Update: In response to iMedicalApps editorial and reader feedback, the folks at Iatros Software have lowered the price of this app to $19.99. They have also given us a few promo codes for our readers. Check out the comments section for the codes!

Advances in imaging technologies and skilled radiologists now allow for routine diagnosis of many previously mysterious disorders. Listening for obscure heart sounds and subtle neurological exams still hold a cherished position in medical education but, as one old saying goes, you can replace a whole room of neurologists with an MRI machine.

However, such aphorisms not only raise the ire of card carrying neurologists but ignore the basic problem of knowing which imaging test to order. Many a diagnosis has been delayed or missed in a patient who had a “negative” MRI – the problem was that the MRI was of the wrong body part.

So, what do you do if you are a busy primary care practitioner and a patient presents with, say, hydronephrosis or neck pain or urinary incontinence? There are so many imaging modalities, it is difficult to avoid ordering the wrong or unnecessary test. It is this important problem the eRoentgen applicaton by iAtros software is trying to address.  In this review we’ll see if this iPhone medical app is worth the high asking price of $49.99.

The author of eRoentgen, Constantine Brocoum, MD was a neuroradiologist by training and surely had first-hand knowledge of the challenge. The application is a straightforward compendium of textual information that lists recommended imaging studies for each item from a voluminous list of symptoms and diagnoses. The main drawback of the application is the high price of $49.99, which seems out of line with comparable medical iPhone applications.

What I liked about this application:
  • the breadth of symptoms and diagnoses is impressive
  • the relative and absolute contraindications for each imaging modality are provided so that incompatible tests can be avoided
  • the additional information on pre-medication for patients with allergies is appreciated

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What I did not like about this application:
  • the navigation between diagnosis, test contraindications and recommended tests is a bit awkward
  • the price is set too high
What I would like to see in future updates:
  • perhaps rather than providing such a breadth of symptoms, a deeper explanation of expected normal and abnormal imaging findings for some important diagnoses would provide more clinical value
  • some indication of the order in which to order tests, rather than a simple list

The eRoentgen application achieves its stated goal of guiding physicians in ordering imaging studies and will probably spare the busy clinician a few phone calls to radiologists. However, whiles the author identified an important problem, I feel that the application does not always live up to its own promise. Perhaps with the addition of some deeper clinical knowledge, it may better serve as quick and effective radiology pretest consult.

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Addendum from iMedicalApps Team:

We completely agreed with Dr. Wodajo’s excellent review of this medical application. Just wanted to add that we ran this app by residents and fellows, including a rad/onc fellow, and for the most part they agreed with the points made in this review. The biggest complaint we received was the high asking price for a relatively simple application. This is the most expensive app reviewed on this site, yet it will not make our top medical app lists. Many of the residents also mentioned how the EMR systems in hospitals and the clinic already point out the contraindications and indications for much of the imaging. One of the main reasons we reviewed this app is because it got a lot of sponsored publicity, and we wanted to make sure our readers had an objective review to go by.