Congenital syphilis, the great mimicker, confused with non-accidental trauma

Congenital syphilis (CS) remains a major health problem worldwide. Children born with CS can present with variable symptoms that can mimic other disease processes. This report describes the case of a 4-month-old infant who presented with the left wrist swelling and distal radial fracture, causing concern for non-accidental trauma (NAT). An osseous survey showed additional findings and led to the correct diagnosis. Although radiographic features of NAT may overlap with CS, certain features such as bilaterally symmetrical skeletal involvement and metaphyseal destruction, as seen in our case, can help distinguish between the two.