There is nothing like a seven-hour transcontinental flight (with the exception of an international one) to help you focus on matters of great significance and importance. It is the perfect isolation chamber, if the in-flight movie is unappealing and your seat mate is not too chatty. It is prime time to ponder Nobel-worthy research, to prepare an acceptance speech for the RSNA Gold Medal, or, if your goals are slightly less lofty, to catch up on your backlog of journals without fear that your 3-year-old will spill his or her apple juice on the critical pages. This aeronautical think-tank is where I am at my most productive. Once airborne, the lack of distractions allows me to solidify my thoughts, in this instance, regarding a problem I have encountered in my practice of radiology: the use and abuse of colloquialisms in medical terminology.

We, as radiologists, are primarily consultants, and every report we generate is a written consultation. As we do this 50, 100, even 150 times a day, we need to have our communication skills down-to mean what we say and say what we mean. I am sure everyone can come up with a list of their favorite malapropisms or misused terms. Since I have the "bully pulpit" right now, I will share mine.

1. Lung "fields": I cringe anytime one of our residents uses this phrase, which is not only meaningless, but also expensive. My departmental administrators state that each word in a report has a definite associated cost of transcription, printing, and physician approval or corrections. I do not know what a lung "field" is; cows stand in a "field"; Kevin Costner built a "field" of dreams, but neither pulmonary texts nor medical dictionaries define a lung "field" and, therefore, there is no way to classify it, either medically or financially. Perhaps my distaste for this term has to do with one of my mentors in residency, an internationally renowned chest radiologist, who strictly forbade its presence in her reports. One may use the term "lung zone" or merely "lung", but let us please bury the "field".

2. "Nonspecific bowel gas pattern": What does this phrase mean exactly? No one I have ever asked has provided a satisfactory or consistent answer. If an image or radiograph is non-specific, it has not enabled us to come any closer to a diagnosis. This term is even more offensive than "fields", not to mention verbose and superfluous. I refer the interested reader to an elegant essay by Dean Maglinte in a previous issue of Applied Radiology (October 1997) as grounds for this phrase never seeing the light of day (or night) again.

3. "Epicenter": This comes from the geologic nomenclature for earthquakes, referring to the part of the earth's surface directly above the seismic focus. In some radiologists' misguided thinking, the term has been adapted to refer to the origin or center of a lesion, for example, "the epicenter of the lesion is in the adrenal gland."

There are many more of my terminological pet peeves, but thankfully no major culprits come to mind at present. Let us do what we can to rid the world of such radiological jargon. Our referring clinicians, who may not be cognizant of the meaning of such "buzz words," will understand and appreciate us all the more. Now if you really want to get me started, just ask me about the vicissitudes of flying these days....

Dr. Harris is Associate Professor of Radiology at Dartmouth Medical School, Dartmouth-Hitchcock Medical Center, Lebanon, NH; he is also on the editorial

advisory board of this journal.