A misleading radiology case for the entire medical community: A letter to the Editor.

Abstract

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 15^th 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?