Guidelines For Writing Case Studies

The following headings are suggested for use in your case studies. However, provided all these areas are covered, different presentations are acceptable. (i) Clinical history - detail all the relevant clinical history to include age, sex, symptoms, clinical examination, bloods, biochemistry, other imaging and explain the reason for the examination and the clinical question being asked. (ii) MR procedure - describe the examination protocol, explaining reasons for choice with particular reference to the clinical presentation and question. Include choice of pulse sequences detailing specific parameters, use of contrast medium etc. Evaluate the influence of these parameters on image quality e.g. variable flip angles, fat saturation, magnetisation transfer etc. Concentrate on the parameters of particular significance to the pathology/area chosen. Discuss any imaging features (pathology, artefacts etc.) which necessitate additional sequences, contrast administration, post processing etc. Justify reasons for choice and any value added. (iii) Imaging findings - demonstrate pattern recognition skills by discussing the image appearances to include normal anatomy, anatomical variants, pathology and artefacts. (iv) End result - obtain follow-up to establish the accuracy of the MR findings. Critically analyse any discrepant results. (v) Outcome - describe the influence of the MR findings on patient management and outcome. Include where necessary other investigations, intervention, therapy etc. (vi) Discussion and literature review - highlight any relevant clinical or imaging features with detailed reference to the current literature. Discuss any limitations of the MR technique or management of the patient and describe potential ways to overcome these. You may prefer to embed this in your case studies as you write them rather than in a separate section*. This is a major part of the work, and critical analysis and evaluation are key here. The role of MRI in comparison with other imaging modalities and the wider issues of clinical decision making should be addressed. Conclusion - combine clinical presentation, results of other tests and MR appearances to form logical diagnostic conclusions. Do not submit the radiologists report. The conclusion should be your own. If you should disagree with the radiologist say so, and explain why. (*NB Students who reflect back on the totality of their work towards the end of it, synthesising key elements of the debates, rather than discussing elements of it piece meal throughout, tend to present stronger discussions.)