A Misleading Radiology Case for the Entire Medical Community: A Letter to the Editor

Abdulwahab Alahmari1

1 Radiology Specialist, Anatomy Department, King Saud niversity, Riyadh, Kingdom of Saudi Arabia.

Conflict-of-interest statement: The author(s) declare(s) that there is no conflict of interest regarding the publication of this paper.

Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http: //creativecommons.org/licenses/by-nc/4.0/

Correspondence to: Abdulwahab Alahmari, Radiology Specialist, Anatomy Department, King Saud niversity, Riyadh, Kingdom of Saudi Arabia.
Email: afaa99@hotmail.co.uk
Telephone: +966562428716

Received: August 18, 2019
Revised: September 5, 2019
Accepted: September 7, 2019
Published online: October 11, 2019


There is a common theme of presenting fake cases among radiology professionals and the entire medical community. Radiopaedia is one of the medical websites who started this initiative. The goal from these fake cases is to make the viewers surprise when they see the unique cases and how rare they are! The issue now, there are many medical professionals still believing that those cases are real and share it with other medical professionals as medical literature.

Key words: Literature; Malpractice; Professional Misconduct; Deception; Ethics

© 2019 The Author(s). Published by ACT Publishing Group Ltd. All rights reserved.

Alahmari A. A Misleading Radiology Case for the Entire Medical Community: A Letter to the Editor. International Journal of Radiology 2019; 6(1): 224-225 Available from: URL: http: //www.ghrnet.org/index.php/ijr/article/view/2657

Letter to the Editor

Radiopaedia is one of the most popular websites for radiology cases. The website administration posted in April 2015 a fake case as “April Fools’ 2015” which was manipulated by using Photoshop to relocate the heart in the abdomen under the diaphragm[1]. The Photoshop editing made the case looks really unique and unreal. The case is titled on the website “Ectopia cordis interna – Tin Man syndrome.” Until today 15th of August 2019 –after 4 years– there are many radiology and medical professionals still sharing this case as medical literature on social media without knowing it’s fake[1]. According to Radiopaedia website the case of Tin Man syndrome was seen 1.8 million times[2]. The majority of them think it’s a real case and ectopic heart looks like what they saw in the pictures which can be a serious issue. There are another group of medical professionals who know that this case is a joke, but they think that this case does not exist in the real life and this is why the website faked it because it does not exist in the first place which is fault and all of the previous misunderstandings are result of spreading this fake case. There are many cases in real life where the heart located outside the thoracic cavity[3,4,5], but they have a different radiological appearance which is not similar to the doctored picture. Every year since 2012, the website decided to post a new fake case every April! The total number of fake cases now are seven[2]. As a result, many radiology professionals lost their trust in Radiopaedia for spreading fake cases! I am very confident that these cases will affect the medical professionals and patients everywhere in different –mostly bad– ways, even though, all the fake cases are still available on their website! Is medicine something that we should joke about it? Is this will be the beginning of other jokes from other organizations (which means more fake cases from different sources)? Is the medical literature something that we should play with? Can we control the damage now?


1. Skalski M. April Fools’ 2015: Ectopia cordis interna - Tin Man syndrome [Internet]. Radiopaedia, 2019 [cited 2019-08-18]. [Link]

2. Hacking C, Skalski M. April Fools’ [Internet]. Radiopaedia, 2019 [cited 2019-08-18]. Available from: [Link]

3. Gonçalves, Flávio Donizete, Fernando Rotatori Novaes, Marcelo Alves Maia, and Francisco de Assis Barros. Thoracic ectopia cordis with anatomically normal heart. Brazilian J Cardiovasc Surg 2007; 22(2): 245-7. [PMCID: 17992332]; [DOI: 10.1590/s0102-76382007000200015]

4. Leca F, Thibert M, Khoury W, Fermont L, Laborde F, Dumez Y. Extrathoracic heart (ectopia cordis). Report of two cases and review of the literature. Int J Cardiol 1989; 22(2): 221-8. [PMCID: 2644176]; [DOI: 10.1016/0167-5273(89)90071-5]

5. Alphonso N, Venugopal PS, Deshpande R, Anderson D. Complete thoracic ectopia cordis. Eur J cardio-thoracic Surg 2003; 23(3): 426-8. [PMCID: 12614821]; [DOI: 10.1016/s1010-7940(02)00811-4]


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