title: Evaluation of the contribution of radiological imaging to the final diagnosis in medical case reports.
abstract: OBJECTIVE
  To evaluate the clinical value and impact of radiological imaging in published medial case reports.
  
  
  METHODS
  We analysed 671 consecutively published case reports of a peer-reviewed medical journal for case reports. The general use of radiological imaging as well as the specific imaging modality used in each case (ultrasound, x-ray, fluoroscopy, CT, MRI) was documented, and most importantly the 'final problem solver', i.e. the diagnostic modality giving the final clue to the patient's diagnosis, was identified.
  
  
  RESULTS
  In 511 of 671 (76.1 %) analysed case reports at least one radiological modality was used in the diagnostic cascade. In 28.6% of all cases the final diagnosis was achieved by radiological imaging. All other cases were solved by the patient's history and physical examination (15.2%), histology (12.4%), and blood analysis (9.6%). When radiology was the 'final problem solver', it was mainly CT (51.6%) and MRI (30.6%). In 52.2% of the case reports the radiological image was included in the article.
  
  
  CONCLUSIONS
  In case reports published in a prominent general medical journal radiological imaging is an important key player in the diagnostic process. In many cases, it is also the diagnostic tool which ultimately leads to determining the final diagnosis.
  
  
  CONCLUSIONS
  • Radiology was the most important specialty for finding the final diagnosis. • CT was the most successful problem-solving imaging modality followed by MRI. • MRI and CT had the best solution rates of more than 30%.
authors.affiliation: Institute of Radiology, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany, isabel.wiesinger@ukr.de.
authors.forename: Isabel
authors.initials: I
authors.lastname: Wiesinger
authors.forename: Gregor
authors.initials: G
authors.lastname: Scharf
authors.forename: Natascha
authors.initials: N
authors.lastname: Platz
authors.forename: Lena M
authors.initials: LM
authors.lastname: Dendl
authors.forename: Michael T
authors.initials: MT
authors.lastname: Pawlik
authors.forename: Christian
authors.initials: C
authors.lastname: Stroszczynski
authors.forename: Andreas G
authors.initials: AG
authors.lastname: Schreyer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging / Q000379:methods* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed; D055815:Young Adult