Monday, July 14, 2014

"You keep using that word. I do not think it means what you think it means."

This post is futile. Language is an evolving process. Words have been joining, splitting, and changing meaning for as long as we've had language. The advent of printing helped slow down the process by disseminating "correct" definitions, but words will continue to evolve in spite of dictionaries and curmudgeons like me. That's a good thing.

The definitions of the words below will soon change to match their current "incorrect" usage, first as alternative meanings, and then as the accepted definition. This will happen as surely as ask is changing to aks/axe before our eyes, a continuation of the battle between āscian and āxian in Old English and asken and axen in Middle English.

Having said all that, the following is a list of incorrectly used words that you should feel free to ignore:
  • Epicenter: This refers to a point on the Earth's surface directly above the focus of an earthquake or some other rumble down below. We have appropriated the term to replace plain old center. If we were to correctly use the term in radiology, we'd use epicenter to refer to the skin on top of a deep lesion: "The epicenter of the femoral lesion is on the skin of the medial thigh." See also penultimate.

  • Serpiginous: Serpiginous (from serpere-to creep) is the term that is used to describe creeping and advancing skin diseases, such as ringworm or noduloulcerative cutaneous syphilis. This term is incorrectly used to describe snaky (serpentine) things like vessels or borders of bone infarctions. The person who is responsible for introducing serpiginous into the radiology literature in 1967 issued a correction in 1988, begging us to use serpentine instead. But the damage had been done. By then, the error had serpiginously crept its way into our mouths, and now spills out daily into millions of microphones and reports.

  • Shotty: This refers to small lymph nodes that feel like buckshot under the skin. You must have serious palpation skills if you can feel shotty mediastinal or retroperitoneal lymph nodes! Bonus activity: Do a poll of your colleagues and trainees and see how many think (or thought) the word is actually shoddy. Bonus activity 2: Ask them what shotty/shoddy means in the context of lymph nodes.


  • Di Chiro G, Doppman J, Ommaya AK. Selective arteriography of arteriovenous aneurysms of spinal cord. Radiology. 1967 Jun;88(6):1065-77.
  • Di Chiro G. Serpentine (not serpiginous) vessels in spinal arteriovenous malformations. Radiology. 1988 Jan;166(1 Pt 1):286.

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