Ambiguous nomenclature in musculoskeletal magnetic resonance imaging

Introduction: Medical vocabulary that conveys different meanings to different groups of readers can lead to confusion and potential misinterpretation of diagnoses. This article reviews words used by radiologists that convey information to the orthopedic surgeon and patient that is different from what the radiologist intended. These terms include meniscal tears, ligament sprains, partial tendon tears, bone bruises, bone contusions, articular cartilage injury, disc bulges, disc herniations, and joint subluxation. These words can, for example, suggest a traumatic etiology when in fact the condition is atraumatic, and they can imply a surgical treatment where none is indicated. This problem is further magnified in the arena of personal injury litigation. Materials and Methods: The terms tear, bruise, contusion, injury, sprain, bulge, herniation, and subluxation are defined and analyzed for their ambiguous use, i.e., their actual versus intended meaning or other interpretation. Results: Abnormalities and variations observed on musculoskeletal magnetic resonance (MR) images are often multi-factorial and may not be the source of any given patient’s symptoms. The same MR image findings can have a congenital, traumatic, or degenerative source. Conclusions: Radiology vocabulary that invokes a singular traumatic event as a cause of an MRI finding can significantly mislead patients (as well as judges and juries). We propose that some terms be either avoided entirely when the findings are of uncertain etiology. At the very least, the various mean-ings of the terms need to be spelled out. Greater cooperation between orthopedic surgeons and radiologists on this matter would be beneficial to patient care.