Here we review Radiology 2.0: One Night in the ED, designed by Dr. Daniel Cornfeld. Dr. Cornfeld, an Assistant Professor of Diagnostic Radiology at Yale University School of Medicine who specializes in Body and Emergency Medicine Imaging, and Mohammed Kaleel, a medical student at Saba University, teamed up to create this app for the iPhone, iPad, and iPod Touch. [Editor’s Note: The iPad version of this apps review is at the end of this post]
In 2005, Dr. Cornfeld started a website, titled “One Night in the ED,” dedicated to teaching common Emergency Medicine imaging pathology.
This website – particularly the case to imaging to discussion format provides the inspiration for the Radiology 2.0 app we are reviewing here. Of note, Dr. Cornfeld has not created any other apps in addition to this one.
The Radiology 2.0 app home screen and main menu offer an option to toggle “Display Answers” on or off, and links to “Information” and “View List of Cases.”
Clicking on “Information” brings up the aforementioned quick bios on the creators, as well as an “Information Desk” with directions on how to use the app as a learning tool.
As described above, toggling the “Display Answers” option from the home screen allows for listing the app’s 65 featured cases by their particular diagnosis (“On”) or listing the cases randomly as unknown diagnoses (“Off”).
Here, we will look at the Aortic Dissection Case to illustrate what the app offers with each case. Clicking on a particular case from the case list brings up a start screen (shown below) with the case number, a very brief description of the patient presentation (here, “acute pain throughout chest”), and a CT image.
Each CT image (one per case) can be scrolled up and down by imaging slices as if at a PACS workstation by conveniently swiping one’s finger up and down.
This function allows for easy navigation through the slices of each CT image; Unfortunately, the app does not allow for zooming in on the image or any portion of it.
After exploring the CT image, clicking on the case’s “Discussion” link opens a thorough discussion of the pathology visible in the imaging. The discussions are notable for the inclusion of several clinical pearls. For example, the discussion for Aortic Dissection includes information on the Stanford classification system and basic management based on type, as well as detailed information on interpreting the imaging, such as how to distinguish the true lumen from the false lumen in dissection.
Of note, the discussion features links to slices of the CT scan annotated with highlights, colorful schematics to illustrate concepts related to the pathology, and bonus chest x-rays to correlate findings. Here, from the Aortic Dissection discussion, we show a CT slice annotated with the intimal flaps of dissection, a schematic illustrating the genesis of aortic dissection, and a corresponding chest x-ray depicting a distinct aortic contour (shown below).