Finally, case reports preserve the human element of medicine. In a world increasingly dominated by large datasets and predictive algorithms, they remind us that medicine is still, at its core, about individual patients with unique stories. A case report, when written well, is not just a clinical observation, but rather a narrative that conveys curiosity, humility and the never-ending process of learning. The most memorable case reports are those that bridge the worlds of narrative medicine with that of evidence-based practice. They reconcile the perspectives of the clinician and the patient with the diagnostic reasoning process through compelling and accessible writing.
The Art of Writing a Case Report
Despite their clear and self-evident value, not all case reports are created equal. Many end up as forgettable footnotes, lost in the archives of specialty journals, while others stand the test of time and become classics in their own right. What separates a good case report from one that simply adds to the noise?
First, start with the right case. Not every unusual case deserves a case report. The best case reports balance novelty with clear learning points. A report of an ultra-rare disease that follows a textbook course may be interesting, but if it does not challenge existing knowledge or offer new insights for readers, it risks being redundant.
Instead, I would recommend potential writers to look for cases that fill a niche. Three prototypical niches include: 1) expanding our understanding of a known disease, such as an atypical and consequential presentation of lupus or vasculitis, 2) highlighting a novel treatment response, such as unexpected efficacy or an adverse reaction, or 3) raising awareness of a diagnostic pitfall (e.g., mimickers of rheumatic disease that could lead to misdiagnosis).
When in doubt, ask yourself: What does this case teach that could change the way that my colleagues approach similar patients in the future? If the answer is “not much,” there may be other opportunities heading your way.
Tell a Story, Not Just a Sequence of Events
A compelling case report is more than just a timeline of symptoms, labs and treatments. It is, at its heart, a narrative—one with a beginning, a middle and an end. The best case reports engage the reader with a clinical mystery, guiding them through the reasoning process that led to the diagnosis and treatment decisions.
Consider structuring your case in a way that mirrors real-world clinical reasoning.
