The devil is in the details: developing a modern methodology for detailed medical illustrations

Emily M. Adams (Lead / Corresponding author), Caroline Erolin

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)
115 Downloads (Pure)


The Pernkopf Atlas has posed an ethical dilemma for the past 30 years. Although its illustrations are of an indisputably high quality, its unethical origins yield questions with its use. This study aimed to identify successful methods for creating equal if not higher quality anatomical visualisations through an analysis and comparison of past and present medical illustrator's techniques. Pernkopf's illustrations were not used as an anatomical reference to ensure the new visuals were ethical; instead other existing visuals and written sources were compiled and reviewed to create an original 3D model of the posterior cervical triangle using ZBrush 2020. Some visualisation techniques used by Pernkopf were used as a part of this project (i.e. rendering in partial colour) this technique is not unique to Pernkopf and was also used by Henry Carter, the illustrator of Grey's anatomy. The survey was distributed to 78 participants with a strong anatomical or medical/biological art background. The reception to the new resource was positive; participants favoured it in terms of quality and ease of understanding. However, participants noted that the images in the survey were not the same resolution which may have skewed the results in favour of the new image. When rated for detail compared to the Pernkopf Atlas, the number of structures in the resource need to be increased before it can be ranked equally to the Pernkopf Atlas for detail. Participants did note that they may have selected differently depending on what was inferred by quality and detail in the survey.

Original languageEnglish
Pages (from-to)97-116
Number of pages20
JournalJournal of Visual Communication in Medicine
Issue number3
Early online date14 May 2021
Publication statusPublished - 2021


  • 2D versus 3D visuals
  • Medical illustration
  • comparative visualization
  • detail level in illustration
  • head and neck anatomy
  • pernkopf atlas

ASJC Scopus subject areas

  • Health Professions (miscellaneous)
  • Visual Arts and Performing Arts


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