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Medical Image

About the Medical Image feature

Medical Image publishes a single clinical image with a short teaching commentary. One image, one lesson, read in a few minutes between cases. The format exists because image interpretation is a perishable skill that improves through repeated exposure rather than through reading about it, and because most clinicians will never see enough of the rarer patterns during a single training post to recognise them reliably when they finally appear.

What gets published

The feature draws on the full range of cardiovascular imaging and its neighbours:

  • Electrocardiograms – the tracing that names a diagnosis on its own, the pattern that is repeatedly missed on first pass, and the artefact that has sent more than one patient to the catheterisation laboratory unnecessarily.
  • Echocardiograms – still frames and described loops showing a structural finding, a haemodynamic consequence, or a measurement that turns out to be decisive.
  • Angiograms – coronary anatomy that changes the plan, a complication caught early, or a lesion that looks straightforward on one projection and not on another.
  • Chest radiographs – the plain film that carries more information than it is usually credited with, particularly in acute presentations.
  • CT and MR imaging – cross-sectional studies that resolve a question the bedside could not, or that show a diagnosis nobody was looking for.

Each image is published with a commentary that states what is shown, how it was recognised, what else it could have been, and what followed clinically from the finding. The commentary is deliberately brief. The point is not to write a review article around the image, but to fix one recognisable pattern in the reader’s memory.

What makes a good submission

The strongest submissions are not the rarest findings. They are the images that teach something a working clinician will actually use.

  • The image is of adequate technical quality, correctly oriented and legible, with the relevant region visible rather than cropped away.
  • There is one clear teaching point, stated plainly. An image carrying five findings teaches none of them well.
  • Enough clinical context is given to make the finding meaningful: presentation, the question the study was asked to answer, and what happened next.
  • The lesson generalises. A pattern that is commonly misread, a finding that changes management, or a discriminating feature between two conditions that look alike is worth more than an exotic case nobody will meet again.

Any image derived from a real patient must be fully anonymised before it is sent. Remove the patient’s name, hospital or record number, date of birth, referring clinician and institution, and check the image itself as carefully as the file: identifiers are frequently burnt into the corner of a DICOM export, printed in a tracing header, or left in the file name and metadata. Photographs of a patient require particular care, and any recognisable feature must be dealt with before submission.

Written consent from the patient, or from the person legally able to give it on their behalf, is required for publication of any patient image or identifiable detail. Contributors must also satisfy whatever their own institution requires. Submissions that cannot meet the consent and anonymisation standard are not published, however instructive the image.

Medical Image sits alongside the Interesting Case feature, which takes a single case further and works through the reasoning and the decisions in full. If you want to build image interpretation systematically rather than case by case, the diagnosis and imaging reference collection covers the same territory in depth, with the discriminating features and the pitfalls set out for reference at the workstation.

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