tabes dorsalis

Tabes dorsalis is a form of tertiary late 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.

Clinical presentation

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 manifestation between primary infection and onset of symptoms, averaging about 20 years.

Radiographic features

General

Radiologically, it can manifest as a Charcot joint (neuropathic arthropathy), usually involving either the hip, knee or spine.

MRI

MRI of the spinal cord demonstrates longitudinal T2-weighted hyperintensity in the dorsal columns of the spinal cord.

Differential diagnosis

General imaging differential considerations include: