Pitfalls in Medical
Nominal Downloaded from www.ajronline.org by 31.25.139.130 on 10/05/15 from IP address 31.25.139.130. Copyright ARRS. For personal use only; all rights reserved
Peter
Writing
Dysphasia
M. Ronai1
Medical nomenclature is both arcane and voluminous. Between 60,000 and 1 00,000 anatomic parts, diseases, syndromes, eponyms, diagnostic tests, physiologic and pathologic processes, biochemical compounds, drugs, therapeutic procedures, and operations are cited in medical dictionaries. This constitutes a lexicon as large as the vocabulary of most languages, and it is not surprising that errors in nomenclature are common in medical publications. The following are exarnples of such errors culled from the recent radiologic literature: The ampulla of Vater. As Marvin Daves [i } has pointed out: “There is no ampulla at the confluence of the bile and pancreatic ducts.” The confluence of these ducts is always characterized by a tapering of the lumen. The word ampulla (Latin: ampulla = a flask or bottle) implies a widening of the lumen, which is not seen normally. Therefore this segment should not be called the ampulla of Vater, but rather the conjoint duct, vaterian segment [1 ], or, simply, confluence of common bile duct and pancreatic duct. Unlike the illusory ampulla of Vater, the papilla of Vater, or greater duodenal papilla, through which the conjoint duct enters the duodenum, is a real structure that can be clearly seen in anatomic specimens and often on upper gastrointestinal examinations. The common duct. There are two common ducts in the biliary tree: the common hepatic duct and the common bile duct. The term common duct is therefore ambiguous, and either common hepatic duct or common bile duct should be specified. The cavum Septum pellucidum. The septum pellucidum is a translucent partition (Latin: saeptum = a barrier; pellucere = to shine through) between the two lateral ventricles. It sometimes comprises two leaves with a space (Latin: cavum = a cavity) between them. This space is therefore the cavum Septi pellucidi (cavity of the septum pellucidum). The possessive-genitive case in Latin (septi pellucidi)-is used to denote of the septum pellucidum. The dorSum sella. The posterior wall of the sella turcica (Latin: dorsum = back; se/la = seat; turcica = Turkish) is the dorsum sellae (back of the sella). Again, the Latin possessive or genitive case (sellae) is used to denote of the sella. The calvarium. The Latin word for the domelike, upper portion of the skull is calvaria. Although calvarium is cornmonly used, it is incorrect [2] and should be replaced by calvaria. Ileus. This word comes from the Greek: eileos meaning intestinal colic [2]. It is often misused to mean exactly the
reverse: a paralyzed bowel. For clarity, the term ileus should always be qualified: adynamic (or paralytic) ileus due to paralysis of the bowel, dynamic ileus due to spasm of a segment of bowel, or mechanical ileus due to a structural block. Contrast allergy. Adverse reactions to radiographic contrast media are idiosyncratic reactions that do not fulfill the criteria for true allergic reactions [3]. The term allergy should not be
used. Thoracic outlet syndrome. There is considerable confusion as to whether the opening at the cranial end of the thorax is the thoracic inlet or outlet. One author recently hedged his bet by writing: “The thoracic outlet syndrome is caused by compression of the neurovascular bundle at the thoracic inlet” [italics mine]. Standardization on a single term-either inlet or outlet-is desirable, and confusion can be avoided by defining the term used. Mucus membranes. The word mucus comes from the Latin: mucus meaning-you guessed it-mucus. Mucus is a noun, not an adjective. When used as an adjective, it becomes mucous, hence mucous membranes, mucous glands, mucous
secretions. EKG, V/Q scan. In the early years of the 20th century, most American physicians who desired foreign postgraduate training went to Germany. The abbreviation EKG for elektrokardiogram dates from this era. Very few physicians know the meaning of the “Q” in V/Q scan. It comes from the German word Quellung, meaning flow. When EKG and V/Q scan are written out in full in the American medical literature, they are invariably written as electrocardiogram and ventilation/perfusion scan. For consistency, therefore, the abbreviations EKG and V/Q scan should be replaced by ECG and V/P scan. Portable X-ray machine. Unless your X-ray technologist is built like Arnold Schwarzenegger, it is unlikely that he or she can carry one of these machines (portable comes from the Latin: portare = to carry). The correct term is mobile X-ray machine (mobile comes from the Latin: mobilis = movable).
REFERENCES 1 . Daves ML. The vaterian segment and the phantom 182:944-946 2. Stedman’s medical dictionary, 25th ed. Baltimore:
1990:232,
1992 0361 -803X/92/1
596-1
1 98 © American
Roentgen
JAMA
Williams
1962;
& Wilkins,
763
3. Moreau ML, LeSavre P. de Luca H, Hennessen U, Fischer AM, Giwerc M. General toxicity of water soluble iodinated contrast media: pathogenic concepts. Invest Radiol 1988:23lsuppl 11:S75-S78
1Department of Imaging, Salem Hospital, P. 0. Box 14001 , Salem, OR 97309. Editor’s note-This is one of several vignettes, which will appear periodically in AJR, examining some of the common pitfalls help authors communicate their observations and discoveries clearly and in accordance with accepted grammatical style. AJR 159:1 198, December
ampulla.
Ray Society
of medical
writing.
The intent
is to
Nominal Downloaded from www.ajronline.org by 31.25.139.130 on 10/05/15 from IP address 31.25.139.130. Copyright ARRS. For personal use only; all rights reserved
Peter
Writing
Dysphasia
M. Ronai1
Medical nomenclature is both arcane and voluminous. Between 60,000 and 1 00,000 anatomic parts, diseases, syndromes, eponyms, diagnostic tests, physiologic and pathologic processes, biochemical compounds, drugs, therapeutic procedures, and operations are cited in medical dictionaries. This constitutes a lexicon as large as the vocabulary of most languages, and it is not surprising that errors in nomenclature are common in medical publications. The following are exarnples of such errors culled from the recent radiologic literature: The ampulla of Vater. As Marvin Daves [i } has pointed out: “There is no ampulla at the confluence of the bile and pancreatic ducts.” The confluence of these ducts is always characterized by a tapering of the lumen. The word ampulla (Latin: ampulla = a flask or bottle) implies a widening of the lumen, which is not seen normally. Therefore this segment should not be called the ampulla of Vater, but rather the conjoint duct, vaterian segment [1 ], or, simply, confluence of common bile duct and pancreatic duct. Unlike the illusory ampulla of Vater, the papilla of Vater, or greater duodenal papilla, through which the conjoint duct enters the duodenum, is a real structure that can be clearly seen in anatomic specimens and often on upper gastrointestinal examinations. The common duct. There are two common ducts in the biliary tree: the common hepatic duct and the common bile duct. The term common duct is therefore ambiguous, and either common hepatic duct or common bile duct should be specified. The cavum Septum pellucidum. The septum pellucidum is a translucent partition (Latin: saeptum = a barrier; pellucere = to shine through) between the two lateral ventricles. It sometimes comprises two leaves with a space (Latin: cavum = a cavity) between them. This space is therefore the cavum Septi pellucidi (cavity of the septum pellucidum). The possessive-genitive case in Latin (septi pellucidi)-is used to denote of the septum pellucidum. The dorSum sella. The posterior wall of the sella turcica (Latin: dorsum = back; se/la = seat; turcica = Turkish) is the dorsum sellae (back of the sella). Again, the Latin possessive or genitive case (sellae) is used to denote of the sella. The calvarium. The Latin word for the domelike, upper portion of the skull is calvaria. Although calvarium is cornmonly used, it is incorrect [2] and should be replaced by calvaria. Ileus. This word comes from the Greek: eileos meaning intestinal colic [2]. It is often misused to mean exactly the
reverse: a paralyzed bowel. For clarity, the term ileus should always be qualified: adynamic (or paralytic) ileus due to paralysis of the bowel, dynamic ileus due to spasm of a segment of bowel, or mechanical ileus due to a structural block. Contrast allergy. Adverse reactions to radiographic contrast media are idiosyncratic reactions that do not fulfill the criteria for true allergic reactions [3]. The term allergy should not be
used. Thoracic outlet syndrome. There is considerable confusion as to whether the opening at the cranial end of the thorax is the thoracic inlet or outlet. One author recently hedged his bet by writing: “The thoracic outlet syndrome is caused by compression of the neurovascular bundle at the thoracic inlet” [italics mine]. Standardization on a single term-either inlet or outlet-is desirable, and confusion can be avoided by defining the term used. Mucus membranes. The word mucus comes from the Latin: mucus meaning-you guessed it-mucus. Mucus is a noun, not an adjective. When used as an adjective, it becomes mucous, hence mucous membranes, mucous glands, mucous
secretions. EKG, V/Q scan. In the early years of the 20th century, most American physicians who desired foreign postgraduate training went to Germany. The abbreviation EKG for elektrokardiogram dates from this era. Very few physicians know the meaning of the “Q” in V/Q scan. It comes from the German word Quellung, meaning flow. When EKG and V/Q scan are written out in full in the American medical literature, they are invariably written as electrocardiogram and ventilation/perfusion scan. For consistency, therefore, the abbreviations EKG and V/Q scan should be replaced by ECG and V/P scan. Portable X-ray machine. Unless your X-ray technologist is built like Arnold Schwarzenegger, it is unlikely that he or she can carry one of these machines (portable comes from the Latin: portare = to carry). The correct term is mobile X-ray machine (mobile comes from the Latin: mobilis = movable).
REFERENCES 1 . Daves ML. The vaterian segment and the phantom 182:944-946 2. Stedman’s medical dictionary, 25th ed. Baltimore:
1990:232,
1992 0361 -803X/92/1
596-1
1 98 © American
Roentgen
JAMA
Williams
1962;
& Wilkins,
763
3. Moreau ML, LeSavre P. de Luca H, Hennessen U, Fischer AM, Giwerc M. General toxicity of water soluble iodinated contrast media: pathogenic concepts. Invest Radiol 1988:23lsuppl 11:S75-S78
1Department of Imaging, Salem Hospital, P. 0. Box 14001 , Salem, OR 97309. Editor’s note-This is one of several vignettes, which will appear periodically in AJR, examining some of the common pitfalls help authors communicate their observations and discoveries clearly and in accordance with accepted grammatical style. AJR 159:1 198, December
ampulla.
Ray Society
of medical
writing.
The intent
is to
