One image, one clinical stem, one month to work it out. The Academy’s image of the month is a deliberately compact exercise in visual diagnosis: an ECG, an echocardiographic still or loop, an angiographic run, a cardiac MRI or CT slice, a chest radiograph or a specimen photograph, presented with only the clinical detail a clinician would have had at the bedside.
How it works
- A new image is published at the start of each month with a short clinical stem and a single question.
- Members submit their interpretation and their reasoning through the response form. Reasoning carries as much weight as the final answer.
- At the end of the month the full case is released: the diagnosis, the features that gave it away, the features that commonly mislead, and what happened to the patient.
- Members whose reasoning was both correct and well argued are named in the answer post.
Why single-image teaching works
Pattern recognition in cardiology is trained, not innate. Clinicians who read a large volume of ECGs and echocardiograms develop the ability to see an abnormality before they can articulate why it is abnormal — and that ability decays without regular exposure. A single monthly image is small enough that busy clinicians actually complete it, and difficult enough that completing it is worth something. Over a year it builds a reference set of thirty-odd well-analysed images across the modalities.
What gets published
Images are chosen for teaching value rather than rarity. A subtle inferior infarct that three readers missed is a better teaching image than a textbook example of a rare cardiomyopathy. Preference goes to images where the diagnostic feature is genuinely there to be found, where the mimic is a real clinical trap, and where the management consequence of getting it wrong is significant.
Submitting an image
Members are encouraged to submit. A submission needs the image at full diagnostic quality, a two- or three-line clinical stem, the confirmed diagnosis with whatever established it, and a note on the specific feature you want readers to find. Every image must be fully de-identified, including the DICOM header and any burnt-in annotation; where an image could still identify a patient, written consent is required and must be retained by the submitting clinician.
Send images through the case submission form or the contact page. Contributors are credited by name and institution.
Related Academy exercises
Cases that need more than one image and a fuller narrative belong in the interesting cases library. The quiz of the month covers the same ground in question form, and the poll of the month asks members what they would actually do rather than what the guideline says. For systematic training in image interpretation, see the diagnosis and imaging reading list and the Academy course programme.