Learning to approach a clinical case systematically and identifying all the pertinent findings in large image datasets in the context of pertinent clinical and pathologic data are essential skills for the radiologist. With the explosion of MDCT and MRI, hundreds of images must now be inspected for pathology and correlated in the context of concomitant abnormalities. In addition, this mode of testing clearly differs drastically from real day-to-day clinical work.

Although this type of case file is valuable in its own right, it stresses interpretive skill and knowledge of disease processes and largely ignores a very important skill that all competent diagnostic radiologists possess- identifying abnormalities in a background of normal findings. Typically, the participant is then asked specific questions or asked to formulate a diagnosis on the basis of the handful of images.

The traditional teaching file in radiology presents images in an artificial setting in which a few selected figures are selectively displayed. Many digital radiology teaching files have been created using the Internet, intranet, or local computer systems.

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