The clinical and the X-ray diagnosis of the bone yaws disease

Objective: To study the clinical and the X-ray characteristics of the yaws disease in bone. Methods: The clinical features and X-ray imaging appearances of 12 cases with bone yaws were analyzed and summarized, and discussed with related cultural heritage. Results: Nine patients were period II yaws, whose skin of all extremities were detected multiple symmetry or no-symmetry papulas and nodes, with systematic toxic symptom. There patients were period III yaws, with multiple brown abscess in and under the skin of all extremities, multiple bayberry-like nodes up and down surrounding the ulcer. In the 9 patients with period II yaws, the bone lesions were predominantly periosteal proliferation and hyperostosis. In the 3 patients with period III yaws, the bone lesions were hyperostosis with destruction of bone. Conclusion: The X-ray characteristics of bone yaws are: (1) multiple bones are involved; (2) the pathological change is mainly located in the long bone diaphysis; (3) local irregular periosteal proliferation and cortical hyperplassia, medullary canal blurring or disappearing; (4)diffusing long bone sclerosis with cortical bone destruction and cancellated bone erosion; (5)the bones involved has no sequestra. (authors)