CTICasesSyphilitic Aortitis
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Imaging findings
Gated chest CT reveals circumferential thickening of the ascending aorta with focal calcifications along its wall and mild luminal irregularity. The abnormalities extend into the origin of the right brachiocephalic artery, while characteristically sparing the sinotubular junction and the aortic root.
Key takeaways
Syphilitic aortitis, a manifestation of tertiary syphilis, classically involves the ascending aorta while sparing the aortic root and the sinotubular junction. Classic imaging features include fine "eggshell" calcification of the ascending aortic wall and extension into the ostia of the brachiocephalic vessels. Although historically rare, the incidence of syphilis has rebounded, making this an important differential diagnosis for isolated ascending aortitis.
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