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Language of the Radiology Report

Sunnybrook & Women's College Health Sciences Centre Toronto, Ont. M4N 3M5 Canada

I very much enjoyed reading Ferris M. Hall's well-thought-out opinion regarding the radiology report [1]. The radiology report is the only contact that we may have with many referring physicians. The only way we will gain their respect is by composing intelligent and well-written reports. I try daily to convey to my residents many of the same points that Dr. Hall makes.

I must, however, strongly disagree with his use of "Impression" as the title of the ending section of the radiology report. According to Webster's dictionary, an impression is "an indistinct notion; remembrance, or belief" [2]. According to the Oxford dictionary, an impression is a "notion, vague or mistaken belief" [3]. Is this truly what we wish to convey in our reports? I believe we should convey certainty at the end of the radiology report, even if that means saying, "I do not know."

I prefer "Interpretation" or "Opinion." We will not "impress" clinicians by an ending that conveys a vague notion.

References

1. Hall FM. Language of the radiology report: primer for residents and wayward radiologists. AJR 2000:175 : 1239-1242[Free Full Text]
2. Webster's revised unabridged dictionary. Springfield, MA: Merriam, 1913
3. The concise Oxford dictionary, 6th ed. Oxford, UK: Oxford University Press, 1977

Reply

Beth Israel Deaconess Medical Center and Harvard Medical School Boston, MA 02215

I thank Dr. Clark for his kind words. It warms my heart that he should "strongly disagree" with only this single point. If only my residents and colleagues were so agreeable.

Actually, I am more flexible regarding the word "impression" than Dr. Clark believes. My statement was: " `Impression' or `Conclusion' is preferable to `Diagnosis' because a diagnosis is more specific and thereby encourages radiologists to hedge. Others disagree and alternative words include summary, opinion, interpretation, and reading" [1].

An AJR editorial [2] devoted entirely to this subject concludes that the most appropriate term is "reading." These authors believe that "opinion" is "virtually synonymous with impression" and that both terms should be avoided because each "suggests knowledge that is vague, subjective, and unreliable" and "focuses attention on the perceiver rather than the subject matter. The subject matter of the radiology report is the patient's radiograph, not the radiologist's mental state."

Perhaps the heading of the final section should vary with the report because when a diagnosis is overtly evident, such as a tension pneumothorax or comminuted fracture, even Dr. Clark might feel foolish with a concluding "opinion."

References

1. Hall FM. Language of the radiology report: primer for residents and wayward radiologists. AJR 2000:175:1239 -1242
2. Orrison WW, Nord TE, Kinard RE, Juhl JH. The language of certainty: proper terminology for the ending of the radiologic report. (editorial) AJR 1985:145:1093 -1095[Free Full Text]

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This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Clark, J. A. Articles by Hall, F. M. Search for Related Content PubMed PubMed Citation Articles by Clark, J. A. Articles by Hall, F. M. Social Bookmarking                      What's this?