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Tabetic arthropathy is a destructive neurogenic condition, which has become rare thanks to the early treatment of syphilis using penicillin G. The causative germ in question is Treponema pallidum. Diagnosis is made when there is a discrepancy between the extent of joint damage and the absence of pain, and confirmed biologically with positive syphilitic serologies. ObservationsA 58-year-old patient, with a history of two occurrences of syphilitic chancre, presented with chronic monoarthritis in the left knee with no pain. An X-ray of the knee showed destruction of the internal tibial acetabulum, and a CT scan of the same limb revealed osteolytic lesions of the two tibial plates and tibial spines with detached bone fragments. The diagnosis was confirmed by the presence of positive syphilitic serologies in the blood and the cerebrospinal fluid. The patient subsequently died from sepsis following a nosocomial infection.Conclusion While it has become rare, tabetic arthropathy should not be discounted. Treatment is based on penicillin G administered intravenously.