Physician's Bookshelf

Am Fam Physician. 1998 Dec 1;58(9):2183-2184.

Book Reviews

Essentials of Musculoskeletal Care

Edited by Robert K. Snider. Pp. 686. Price, $100.00. American Academy of Orthopedic Surgeons, 6300 N. River Rd., Rosemont, IL 60018-4262, 1997.

Essentials of Musculoskeletal Care is a collaborative effort between the American Academy of Orthopedic Surgeons and the American Academy of Pediatrics. This textbook presents a unique perspective of the 300 most common adult and pediatric musculoskeletal problems. It is probably one of the most useful orthopedic resource textbooks for family physicians who are confronted daily with complaints of musculoskeletal pain, stiffness, swelling and trauma.

The textbook is organized around these various presenting complaints. The first page of each section contains regional pain diagrams and lists the appropriate differential diagnosis for pain in that specific area. The reader then reviews the text for those diagnostic entities and finds a brief paragraph revealing the following information: definition, symptom presentation, necessary testing, differential diagnosis, adverse outcomes, treatments, complications of treatments and referral decisions. The section on pediatric care has a similar format but takes into consideration age and gender issues, deformity, limb guarding and abnormal gait.

The illustrations are useful and well done, including drawings on anatomy, joint injection techniques and specific joint and muscle testing maneuvers (e.g., Ortolani's and Barlow's maneuvers, etc.). Photographs provide detailed steps for a thorough orthopedic examination (i.e., spine and extremity testing). Radiographs are included when appropriate and clearly delineate pertinent teaching points. Many common procedures are depicted, including nail avulsion, joint injections, joint aspirations, digital block, fish hook removal and paronychial drainage.

Excellent special sections on the care of the diabetic foot, preparticipation sports examination, use of orthotic devices and evaluation of the limping child would lend themselves nicely to patient teaching references.

Conspicuously absent are discussions on details of fracture management and sports medicine. However, I highly recommend this book because it is well organized and pragmatic in its clinical focus and unique in format.

Common and Chronic Symptoms in Pediatrics

Edited by J. Carlton Gartner Jr. and Basil J. Zicelli. Pp. 488. Price, $64.95. Mosby, 11830 Westline Industrial Dr., St. Louis, MO 63146-3318, 1997.

The textbook Common and Chronic Symptoms in Pediatrics fills a unique niche, because the clinical problems the book focuses on are relatively common but also ongoing, such as constipation, headache, growth problems, limp and so forth. These problems are often benign but take a long time to control and frequently require intensive advice to worried parents. This is not a textbook a physician would seek for a five-minute consultation. More important, the problems discussed in this book occasionally are indicators of serious disease. Sometimes familiarity with a pediatric presentation leads physicians to forget how broad a differential diagnosis can be and how high the index of suspicion must be to make an obscure diagnosis.

Let's take the chapter on lymphadenopathy as an example. Highly detailed, it includes a section on the differential diagnosis of the pediatric neck mass, which could be a chapter in itself. It also discusses a variety of infectious and malignant causes of both regional and generalized lymphadenopathy. This chapter may provide more information about the topic than the reader wants in one sitting. At the same time, it includes very practical information. For example, it enumerates warning signs that allow a clinical diagnosis of malignancy to be made correctly in the majority of cases, or it reminds the reader that certain medications such as phenytoin can be a cause of enlarged lymph nodes. Overall, the chapters are strong teaching and review tools that include practical guidance to immediate clinical problems.

All of the chapters follow a similar organization, and they place an emphasis on diagnosis. It seems that this approach could limit the reader's interest, but it doesn't, because of the diagnostic detail and the clinical organization of symptoms and findings (e.g., chronic cough, noisy breathing, spells and unusual movements). These entities often present dilemmas to even a highly experienced clinician. However, readers may want more treatment advice. In some situations, as in management of the limping child, a good differential diagnosis readily dictates the subsequent imaging and treatment steps, so the reader is satisfied with the diagnostic approach. However, in the section on management of constipation, readers are given the information that 97 percent of cases are idiopathic, and it would have been useful to have more precise detail about the initial dosing and frequency of the ‘cleaning out’ process, maintenance doses over the following period and the length of time required for treatment.

The authors say in the preface that they weren't sure how they came up with the final list of topics. There are no glaring omissions—the text is inclusive in range as well as in depth. Ultimately the authors' choice of subacute and chronic symptoms is based on experience with residents and their most frequent questions. It goes to show that we often keep coming back to the same clinical dilemmas, and each time we learn more of what we need to know.

Primary Care Dermatology

Edited by Kenneth A. Arndt, Bruce U. Wintroub, June K. Robinson, and Philip E. LeBoit. Pp. 352. Price, $49.95. Saunders, Curtis Center, Ste. 300, Independence Square West, Philadelphia, PA 19106, 1997.

This textbook was written for primary care physicians, who are often the first to see and treat patients with dermatologic problems. It does a fine job of discussing common diagnoses and treatments. Additionally, the end of each chapter contains a helpful section that points out the pitfalls and problems a primary care physician may face while treating a specific problem. The textbook also includes a section on referrals and consultation guidelines for each diagnosis.

The textbook is easy to read and understand, with clear and concise presentation of information. The illustrations are representative of what a physician may actually view in a clinical setting, and they are clear enough to be shared with the patient during the office visit.

The section on procedures is quite useful, particularly the chapter on biopsy. It includes a brief section on the names of some common dermatologic problems and correlates them with the type of biopsy that would most likely assist in an accurate diagnosis. I found this helpful because it lists the disorders that should be considered for biopsy and specifies the process that should be used to obtain the sample.

For the most part, the method for diagnosing and treating a disorder agreed with other references that I have consulted. In summary, the textbook accomplished what it set out to do by providing practical information on office dermatology for primary care physicians.

Also Received

Antibiotic Crisis: Antibiotic Alternatives

By Leon Chaitow. Pp. 233. Price, $19.95. National Book Network, 4720 Boston Way, Lanham, MD 20706, 1998.

Asthma Explored (CD-ROM)

By Avraham Kadar. Price, $19.99. KADMED Medical Marketing, LLC, 530 Park Ave., New York, NY 10021, 1998.

A Woman's Decision: Breast Care, Treatment and Reconstruction

By Karen Berger and John Bostwick III. Pp. 680. Price, $18.50. 3d ed. Quality Medical Publishing, 11970 Borman Dr., Ste. 222, St. Louis, MO 63146, 1998.

The Cleveland Clinic Intensive Review of Internal Medicine (CD-ROM and Textbook)

Edited by James K. Stoller, Muzaffar Ahmad and David L. Longworth. Pp. 864. Price, $499.00. Cleveland Clinic Foundation, 9500 Euclid Ave., Cleveland, OH 44195, 1998.

Clinical Management of Diabetic Neuropathy

Edited by Aristidis Veves. Pp. 337. Price, $69.50. Humana Press, 999 Riverview Dr., Ste. 208, Totowa, NJ 07512, 1998.

Core Curriculum in Primary Care: Dermatology (CD-ROM)

Edited by Michael K. Rees. Price, $99.00. SilverPlatter Education, 246 Walnut St., Ste. 302, Newton, MA 02460-1639, 1998.

Core Curriculum in Primary Care: Foot and Ankle (CD-ROM)

Edited by Michael Corbett. Price, $99.00. SilverPlatter Education, 246 Walnut St., Ste. 302, Newton, MA 02460-1639, 1998.

Core Curriculum in Primary Care: Gynecology (CD-ROM)

Edited by Michael K. Rees. Price, $99.00. SilverPlatter Education, 246 Walnut St., Ste. 302, Newton, MA 02460-1639, 1998.

Core Curriculum in Primary Care: Infectious Disease (CD-ROM)

Edited by Michael K. Rees. Price, $99.00. SilverPlatter Education, 246 Walnut St., Ste. 302, Newton, MA 02460-1639, 1998.

Psychiatric Mnemonics and Clinical Guides

By David J. Robinson. Pp. 160. 2d ed. Rapid Psychler Press, P.O. Box 596305, Fort Gratiot, MI 48059-6305, 1998.

The Right Test

By Carl E. Speicher. Pp. 368. Price, $29.95. 3d ed. Saunders, Curtis Center, Independence Square West, Philadelphia, PA 19106-3399, 1998.


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