Clinical Cases by Organ System. Click on the menu buttons above to explore the cases.


After a few weeks of clinical practice, medical students and residents realize that there is a significant difference between what they read in the textbooks and what they see in the hospital wards and clinics every day. Patients are different from their disease description in the books. One experienced physician summarized this experience by saying: "his CHF did not read the book." How to bridge this gap between theory and practice? Our answer was to create this free case-based curriculum of clinical medicine. ClinicalCases.org was featured in the British Medical Journal and Medscape.com, and was referenced several times in the medical education literature. The project is hyperlinked in the web sites of 27 medical schools in the U.S., Canada and Europe.

This case-based curriculum was started by physicians at Cleveland Clinic and Case Western Reserve University (St. Vincent/St. Luke) Internal Medicine Residency Program for the purpose of medical education. The case reports do not follow real cases, may be compiled descriptions and are modified in compliance with HIPAA to protect patient confidentiality. Please read the web site disclaimer.

Physical Examination Videos

Vocal vs. tactile fremitus? Percussion of the spleen? You can refresh your physical exam skills by reviewing medical videos offered by several U.S. medical schools and other organizations.

Electrocardiograms, X-rays, CT scans

Electrocardiograms (ECG/EKG)
ECG Wave-Maven by Harvard Medical School is a fully-fledged ECG-trainer. You can browse through typical or not so typical EKGs in the EKG World Encyclopedia by McGill University. Check out the arrhythmia simulator by SkillStat with a play, pause and quiz mode. ECG Palm Brain is a useful online and PDA reference. Our own Systematic Approach to Reading Electrocardiograms by Using 2 Mnemonics can also be helpful along with EKGs with Dr. Koch: It's Not Only Educational It's Also Fun!

X-rays and CT scans
University of Virginia has a comprehensive web site dedicated to CXR and CT scans. Compare what you see on the screen to the CT scans of your patient. You are not sure if this is the tail of the pancreas? Just click with the mouse and the anatomical structure is colored in red. ICU CXR is another useful website from University of Virginia. It will answer such burning questions as "Is the central line where it is supposed to be?" or "Does he have a pneumothorax?!"

Procedure Guides Step-by-Step

Central line placement. See also Central line placement with ultrasound guidance.
Thoracentesis (pleural tap)
Paracentesis (ascites tap)
Arthrocentesis (joint tap)
Arterial line placement is illustrated in The Internet Journal of Health.
Lumbar puncture in eMedicine
More procedure links

Best Clinical Evidence

The project started with the British Medical Journal idea to review the evidence behind some common clinical decisions. This evidence is amazingly scarse even today although it is growing daily. UHF provides a free access to Clinical Evidence.com which is the official website of the project. Click here to to register.

Question & Answer

Click for the answers of clinical questions from every day practice.

Web Site Disclaimer

Click here for full text.

All opinions expressed here are those of their authors and not of their employer. Information provided here is for medical education only. It is not intended as and does not substitute for medical advice. If you are a patient, please see your doctor for evaluation of your individual case. Under no circumstances will the authors be liable to you for any direct or indirect damages arising in connection with use of this website. Patient data published on this website is modified and information from several cases may be compiled into one posting for teaching purposes and to protect patient confidentiality in strict compliance with HIPAA. Cases course and description do not follow real cases. The appearance of external hyperlinks to other websites does not constitute endorsement. We do not verify, endorse, or take responsibility for the accuracy, currency, completeness or quality of the content contained in these sites. Report a suspected HIPAA violation to: clinicalcases@gmail.com.

Updated: 04/19/2008