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Deputy Editor
estern{at}u.washington.edu
In that same issue of the AJR, Editor in Chief Lee Rogers [2] also opined about plain films, in essence agreeing with Dr. Pope and making it a point to change the style manual of the AJR to exclude the term for the more scientifically accurate and less demeaning term, "radiograph." In checking with our copyeditors, I can confirm that our in-house style manual does indeed offer this guideline: "Do not use plain film as a substitute for radiograph; use radiograph instead."
In the 8 years since these editorials were published, the use of the term
plain film is still quite in fashion and used in day-to-day conversational
plain speak by the lay public, our clinical colleagues, and our own radiologic
colleagues around the English-speaking globe. In fact, similar terminology is
in common usage in other languages across the globe. Through a very informal
survey, I found that in Greek, the phrase is
And somewhat surprisingly, this usage of the phrase plain film occurs despite the diminishing use of physical hard-copy radiographic film. With the enormous growth of various computed and digital radiography systems, PACS, teleradiology, CD-ROMs, and flat-screen displays, the entire idea of "film," whether for recording, viewing, or archiving, starts to lose its meaning altogether. That is, unless the definition of film, in our ever-fluid use of language, is changing. If we think of the word film to mean a recording or display medium, then the term still fits. It is, of course, simpler and more common to use the term film than to say digital X-ray recording media with high-definition display.
A Google search of the term plain film returns approximately 1,880,000 matches. The term matches not only many popular lay Websites but also the Websites of many prestigious organizations, universities, and journals, including the New England Journal of Medicine.
In searching PubMed, Dr. Rogers and Dr. Pope would certainly be pleased to find that in the 8 years since their respective editorials, the term plain film has appeared in the pages of the AJR just one time. Various lay presses and colloquialisms aside, in English scientific literature, this term seems to be used most often in nonradiology journals, by nonradiologists.
You may ask, so what? What's the harm in such a commonly used and accepted term? I for one agree with Drs. Pope and Rogers that we should abandon the phrase plain film—not just in our academic vocabularies but in our social vocabularies as well. If we are to remain valued specialists and consultants to our clinical colleagues and the general public, we should take every opportunity to reinforce the expertise that we work so hard to attain and maintain, including how we communicate. Perception is very important. There is nothing plain about the infrastructure required to obtain, record, process, display, copy, interpret, or archive a radiograph.
Speaking of plain radiographs, I'd like to highlight an interesting article in this issue of the journal from Thompson et al. [3], "The Accuracy of Abdominal Radiographs in Acute Small-Bowel Obstruction: Does Experience Matter?". You'll find this article in our popular Web exclusive section of the journal. Incidentally, I've been told on good authority by the Editor in Chief of this journal that the term plain film was originally used to distinguish radiographs from images obtained with the use of contrast material, which, back in the first half of the 20th century, mostly meant barium studies. In this issue of the journal, former ARRS Figley Fellow Perry Pickhardt [4], has written an interesting article for our Centennial section to which I'd like to draw your attention, titled "On the Natural History of Colorectal Polyps and Masses: Rediscovered Truths from the Barium Enema Era."
Although William Penn, more than 2 centuries ago, said, "Speak properly, and in as few words as you can, but always plainly, for the end of speech is not ostentation, but to be understood," I find it heartening to see that in academic speak, at least in our radiologic scientific journals, such colloquialisms are no longer rampant.
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