目的 :探讨早发型先天性骨梅毒的 X线诊断。方法 :报告 3个病例并复习文献资料。结果 :广泛、多发、对称的干骺炎、骨膜炎、骨炎 /骨髓炎为其 X线特点。其中干骺炎可为先天性骨梅毒最早出现的征象。“夹心饼征”、“猫咬征”为早发型先天性骨梅毒较特征性的 X线改变。结论 :对 RPR、TPHA阳性的婴儿常规进行四肢长骨照片是必要的。可发现婴儿先天性骨梅毒及其受累程度 ,有利于及时治疗。 Objective: To investigate the X-ray diagnosis of early-onset congenital bone syphilis. Methods: Report 3 cases and review the literature. Results: Extensive, multiple, symmetrical metaphyseal inflammation, periostitis, osteitis / osteomyelitis for its X-ray features. Which metaphyseal inflammation can be the first signs of congenital bone syphilis. “Sandwich cake syndrome”, “cat bite sign” for early-onset congenital bone syphilis more characteristic X-ray changes. CONCLUSIONS: Rip and TPHA-positive infants routinely performed long-limb photographs of the extremities are necessary. Can be found in infants congenital bone syphilis and its involvement, is conducive to timely treatment.