Patient-safe radiological language: Reducing nocebo harm in orthopedic imaging reports

As patients increasingly access radiology reports through electronic portals, imaging reports are no longer private technical communications between clinicians. They have become patient-facing texts that can shape how people understand pain, ageing, bodily damage, activity, and treatment choices. In orthopedics, terms such as degeneration, tear, collapse, compression, severe narrowing, and metaphors such as bone-on-bone may be technically familiar to clinicians but frightening or misleading to patients. This discussion paper argues that orthopedic imaging language should be considered part of patient education, patient safety, and ethical communication. Recent debates over medical terminology, including the renaming of polycystic ovary syndrome to polyendocrine metabolic ovarian syndrome and the use of vaginal corona to challenge hymen-related myths, show that medical naming can affect understanding, stigma, diagnosis, and care pathways. We propose patient-safe radiological language: clinically accurate reporting that reduces avoidable nocebo-relevant harm through readable, contextualized, and accessible explanation. A two-layer reporting structure, supported by readability targets, multilingual resources, clinician review, and carefully governed digital or artificial intelligence tools, may improve patient understanding while preserving diagnostic precision.