26.07.2021: This X-ray shows the knee of a teenage boy with multiple, transverse, sclerotic (white) bands in the tibial and femoral metaphyses. The patient has similar bands in several other joints. He has been diagnosed with osteogenesis imperfecta type 1 and has been receiving treatment with intravenous zoledronic acid (bisphosphonate) for five years. Each of the transverse bands corresponds to a treatment cycle/injection of bisphosphonate. More frequent injections result in shorter band intervals. The bands are most common in the metaphyses, but can also occur in the epiphyses and apophyses. The...

24.06.2021: This X-ray radiograph of the left elbow shows elevation of the fat pads as a sign of joint effusion (marked with asterisks), but no visible fracture or luxation. A thin strip of reduced subchondral bone density can be seen in the ventral capitulum (black arrow); on the CT scan, this strip corresponds to several small gas bubbles in the same location – the so-called vacuum phenomenon. The articular contour of the ventral capitulum is also irregular. These findings are typical of Panner's disease. The images are from a girl of late kindergarten age who was brought to the doctor after four days...

01.02.2021: The image shows a longitudinal fracture in the body of the hamate with subluxation of the fifth carpometacarpal joint in a man in his forties after a fall. Hamate fractures are rare, accounting for about 2–4 % of all carpal fractures (1). Diagnosis and treatment are often delayed because clinical findings are limited and the fracture may be difficult to detect on conventional X-ray images. CT is therefore recommended in the case of continued pain in the ulnar region of the wrist following a negative X-ray (1, 2). Fractures are divided into fractures of the body and of the hook. Injuries are...

07.01.2021: The picture shows a divided melanocytic naevus along the margins of the upper and lower eyelid of a teenage boy. He was referred because of two congenital pigmented naevi located opposite to each other, laterally on the right eyelids. During his childhood and adolescent years, they had gradually grown larger and caused cosmetic problems, discomfort with foreign body sensation, and stickiness of the eyelids. The naevi were therefore removed surgically under general anaesthesia by means of a full-thickness pentagonal excision of both the upper and the lower eyelid. A histological examination...

11.12.2020: The X-ray shows a ring of circular foreign bodies inside the abdomen of a one-year-old child. The patient had been admitted with a two-day history of vomiting. Clinical examination revealed mild abdominal tenderness but no rebound tenderness. Blood tests were normal, with the exception of mild hypochloremic alkalosis and CRP of 25 mg/L (reference range 0–4 mg/L). The patient's mother was shown the X-ray and thought that the object in question might be magnetic beads belonging to a sibling. The patient underwent laparotomy. A ring of magnetic beads was found in the small intestine about 70 cm...

26.10.2020: The dermatoscope is the dermatologist's stethoscope. It is used for diagnosing pigmented lesions, benign and malignant tumours and inflammatory dermatoses, and in connection with infestations. The dermatoscope may also be useful to general practitioners, amongst other things for scabies diagnosis (1, 2). A scabies mite is 0.2–0.5 mm in diameter. It burrows a track in the epidermis, in the stratum corneum, where it lays its eggs. Both mite and burrows are easily visualised with a dermatoscope which provides x 10 magnification. Once we have found a possible or definite scabies track under the...

26.10.2020: The image shows microscopy of a scabies mite – Sarcoptes scabiei. It was extracted with a dental probe from a scabies track on a patient. Several generations of family members were infected. A total of about ten persons were treated according to the current guidelines of the Norwegian Institute of Public Health (1). The incidence of scabies in Norway is increasing sharply, with a tripling of the number of cases diagnosed in general practice from 2012 to 2018 (2). This tendency is continuing, and has been reported from all over the country. Scabies can be seen in all age groups, but most...

20.08.2020: The picture shows an infant with clearly yellow skin along with a relative with normally pale skin. A three-month-old child was referred to the paediatric department by a health centre clinician owing to yellow-coloured skin. The paediatrician who attended to the patient found an apparently healthy child with yellow skin and pale sclerae (photo). Serum bilirubin was 12 µmol/l (reference < 20 µmol/l). The child had been fully breastfed with normal weight gain. Stools and urine were normal in colour. It was concluded that the child was healthy and no diagnosis was made. At six months of age, the...

01.07.2020: The image on the left shows a blood smear with normal neutrophil granulocytes, stained with May-Grünvald-Giemsa stain. It was taken from a patient with COVID-19 on the day of admission. The image to the right was taken five days later and shows that all the granulocytes have developed a notably abnormal morphology. A few days later, the cell image had normalised again. Today's haematology instruments are programmed to identify a number of abnormal findings in blood cells. When abnormal morphology is detected, the instrument will prepare and stain blood smears and perform automated cell...