The most difficult problem we face in review of manuscripts is poor language or grammar. It is a huge shame to reject articles because they are badly written when the message they contain is important. The language reflects the authors, their institution and the journal, and inevitably, presentation and style hugely influences the perception of the management of any case

• Read the case presentation back to yourself. Is there a natural flow from presentation to discharge and follow-up? Are all decisions explained?

Don’t be afraid to write about complications. They are universal and learning from each other’s experience is key in health care. Do discuss these with clarity so that all findings and management decisions are obvious. The audience are not reading to approve or disapprove but needs to be in a position to make sense of the story. The discussion of pitfalls is the single biggest contribution to learning in case reports:

• unusual presentations of common cases
• inconclusive results
• grey areas in indications for treatment
• management challenges
• near misses

Title of Case

You do not need to include “a case report” in the title – you may be cryptic if you wish. In fact, we do not want you to use the words “a case report”.

Summary

Up to 150 words summarizing the case presentation and outcome We need a good flavor of the case – emphasize the learning points.

Background

Why you think this case is important – why did you write it up?  Why is the case of interest to our readers?  Is this a prevalent health problem?  Is there a clear message?

Case Presentation

Presenting features, medical / social / family history This is the patient’s story – but please be sensitive to patient confidentiality

• How did they present?
• What is the relevant history?  Why is this relevant?
• Explain your findings and how they influenced your decisions.

Do not use abbreviations for diseases or investigations.

Investigations – If relevant

All investigations that create a background (baseline) picture are relevant.  All investigations that are crucial to management decisions should be discussed in full.  Chose appropriate images and videos to illustrate your point while maintaining patient confidentiality.

Differential Diagnosis (if relevant)

Please don’t list these.  What we want to see is how the final diagnosis is teased out.   What are the consequences to management or treatment for the differential diagnosis? For example: A man in his 60’s who has smoked for 40 years and presents with epigastric pain radiating posteriorly may have a leaking abdominal aortic aneurysm, acute pancreatitis or a perforated duodenal ulcer.  Particular historical details and investigations separate these diagnoses, and treatment of each is vastly different; indeed, treating one cause for the other is detrimental.  Discuss these and the pitfalls that may ensue.

Treatment (if relevant)

Include pharmacological and non-pharmacological, eg, rehab strategies, exercises, therapies, home therapy and patient instructions.

Outcome and Follow-Up