# Diagnostic Methods Used in Detecting Syphilis in Paleopathological Research—A Literature Review

## TL;DR

This paper reviews methods for detecting syphilis in ancient bones, focusing on visual, radiological, and molecular techniques to understand the disease's history.

## Contribution

The paper provides a comprehensive overview of modern diagnostic approaches for identifying syphilis in paleopathological studies.

## Key findings

- Macroscopic and microscopic analysis of bones can identify syphilis-related changes like periostitis and gummata.
- Radiological methods like CT and Micro-CT are useful for detailed skeletal analysis.
- Molecular techniques offer additional insights into the presence of Treponema pallidum in ancient remains.

## Abstract

Syphilis is a disease caused by Treponema pallidum. It is primarily transmitted sexually or vertically during pregnancy. The origin is twofold, namely, it comes from America or Europe. Syphilis was first recorded in a human skeleton in the 11th century. However, signs of treponemal disease were observed in osteological material from a Pleistocene bear. Hence, it is necessary to study syphilis on bone material to better understand the etiology of the above disease and, consequently, introduce preventive measures. Examination of syphilis on skeletal material can be performed at the macroscopic and microscopic levels. Those methods refer to the visual assessment of skeletal material, namely the identification of characteristic pathological changes caused by syphilis, such as periostitis, which manifests itself as thickenings on the bone surface, and syphilis nodules (gummata), which are defects in the bones. Most often, these changes are found on long bones such as the tibia, femur, and skull. Radiological methods may be used, such as X-ray, computed tomography (CT), Micro-CT (ICT), as well as molecular examination. Summarizing, this review is an overview of the latest methodology regarding syphilis research on skeletal material, thanks to which it can better understand its genesis.