Skull with syphilitic osteitis
GC.10633
Calvaria of an adult, showing osteitis and necrosis following acquired syphilis.
The whole of the frontal bone above the temporal lines is rough and irregular, not from the formation of new bone but from extensive fissuring which divides the outer table into innumerable, small, irregular areas giving it a worm-eaten appearance. The fissures have been formed by an ulcerative process destroying the outer table and affecting the diploe, and in the course of healing new bone has been deposited on the diploe in the depths of the fissure. The right parietal at the bregma is similarly affected and to a less extent both parietals in the neighbourhood of the coronal suture and the right at its tuberosity. The frontal squama between the two frontal tuberosities forms a large sequestrum 65 x 40 mm. in diameter perforated at numerous points and separated from the bone superiorly and to the left by a sulcus varying up to 3 mm. in breadth, which passes through both tables and the diploe. Inferiorly and to the right the sequestrum is still adherent and at all parts of the irregular margin the outer table forms a ledge which more or less overhangs the sequestrum. On its cerebral surface the calvaria has undergone little change except in the neighbourhood of the sequestrum where the inner table has been destroyed over an area measuring 45 mm. sagittally by 56 mm. coronally and the bone around this area forms a margin somewhat irregular and for the most part sclerosed. The cut calvarial margin shows absence of the diploe, the bone being sclerosed though not thickened. Both externally and internally the coronal and sagittal sutures are still recognisable.
