Book Reviews

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"Essentials of Musculoskeletal Care" | to pdf >>
A Book Review
By William H. Browning, MD

As indicated in the preface, this volume is "a guide to decision making in the care of approximately 300 common musculoskeletal conditions." As such, the book achieves this goal very well by providing a useful, structured review of many problems seen in the office.

Included are sections on general orthopedics as well as separate discussions of the shoulder; elbow; hand and wrist; hip and thigh; knee and leg; foot and ankle; spine; and pediatric conditions. For each disease or entity, separate paragraphs present the definition; clinical symptoms; examination and laboratory tests; differential diagnosis; adverse outcomes; treatment; and discuss referral decisions as well as "red flags" to be aware of. Each section starts with a "pain diagram" that suggests possible entities associated with pain at a given anatomic location. Each anatomic area is afforded a brief overview discussing type of pain, instability, stiffness, and age-related considerations. This overview is followed by heavily illustrated pages (using x-ray films and excellent drawings) on examination, diagnosis, and injection techniques.

Emphasis is placed on common musculoskeletal problems such as animal bites; hand arthritis; crystalline deposit diseases; osteoarthritis of the spine, hip, and knee; and various shoulder conditions. Extensive coverage is given to hand conditions, including Dupuytren's contracture; carpal tunnel syndrome; sports injuries to the fingers; ganglions; and "trigger finger."

Highlights of the book:
The section on osteoarthritis of the hip provides for each age group an overview of examination techniques; differential diagnosis; prognosis, with symptoms; and treatment options other than hip replacement.

The section on foot and ankle disorders offers excellent illustrations of various conditions, suggests possible treatments, lists referral indications, describes management of foot pain, and presents points to discuss with patients who have been referred for surgical evaluation.

The spine section includes a concise review of the vertebral levels associated with specific neurologic symptoms or findings and illustrations that may help clinicians to distinguish psychogenic from mechanical symptoms.

The section on pediatric orthopedics is valuable because many conditions seen in adults do not translate directly into corresponding pediatric conditions. For example, many pediatric conditions can be attributed to fragility of the growth plates, and many injuries and infections are manifested differently in children.

In summary, this volume is a valuable desk reference for primary care physicians, for pediatricians, and for orthopedists who seek to quickly review a differential diagnosis that may be outside their subspecialty area.

Snider RK, editor. Essentials of musculoskeletal care. Rosemont, IL: American Academy of Orthopedic Surgeons, American Academy of Pediatrics; 1997. Available from Customer Service, American Academy of Orthopedic Surgeons, 6300 North River Road, Rosemont IL 60019-9525. ISBN: 0-89203-162-X. Price: $100. 686 pages.