One of the chief roles of a journal editor seems to be to defend the English language from the continual intrusion of spurious, unnecessary, confusing, and, at times, very annoying abbreviations.

Why? Papers with too many abbreviations are challenging to read—clunky, distracting, and inconsiderate of the reader. Good writing does not necessitate any abbreviations. How many times have you sat down with a good book, even non-fiction, and found many abbreviations? If the purpose is to communicate meaningfully with the reader, then make your writing good and make it easy to understand.

What is an abbreviation? An “abbreviation” is a shortened form of a word or phrase (e.g., St., Mr., MI, MRCP, SPECT). Acronyms and initialisms are forms of abbreviations. An acronym is a word made from the initial letters of each in a group of words (or syllables), pronounced as a single word (e.g., PET, CAT, STIR). An initialism is a group of initial letters used as an abbreviation for a name or expression with each letter or part being pronounced separately (e.g., CT, MRCP). Most abbreviations are included without intervening periods. There are some exceptions, most notably author initials (e.g., P.J.S.), U.S.A. for United States of America (to distinguish from the more common radiology-centric abbreviation of US for “ultrasound”), et al. for “et alia,” Latin for “and others” (although for unclear reasons and paradoxically, our publisher does not include the period after “et al” in truncated author lists in article citation lists).

Why do authors use abbreviations? Some abbreviations are commonplace in everyday talk and communication, including in medicine. These abbreviations are usually acceptable as they are readily understood based on their common usage. Authors also use abbreviations because they are shorter—they are easier to type, easier to spell, better known than the source term, shorten the paper, etc.

Abbreviations are acceptable, but only in moderation. Some general principles can be applied in regard to abbreviations:

  1. 1.

    Fewer abbreviations are better.

  2. 2.

    If in doubt, do not abbreviate.

  3. 3.

    Do not use a novel abbreviation. Do not create new abbreviations.

  4. 4.

    Do not use an ambiguous abbreviation (e.g., MRE).

  5. 5.

    Do not use an abbreviation which is distracting/confusing.

  6. 6.

    Do not use abbreviations simply to shorten text.

It would be impossible for a journal to define a comprehensive list of which abbreviations are acceptable for use and which are not. Compendiums of medical abbreviations can be found online [1], including lists of MR sequence abbreviations [2, 3]. Suggestions for determining if an abbreviation is acceptable:

  1. 1.

    Do you use it in everyday speech?

  2. 2.

    Is its use commonplace in the field?

  3. 3.

    If you ask a colleague what the abbreviation means (out of context, just the abbreviation), do they get it right?

  4. 4.

    When you read the abbreviation in text out loud, what do you say?

  5. 5.

    Is the abbreviation unambiguous?

  6. 6.

    Is it an abbreviation for one word? With rare exceptions, abbreviations for a single word are unnecessary. As a corollary, expanding an oft-used abbreviation by adding a single letter to abbreviate a single word is also unnecessary (e.g., CMR, LUS).

Guidelines for use of abbreviations

These rules are for Pediatric Radiology but can also serve as a guide for a submission to any journal or, for that matter, any written article. Except for common-use radiology abbreviations (e.g., CT, MR, US, PET, PACS), all abbreviations must be defined at first use in the abstract, first use in the text, and first use in each figure legend. For tables, abbreviations can be defined in the title of the table, within the table itself at first use, or within a footer. Other guidelines regarding abbreviations:

  1. 1.

    The use of abbreviations in an article title is discouraged (with very few exceptions).

  2. 2.

    Abbreviations are not used as keywords.

  3. 3.

    Gene names are italicized and do not need to be defined, but should be if the abbreviation is known, pertinent, and/or useful.

  4. 4.

    Units of measure, unless novel or unfamiliar, do not need to be defined.

  5. 5.

    Abbreviations for states of the United States do not need to be defined.

  6. 6.

    No key to abbreviations is needed.

These guidelines are largely consistent with other medical journals; however, all abbreviations acceptable in another journal are not necessarily acceptable in Pediatric Radiology.

What about the US (ugh)? By accepting the abbreviation “US,” we are highly inconsistent. The spoken term “US” is rarely, if ever, used in reading room conversation or lectures. “US” is ambiguous—it also stands for “United States.” When you read “US” in print, you say, “Ultrasound.” “Ultrasound” is a single word and not that long. So why do we (reluctantly) allow the use of the US?—it is ingrained and of common use in radiology journals and practice; it is two letters like its cross-sectional imaging counterparts CT and MR. Needless to say, US would be preferred to other abbreviations that we have seen for ultrasound including USS, USN, and UZN.

The bottom line regarding abbreviations in Pediatric Radiology is a quest for consistency and sensible, judicious use. We seek to make your work better and more readable for all, not just those who are experts on the subject. Yes, this requires a few more characters. So be it; such is good medical writing.