may not reveal its presence until it
erupts through the shell and reaches the periosteal surface or invades
an adjacent joint. Sometimes the first manifestation is a fracture of
the bone produced by slight violence.


In radiograms the appearance of syphilitic bones is usually
characteristic. When there is hyperostosis and sclerosis, the shaft
appears denser and broader than normal, and the contour is uneven or
wavy. When there is a central gumma, the shadow is interrupted by a
rounded clear area, like that of a chondroma or myeloma, but there is
sclerosis round about.

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