Spinal Syphilitic Gumma: A Rare Presentation of an Old Disease

Figure 1

MRI of the spine with gadolinium contrast performed at days 0, 1, 15, and 25. Initial examination revealed a small cavitating mass (7.3 mm) within the left thoracic hemicord at the level of T5 and nodule (4 mm) at T4 with associated marked cord oedema and meningeal thickening which peripherally enhanced on contrast administration. By day 25, the lesion had shrunk to 5.5 mm with marked improvement in cord oedema and meningeal thickening. The superior T4 nodule remained unchanged in appearance.