Journal Scan

Journal Scan: A review of images in clinical medicine of immediate clinical significance, harvested from major international journals

From the desk of the Editor-in-chief

Images in clinical medicine

(1) Atretic cephalocele

A diagnosis of atretic cephalocele was made. Cephaloceles are herniations of cranial contents through a defect in the skull. They are described as atretic when they do not contain neural tissue. The ring of dark, coarse hair seen around the lesion, consistent with the “hair collar” sign, raised concern for a neural-tube defect, thus a biopsy was not performed. The MRI showed an extracranial cystic lesion with high signal intensity on T2-weighted sequences and low signal intensity on T1-weighted sequences. Blake’s pouch cyst (a cystic malformation on the posterior fossa) was also incidentally identified. Neurosurgical resection of the lesion was performed, and at 1-year follow-up, the child was developing normally.

(2) Osteogenesis Imperfecta

Stefanie Stasek, er al, Published December 27, 2025, N Engl J Med 2026;394:78, DOI: 10.1056/NEJMicm2510135, VOL. 394 NO. 1

Abstract

A 17-day-old boy was referred to a specialty clinic for evaluation of suspected osteogenesis imperfecta. Serial radiographs of the spine showed the development of vertebral compressions by 3.5 months of age.

(3) Congenital Zika Syndrome

Felipe Baccin et al, published December 29, 2025, New Engl J Med 2026;394: e2, DOI: 10.1056/NEJMicm2511220, VOL. 394 NO. 1

Abstract

A 6-month-old boy was referred to a pediatric neurology clinic in Brazil for evaluation of developmental delay. CT of the head at 1 month of age had shown lissencephaly and intracranial calcifications.

(4) Periumbilical Erythema Migrans

Paul Bellmann, etal, Published December 29, 2025, N Engl J Med 2026;394: e3, DOI: 0.1056/NEJMicm2512486, VOL. 394 NO. 1

Abstract

An 80-year-old man presented with a 4-day history of a rash on his abdomen. Physical examination was notable for periumbilical erythema and a small gray protrusion in the umbilicus.

(5) Collision Lesion

Maria Murphy etal, Published January 3, 2026, N Engl J Med 2026;394: e4, DOI: 10.1056/NEJMicm2512705, VOL. 394 NO. 2

Abstract

An 80-year-old woman presented with a skin lesion on her left ar al, . Examination showed a brown lesion with eccentric hyperpigmented asymmetric globules adjacent to a second, pink lesion with well-defined borders.

(6) Granulomatosis with Polyangiitis

Jian Zhu et al, Published January 10, 2026, DOI: 10.1056/NEJMicm2513376

Abstract

A 20-year-old woman presented with 9 days of pain and decreased vision in the right eye, as well as 2 weeks of a rash and gum swelling. Fever, dyspnea, and hemoptysis developed.

(7) Primary Palmoplantar Pustulosis

Leila Shayegan, Published January 14, 2026, N Engl J Med 2026;394: e5,DOI: 10.1056/NEJMicm2505935,VOL. 394 NO. 3

Abstract

A 60-year-old man with a 30-pack-year smoking history presented with a 2-year history of a painful rash on his palms and soles. Numerous pustules with erosions, crusting, and surrounding erythema were noted.

(8) Merkel-Cell Carcinoma

Zunaid Ahmed etal, Published December 17, 2025, N Engl J Med 2025;393:2459, DOI: 10.1056/NEJMicm2513302, VOL. 393 NO. 24

Abstract

A 72-year-old woman presented with a 3.5-month history of an enlarging, painless lump on her cheek. Examination showed a dome-shaped, reddish nodule on the left cheek, with a shiny surface and central hemorrhagic crust.

(9) Motor Vehicle Collision Due to Left Hemineglect Associated with a Stroke

Sho Matsunaga et al, Published December 17, 2025, N Engl J Med 2025;393: e41, DOI: 10.1056/NEJMicm2506958, VOL. 393 NO. 24

Abstract

A 75-year-old man with hypertension was brought to the emergency department after a motor vehicle collision. A video recording from the dashboard camera in his car showed a loss of ability to react to events on his left side.

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