In Nigeria and many places in the third world, the patients are "black boxes". We really don't know whats going on inside them. Most diagnoses are made clinically or with the scalpel scan since most patients cannot affort costly diagnostic tests. This contrasts with the USA, where, for example, almost every patient that comes to the ER with abdominal pain gets an "abdomnal panel" and abdominal CT. 

This 3D reconstruction of a CT shows a pulmonary arteriogram which also catches the upper abdominal vessels. The detail is incredible. The celiac axis, hepatic artery, splenic artery and SMA are beautifully visible. Pathology cannot hide from this test.

While these tests are great and the detail exquisite, in most cases we don't need these tools. Good clinical exam and judgement can usually produce good clinical results.

Nonetheless, the scalpel scan will always be a powerful tool in the third world.