is a wiki or collaborative site for radiologists that aggregates imaging studies and information on spectacularly wide-ranging set of topics. The site content is made up entirely of voluntarily contributed patient cases, each with associated diagnosis, questions and discussion. In addition, there are topic pages for classifications of diseases, radiology physicis, radiographic signs (for example the “anteater nose” sign of the calcaneus), etc. As with most user-contributed content, the depth and quality will vary. But, in its breadth and immediacy of available information, the site is a remarkable and invaluable resource for physicians.

The site was started by a single physician, Dr. Frank Gaillard, in 2005. It has since incorporated entries from numerous radiologists with section editors monitoring contributions in their respective spheres and has commercial backing. Now, for its next evolution, iPhone and iPad companion apps have been released. The iPad app is meant to serve as a tutorial for reviewing cases from specific disciplines. In fact the tag line for the iPad app is “Get more cases right during rounds. Because victory is Sweet”.

So far two volumes have been released, Head & Neck and Musculoskeletal (MSK). We were able to get a peek at the musculoskeletal version (iTunes link) which includes over 50 cases, running the gamut of degenerative, trauma, tumor and metabolic conditions. The MSK app sells for $7.99, there is a free “Lite” version of the Head and Neck app (iTunes link) with 10 cases and a neuroradiology volume is to be released shortly.

The description for the app starts with “Whether it is an hour long sit down study session or 5 minutes in the cafeteria,’s Radiology Teaching Files are the perfect companion to all students of radiology”, which is a reasonable representation for the value of the app. The cases are displayed on the home page as a series of thumbnails. Tapping on one shows the full screen version with button allowing navigation to other images from the same patient. Tabs on the top allow navigation between the list of questions, answers and discussion about the disease.

The quality of the images, not surprisingly, was excellent. The discussions were accurate although understandably sketches rather than full discourses. At least for the tumor cases, I did not detect any serious errors that would cause embarrassment on rounds although some of the information could be refined a bit. My first impression is that the MSK app seems to be a little heavy on tumor cases, at least in comparison to the real world distribution where bone and soft tissue tumors are uncommon.

Perhaps, this reflects that these are the cases that more commonly trip up trainees and attendings. It would be interesting to hear the perspective of a radiologist on this. However, since it is a collaborative database, future releases will include more and more cases.

In terms of how the app could be improved, I would focus on navigation. The most annoying deviation is that swiping on the images does not switch among images, rather on has to tap a series of numbered buttons on the margin. This is a deviation from the standard iPad user interface and non-intuitive. Also, while the questions appear to be strategic and helpful for understanding the topic, all the questions for a single condition are presented as a static page with all the answers presented on separate single static page. A more entertaining and educational presentation would be for the questions to be asked individually and the answers presented after each one. This seems more intuitive, especially since the questions appear to escalate in terms of complexity.

Overall, the app definitely lives up to its promise of being a great learning tool for radiologists or other specialities heavily dependent on imaging. Medical education, in particular, seems to be well-suited to a tablet device and we look forward to seeing more such tools for other specialties in the future.