The application of Large Language Models (LLMs) to diagnostic decision-making has garnered growing interest. However, existing benchmarks largely focus on textual reasoning or isolated visual question-answering (VQA) tasks, lacking holistic integration of clinical narratives and medical imaging, and thus failing to assess the multimodal diagnostic synthesis capability central to expert clinical judgment. To bridge this gap, we introduce **MedReaMM**, a benchmark specifically designed to evaluate models’ ability to synthesize heterogeneous clinical evidence consisting of detailed patient histories alongside multiple medical images into accurate differential diagnoses under a complete-information paradigm. Constructed from case reports sourced from top-tier medical journals and curated clinical case databases, MedReaMM comprises 625 expert-validated cases with an average of 2.79 medical images per case and a total of 1,042 standardized diagnoses annotated with ICD-11 codes. These cases predominantly represent rare, atypical, or multi-system presentations that demand expert-level evidence integration beyond routine pattern recognition. We evaluate 23 Large Multimodal Models (LMMs) and find that most achieve diagnostic accuracy scores below 50%, underscoring a substantial gap in multimodal diagnostic synthesis capability. Further analysis reveals that medical knowledge proficiency, medical image understanding, and evidence integration are all highly correlated with diagnostic performance.

Electromyography (EMG) tables are crucial for diagnosing muscle and nerve disorders, and advancing the automation of EMG diagnostics is significant for improving medical efficiency. EMG tables contain extensive continuous numerical data, which current Large Language Models (LLMs) often struggle to interpret effectively. To address this issue, we propose EMGLLM, a data-to-text model specifically designed for medical examination tables. EMGLLM employs the EMG Alignment Encoder to simulate the process that doctors compare test values with reference values, aligning the data into word embeddings that reflect health degree. Additionally, we construct ETM, a dataset comprising 17,250 real cases and their corresponding diagnostic results, to support medical data-to-text tasks. Experimental results on ETM demonstrate that EMGLLM outperforms various baseline models in understanding EMG tables and generating high-quality diagnoses, which represents an effective paradigm for automatic diagnosis generation from medical examination table.