Teaching file
A curated library of classic teaching cases across every modality. Read the clinical vignette and key findings, form your diagnosis, then reveal the answer with a full discussion, differentials and high-yield pearls. 20 cases and growing.
Epidural haematoma
Head
Young adult struck on the side of the head. Brief loss of consciousness, then a lucid interval, followed by rapid neurological deterioration.
Subdural haematoma
Head
Elderly patient on anticoagulation with progressive confusion and headache weeks after a minor fall.
Pneumoperitoneum (Rigler sign)
Abdomen
Patient with sudden severe abdominal pain and rigidity, a history of peptic ulcer disease and NSAID use.
Tension pneumothorax
Chest
Trauma patient with acute severe dyspnoea, hypotension, distended neck veins and absent breath sounds on one side.
Aortic dissection
Chest
Hypertensive patient with sudden tearing chest pain radiating to the back and a blood-pressure differential between the arms.
Pulmonary embolism (CTPA)
Chest
Post-operative patient with acute pleuritic chest pain, dyspnoea, tachycardia and a raised D-dimer.
Acute appendicitis
Abdomen
Young patient with periumbilical pain migrating to the right iliac fossa, anorexia, low-grade fever and a raised white cell count.
Intussusception (target sign)
Abdomen
Infant with intermittent colicky abdominal pain, drawing up of the legs, a palpable mass and redcurrant-jelly stools.
Boerhaave syndrome
Chest
Middle-aged patient with severe retrosternal pain and subcutaneous emphysema following an episode of forceful vomiting.
Hip avascular necrosis
Musculoskeletal
Adult on long-term corticosteroids with progressive groin pain worse on weight-bearing; radiographs initially normal.
Scaphoid fracture
Musculoskeletal
Young adult with wrist pain and anatomical snuffbox tenderness after a fall onto an outstretched hand.
Colles fracture
Musculoskeletal
Post-menopausal woman with a painful, deformed wrist after a fall onto an outstretched hand — a dinner-fork deformity.
Multiple sclerosis (Dawson fingers)
Head
Young woman with episodes of optic neuritis and limb paraesthesia separated in time, with symptoms partly resolving between attacks.
Glioblastoma
Head
Older adult with subacute headaches, new focal neurological deficit and a first seizure.
Berry aneurysm / subarachnoid haemorrhage
Head
Sudden thunderclap headache — the worst of the patient’s life — with neck stiffness and photophobia.
Hepatocellular carcinoma (LI-RADS)
Abdomen
Patient with cirrhosis under surveillance; a new liver lesion is found and alpha-fetoprotein is rising.
Ovarian dermoid
Abdomen
Young woman with an incidental adnexal mass found during pelvic ultrasound for unrelated pelvic discomfort.
Ectopic pregnancy
Abdomen
Woman of reproductive age with a positive pregnancy test, pelvic pain and vaginal bleeding, and an empty uterus on ultrasound.
Thyroid papillary carcinoma
Head
Adult with a palpable thyroid nodule and a suspicious level VI cervical lymph node.
Osteosarcoma (Codman triangle)
Musculoskeletal
Adolescent with progressive pain and swelling around the knee, worse at night, without a clear history of trauma.