360° – Are we getting the full clinical story all of the time?

I am of the firm belief that “what you can see, you can photograph!” and it certainly has been a long time since Louis Daguerre presented the first process of photography to the world at the Paris Academy of Sciences on January 7, 1839.[1] Hence, it is very disheartening when sometimes manuscripts submitted to JISP do not follow even the basic minimum requirements as far as images are concerned.

In today's day and age, keeping good records is an absolute must. Proper documentation includes radiographs and photographs (with lips fully retracted) very importantly documenting the pre and postoperative, surgical, and prosthetic phases as well as some laboratory procedures and finally the clinical outcome. Before the introduction of digital photography, I agree, it was expensive to purchase cameras and accessories and film - based photography required film selection, film and processing costs, and waiting for the roll to end. However, digital cameras and technology have brought costs down considerably, have introduced efficiency to the process and every postgraduate student can now easily turn into an amateur photographer. In the light of the confusion that we sometimes encounter about requirements for file formats and image resolutions for figure files, let me share a few details here for obtaining a good quality image.

The size of the an image can be depicted in various ways, such as length by the width, total number of pixels, or number of megabytes that it takes to store on a computer disk. Digital cameras capture images in pixels. A pixel is a square (or dot) of uniform color in the image. A megapixel is equal to 1-million pixels. The more the number of pixels in an image, the higher is the resolution. The size of a pixel may vary, and the resolution of an image is the number of pixels per unit area. Resolution relates primarily to print size and the amount of detail visible in the image when viewed on a computer monitor at 100% magnification. Although resolution is defined by area, it is often described using a linear measurement, dots per inch (dpi). Thus, 300 dpi indicates a resolution of 300 pixels/inch × 300 pixels/inch = 90,000 pixels per square inch. 300 dpi is the minimum resolution required to prevent “pixelation” of images (i.e. to not see individual pixels) when the image is printed on paper. In general, a camera that can acquire an image of 6 megapixels is sufficient for daily clinical use. This can generate an image of approximately 2,400 × 2,400 pixels, or 8 inches × 8 inches at 300 dpi.[2,3]

There are many file types (encapsulated postscript [EPS], RAW, joint photographic experts group [JPEG] and tagged image file format [TIFF]) which can be used for saving digital images. The RAW format is mostly used in professional photography. A JPEG file is a file that is compressed and when saved tends to lose its quality. This results in lower quality and smaller image file. A TIFF file is also compressed, but the file does not lose quality upon being saved; therefore, TIFF files are larger than JPEG files. In general, line art (flow charts and line diagrams) can be prepared in an illustration application such as adobe and saved in an EPS format. Photographic images can be accessed in Photoshop and saved in TIF format.[2,3]

Observing some simple rules allows us to obtain standardised, good quality images. By improving your image you can help us reproduce your data as accurately as possible; for you should remember - high quality “before and after” images of your work are the best advertisement of your skills and expertise.