Tabes dorsalis is a form of tertiary neurosyphilis in which there is demyelination of the posterior columns of the spinal cord.
For a general discussion, and for links to other system specific manifestations, please refer to the article on syphilis.
Patients present with symptoms related to dorsal column/nerve-root involvement such as weakness, sensory ataxia (tabetic gait), lancinating pain, hypoesthesia, and other manifestations of neurosyphilis such as personality changes. It has the longest latent period of any neurosyphilis between primary infection and onset of symptoms, averaging about 20 years.
Radiologically, it can manifest as a Charcot joint (neuropathic arthropathy), usually involving either the hip, knee or spine.
Longitudinal T2W hyperintensity in the dorsal columns of the spinal cord.
General imaging differential considerations include:
- subacute combined degeneration of the cord: B12 deficiency related myelopathy of the cervical and thoracic cord
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